Black women comprise 52% of women with AIDS, yet there is minimal development of prevention efforts geared to needs of black women. This paper presents the results of intensive group discussion with 28 lower‐income black women and teenage girls in San Francisco examining patterns of sexual behavior. The comments of participants suggest that traditional sexual roles, which permit men to have sexual freedom but censure women for the same activities, are still operating in the black community. A major problem in relationships between men and women is the lack of effective communication about sexual practices, particularly the use of condoms when partners are not mutually monogamous. The communication difficulties are aggravated by imbalance of power between the sexes, as well as dramatic shifts in the economy of the black community. Suggestions are made for effective AIDS prevention programs, based on improved communication in the context of efforts to rebuild communities.