Recent research of HIV infection has attributed high rates of infection among heterosexual Black adolescents to multiple sexual partners and inconsistent condom use. Social science explanations emphasize limited family support, poor access to information, and unwillingness to change. This article presents an analysis of the effects of economic inequality and changes in urban areas on sexual risk-taking among poor Black women. Data come from an ongoing ethnographic study involving 53 young women in New Haven, Connecticut. Theoretical frameworks of urban development, economic isolation, and opportunity structures inform the results. Findings show that structural, social, and individual characteristics influence how young Black women define and assess personal risk. The residual and cumulative effects of racial inequality, poverty, and destabilization of communities contribute to risk-taking. Teenagers are more likely to engage in risky behavior when they believe their life options are limited. Recommendations include focusing on the reduction of social inequality as a health seeking strategy.