This study qualitatively examined the social-ecological stressors that youth experience during the first year following an HIV diagnosis. Thirty HIV-positive youth (16 males, 14 females) between the ages of 16-24 participated in either focus groups or individual interviews. All sessions were transcribed and themes were identified through cross-case and comparative analyses. Participants reported experiencing stressors within multiple social-ecological systems, including interactions with their families, sexual partners, health care providers, work, and school. The results from this study highlight the need for youth-focused services that assist with multiple layers of stressors during the first year following an HIV diagnosis.