This study examined the association between HIV/AIDS knowledge, attitudes, and perceptions among high school students age 14 years and older who attended school in two large urban towns, Bo and Freetown, Sierra Leone, West Africa. All subjects in the survey were Africans in grade two to ten in schools in Sierra Leone (n = 137). The mean age of the respondents was 18 years; 55 percent were female and 45 percent were male. The AIDS Social Assertiveness Scale (ASAS) was used. There were five factors derived from the ASAS in the study, which are similar to those used in previous studies. The factors derived were: Disclosure-Help Seeking, Contact with Infected People, Sexual Negotiation, Difficult Social Interaction, and Refusal of Risk Behaviours. These data indicate that the sub-scale structure of the ASAS in students from Sierra Leone is almost identical to the sub-scale structure of the ASAS reported by Venier, Akande, and Ross for Kenya, Nigeria and Zimbabwe, and by Ross, Caudle, and Taylor for Australia. Some 52 percent of the subjects who had intercourse reported that they used condoms. Factors related to condom use were age, knowledge about HIV/AIDS, and anxiety about disclosure of HIV/STD problems. Data indicate that intercourse was common and that greater condom use was associated with less anxiety over sexual-negotiation and greater anxiety over disclosure of having HIV or an STD.