First-year undergraduate students in the United Kingdom undergo significant change in their lives as they embark upon their university experience. They may be exposed to various social and psychological factors that increase their risk of poor sexual health. Indeed, epidemiological data suggest that young people (including students) face sexual health inequalities compared to the general population. People’s perceptions are key to understanding their behavior. This study explores the sexual health perceptions of a group of first-year students at a British university. Sixteen heterosexual students were interviewed, and the data were analyzed using qualitative content analysis. The analysis revealed three content categories: (1) sexual freedom and exploration at university, (2) university environmental sexual risk factors, and (3) stigma as a barrier to sexual health. These risk factors can undermine sexual health outcomes in students in the long term and should, therefore, be considered in sexual health education programs for university students in the United Kingdom. It is argued that the incorporation of social and psychological factors into such programs will lead to more effective sexual health promotion in this high-risk population.