We aimed to explore the sexual health of young adults with perinatally acquired human immunodeficiency virus (PHIV). Eighteen to 25 years old PHIV participants were recruited in two tertiary care units in Paris. Sexually transmitted HIV was an exclusion criterion. Individual interviews were conducted. Transcripts were analyzed using a semio-pragmatic phenomenological method. Twenty-five participants were interviewed from March 2022 to September 2022. Some of them renounced being in any romantic relationship. Those who disclosed their HIV status to their romantic partner reported that dating was more complex and those who did not disclose reported that keeping HIV a secret was a significant mental burden. Young men tended to disclose their HIV status to their romantic partner whereas young women did not consider doing so before marriage. Many participants had to educate themselves about sexuality, through school or websites. Identified interlocutors for sexuality varied across participants. All participants were aware of U = U (Undetectable = Untransmittable) slogan. Despite that, participants remained worried about transmitting HIV to their sexual partners. That hindered their sexual satisfaction. In addition, they neglected the risk of unwanted pregnancies or sexually transmitted diseases (STDs). In our study, knowing the U = U slogan did not provide reassurance to PHIV participants regarding the risk of onward HIV transmission. Further, they showed very little concern for protecting themselves from their partneru2019s STD.