ISSUE ADDRESSED: Community participation is vital if sexual health disadvantage among Aboriginal and Torres Strait Islander young people is to be addressed, yet there is a paucity of literature examining this issue. METHODS: The development, nature and impact of a community participation strategy for sexual health, implemented in two North Queensland sites, provided the opportunity for a systematic study, using qualitative and grounded theory analytic methods, of the factors that enable and constrain community participation in this context. A total of 30 people participated, in individual interviews and focus groups. RESULTS: The community participation strategy was fundamental to the development of culturally and community congruent sexual health initiatives. There were also signs of a changing discourse in community around sexual health. Factors that enabled effective community participation involved individual attributes, structured group processes, organisational support, empowering external relationships, a culturally sensitive strategy and enhanced health and wellbeing. CONCLUSION: The model developed here identifies factors that enable community participation and mobilisation, thus providing a valuable tool for health practitioners seeking to plan and evaluate strategies that address entrenched disadvantage in Aboriginal and Torres Strait Islander populations.