The aim of this paper is to present and discuss some of the obstacles to effective sexuality education in rural Lesotho schools and offer some suggestions that could facilitate positive change in the current status of sexuality education. The call for education as a ‘vaccine’ against new HIV infections places teachers at the forefront of the fight against the pandemic, and thus it is imperative to understand how they experience teaching about sexuality. Findings in the present study derive from data generated through a research project that sought to explore women teachers' experiences of teaching sexuality education in rural schools in Lesotho. Twelve women teachers' narratives are used to examine the obstacles to effective sexuality education in rural contexts. The study highlights the role of gender dynamics and culture in the effectiveness of school-based sexuality education. The paper argues for a more concerted effort and collaboration between curriculum developers and education stakeholders such that the Lesotho sexuality education curriculum is more context-specific and relevant to the communities it serves, so that it can achieve the desired goals of, amongst other things, reducing the transmission of HIV.