In this grounded theory qualitative study, 22 female, heterosexual, undergraduate students were interviewed about the health related sexual communication (HRSC) that occurred with their most recent new sexual partner prior to intercourse. Semi-structured interviews were used to develop insight into the content and went of HRSC occurring prior to intercourse; the perceived barriers and facilitators to HRSC; and the strategies used to initiate such discussions. The open and axial coding process resulted in the development of ten categories. Subsequent data analysis facilitated the development of a substantive theory of young women's experiences engaging in HRSC with a new partner. Until there is widespread change in societal attitudes towards talking about sex, serious deficiencies in HRSC will continue to put young women's sexual health at risk.