Objectives: This study examines correlates and predictors of sexual HIV risk reported by a sample of midlife and older women (M age = 56.01 years, SD = 4.34). Methods: In sum, 1,280 participants were recruited from primary health clinics and a hospital emergency department. Results: Of those women in a heterosexual relationship (n = 623), 73% reported having vaginal sex in the past 6 months. Only 12% of these women reported always using a condom during vaginal sex; 45% reported having been tested for HIV. Logistic regression analyses revealed that condom use is associated with more education, being employed, living with a partner, and being HIV positive. HIV testing is associated with being younger, unemployed, and not living with a partner. Discussion: These results (a) demonstrate that midlife and older women are at risk for HIV/AIDS and (b) contribute to a growing understanding of the risk picture involved with such women.