Adolescent women are at risk for unintended pregnancies and sexually transmitted diseases, including human immune deficiency virus (HIV)/acquired immunodeficiency deficiency syndrome (AIDS), if they do not engage in safer sexual practices. Adolescent women are biologically, behaviorally, and socially more at risk for sexually transmitted diseases (STDs) and HIV than adolescent men. Although abstinence is the safest sexual health practice for adolescent women, once sexual activity begins, safer sexual practices involve condom and contraceptive use, and communicating with sexual partners to negotiate condom use. A number of implicit and explicit decisions are involved in these activities. A number of researchers have examined safer sexual decisions of adolescent women, some of whom have used theory models such as the Transtheoretical Model of Change. Although these findings have contributed to the knowledge base about safer sexual decision making, many questions remain unanswered about how adolescent women make safer sexual decisions. The Conflict Model of Decision Making is presented and discussed as a framework for enhanced understanding of safer sexual decision making by adolescent women.