The global pandemic of HIV/AIDS is at catastrophic levels in sub-Saharan Africa, while the need for research and treatment initiatives throughout the developing world remains critical. The West African country of Sierra Leone is representative of both of these facts. The purposes of this study were to assess the HIV-related knowledge, attitudes, and behaviors of adult Sierra Leoneans to determine what type of HIV prevention efforts are needed in this population and to determine how such efforts could be developed and implemented. Interviews with 487 adults residing in the capital city of Freetown, Sierra Leone, and in the Northern Province of that country revealed HIV/AIDS-related knowledge, attitudes, and behaviors that reflect the impact of culture and tradition on the spread of HIV/AIDS. The challenges for HIV prevention raised through this study indicate the need to examine in greater depth the culturally specific use of traditional healers and traditional theater as channels of information that could serve to make HIV prevention initiatives more effective in Sierra Leone.