Young Black women (YBW) are at high risk of HIV infection. Although sexual health communication in social networks has been shown to help prevent HIV among high-risk populations, sexual health communication between YBW and their social network members (SNMs) has been insufficiently studied. Egocentric social-network-level and individual-level data were collected from 78 YBW ages 18–25 to examine their sexual health communication. Multilevel multivariable logistic regression models assessed the association among individual sexual risk behaviors, SNM characteristics, and sexual health communication. Participants nominated an average of 14 SNMs (N = 1,068). Friends were most frequently nominated (55%). YBW communicated to 55% of their SNMs about sex, to 32% regarding condom use, and to 21% regarding HIV testing. If SNMs provided emotional support, YBW were 4 times more likely to talk with them about sex and HIV testing and 2 times more likely to talk about condom use. These results indicate that before developing or adopting HIV interventions geared toward YBW, we need to assess how and with whom YBW are communicating about sexual health to better inform those interventions.