This article analyzes health mediation among equals as an educational strategy against risk behaviors in young people from both the educational and associative systems in Seville (Spain), based on qualitative research, with the aim of assessing and comparing its impact in those areas. To this end, interviews with 49 professionals and 427 adolescents were conducted in discussion groups. Results acknowledge mediation as individual or group intervention accepted by young people as advice and information on health issues and conflict resolution, but also as a method for data collection in order to obtain a community health diagnosis. The educational system implements this strategy, but in associations it seems to work better, particularly in the psycho-emotional and sexual spheres. Unfortunately, intervention programs are usually discontinuous due to lack of resources and territorial variability. And this is why mediators’ support is highly valued by the target users, with preference for a male figure in the case of boys, and larger predisposition towards a female mediator in girls, except in cases where this agent has a special social relevance.