Rape survivors engage in more risky sexual behavior and report more sexual dissatisfaction and dysfunction than those without a rape history. However, little research has examined possible mechanisms to explain the relation between rape and sexual health outcomes. Therefore, the current study examined sexual motives as one mechanism to explain why survivors engage in more risk behavior and report lower sexual satisfaction. We hypothesized that rape survivors would be more likely to report engaging in sex for a variety of potentially maladaptive motives, including to reduce their negative affect, improve their self-esteem, and obtain approval or avoid censure from their peers and sexual partners. Engaging in sex for these reasons was then hypothesized to mediate the relation between rape history and sexual risk behavior as well as sexual satisfaction. These hypotheses were tested among 1,534 sexually active college women. Results supported that all four sexual motives mediated the relation between rape history and risky sexual behavior and sexual satisfaction. In both cases, the size of the standardized indirect effect was larger for the models including the two affect regulation motives as mediators, as compared to the models including peer and partner approval motives as mediators. Thus, survivors who endorse affect regulation motives for sex are more likely to engage in risky sexual behavior and more likely to report feeling dissatisfied with their sex lives. This suggests that sexual motives may be an important area to target for future sexual health research and intervention programs targeting survivors.