This paper addresses the question: For isolated First Nations youth, would employing Nurse Practitioners on reserve to provide Primary Health Care reduce teen pregnancy rates compared to the present system of accessing Primary Health Care in neighboring larger centres? Teenage pregnancy rates among First Nations are substantially higher than for Canadians at large. Additionally, culture and context are factors which play a significant role in this situation and must be acknowledged and incorporated into prevention efforts. The Conceptual Framework of Sexual Health for American Indian Youth will be used as a reference for examining the literature and to guide the development of a tool for delivering Primary Health Care related to sexual health. Nurse Practitioners working in First Nations communities are poised to build long lasting bonds with communities while increasing access to contraception. In this paper it is argued that provision of contraception in a culturally safe framework will contribute to decreasing teen pregnancy rates while improving the overall health of First Nations communities.