Background: Youth subjected to enforced placement due to criminality, alcohol or drug abuse or antisocial behavior is a vulnerable group; their overall health as well as their sexual health is worse than the one of their non-detained peers. In a previous survey we found elevated sexual risk-taking among Swedish adolescent at detention centers. What is the underlying significance of these risky sexual actions, such as first intercourse at the age of 11-12, sex under the influence of drugs or alcohol, and/or having unprotected sex with an unknown partner? Methods: In-depth interviews were conducted in 2011 with 9 girls and 11 boys aged 15-20 who at the time of the interviews were subject to mandatory care in enforced placement. Using constructivist Grounded Theory, these interviews were analyzed jointly with the results from a previous 2010 survey that included 148 detainees aged 15-20. Results: The sexual risk-taking can be understood along three separate but intersecting dimensions: the individual, the group and the society. Individual differences such as gender, age, ethnicity, substance abuse and cognitive ability affect the risk-taking. Like most adolescents in a normative context, the interned youth are seeking intimacy, confirmation and a sexual identity. Their search is an ambivalent one, as they navigate between traditional and modern sexual norms. For these teens from difficult backgrounds and with deleterious experiences, this process begins at an early age. Low school attendance leads up to a lack of basic sexual knowledge; in addition, alcohol and drug use, and in many instances a chaotic lifestyle all contribute to hazardous risk assessment. In their ongoing marginalized life, the desire to experience something good (intimacy, confirmation, pleasure), outweighs the risk for something bad (STI, unwanted pregnancy, unwanted sex). A pragmatic view of sex and sexual risk-taking occurs among the youth in this impacted population. Conclusion: Respect for this pragmatic sexual risk-taking and its many different layers of origin as well as for its positive meaning for the adolescents is needed. Furthermore, understanding these intersecting dimensions is essential if preventive work within this group is to be regarded as relevant by the adolescents themselves.