Objective: This article updates our 1997 review that examined the literature on HIV risk behavior among college students. Methods: The current review focuses on college student sex-risk behaviors related to HIV-related knowledge, communication with sex partners, self efficacy, and behavioral skills. Results: As reported in our original review, the majority of students continue to have multiple sex partners, use condoms inconsistently during intercourse, and have a tendency to combine alcohol and/or other drugs with their sexual experiences. They remain very knowledgeable about the virus and routes of basic transmission, but that does not impact condom use. Communication among partners about safer sex continues to be limited. Conclusions: Enhancing self efficacy should be an important focus for intervention strategies among students, given consistent evidence for its impact on lowering risk for HIV transmission. Additional evidence-based recommendations for strategies to prevent the spread of HIV within the college population are provided.