In Canada, young Aboriginal men and women are faced with growing sexually transmitted infection (STI) rates and a human immunodeficiency virus (HIV) epidemic. Historical and present day social conditions interact and impact on the vulnerability of the Aboriginal population. The purpose of this ethnographic study was to enhance the public health understanding of Aboriginal youths’ experiences with sexual health services. A culture and community-based qualitative process sought to understand youths’ lived experiences of accessing sexual health services and HIV/STI testing. A purposeful sample of twenty Aboriginal youths was used for this study. Thematic analysis was informed by all data sources was carried out to interpret the data for themes. Four themes were identified in regard to access: funding and legislative bodies, intergenerational shaping of sexual health, sexual health places and education, and perceptions of sexual health services and HIV/STI testing. It is vital that health care providers and policy makers work with a culturally competent and gender-based approach that is sensitive to the many processes that interact to influence health promotion and disease prevention.