Hispanic women in the United States (US) are disproportionately affected by human immunodeficiency virus (HIV) infection. There are very limited data on the sexual risk differences among US-born Hispanic women (USBHW) and foreign-born Hispanic women (FBHW). Sexually active USBHW and FBHW were asked to complete a self-administered questionnaire. Demographics, sexual history, testing for HIV or sexually transmitted infection (STI), condom use, partner sexual risk and alcohol/substance use were compared between USBHW and FBHW. FBHW were 3.5 years older than USBHW at first sexual experience (95% CI: 2.8, 4.1; P < 0.001). This remained significant after controlling for age and education. There was no difference between groups in the proportion of women with >1 reported sexual partner in the last year. FBHW reported fewer risk behaviors and lower rates of STI and alcohol/drug abuse. However, FBHW were less likely to have been tested for HIV. HIV prevention strategies would better target Hispanic women in the US if differences in risk behavior between FBHW and USBHW were incorporated.