HIV/AIDS remains a significant public health issue in South Africa, affecting secondary school students disproportionately. A cross-sectional qualitative study was conducted with focus groups and interviews in four randomly selected secondary schools across different regions of South Africa, involving a total of 120 participants (aged 14-18). Participants reported mixed perceptions regarding the implementation and content of HIV/AIDS prevention programmes. A significant theme identified was students' preference for interactive learning methods over traditional lectures. School-based HIV/AIDS prevention programmes in South African secondary schools require adaptation to better engage students and ensure their understanding of preventive measures. Programmes should incorporate more practical, hands-on activities and integrate feedback from students into the curriculum development process.