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Background: A significant proportion of youth is infected by HIV and other sexually transmitted infections mainly through sexual intercourse, while the prevalence of unwanted pregnancies is rising. Objective: To describe knowledge, attitude and practice and factors influencing sexual relationships and contraceptive practice among the youth in Kisumu town in western Kenya. Methods: A descriptive cross-sectional study using a semi-structured questionnaire, key informant interviews, focus group discussions and informal conversations was carried out. The sample population of 388 youth aged 15 — 24 years was determined by simple random cluster sampling. Quantitative data were analysed using SPSS computer package. Results: The majority of the youth are sexually experienced (73.5%) with most of the first sexual experiences occurring within the 15-19 years age group. There is a high level of knowledge (99.2%) of contraceptive methods and a positive attitude towards contraception. However, the level of contraceptive use is relatively lower (57.5%) even for the sexually active. Factors influencing this practice are associated with the individual’s background as well as health delivery systems and policy. Conclusion: There is a wide disparity between contraceptive knowledge and practice, which needs to be bridged. There is need to review policies and practices regarding reproductive health, sexuality and family life education. African Health Sciences 2002; 2(1): 33-39