The built environment & the impact of neighborhood characteristics on youth sexual risk behavior in Cape Town, South Africa

► Neighborhood structural deprivation negatively impacts young people's adherence to pro-social sexual behavior. ► Access to basic services contributes to the observed racial differences in the sexual risk behavior of youth in Cape Town. ► Youths living in more structurally deprived conditions have more sexual partners and are less likely to use condoms. ► The impact of a poor built environment on risky sexual behavior is more pronounced for females than for males. ► Structural-level interventions i.e. provision of basic municipal services in poor neighborhoods may reduce HIV risk.