Health education programmes need to address local understandings of HIV/AIDS within the broader context of sexual behaviour. We report on a locally derived and community orientated questionnaire survey of HIV/AIDS and sexually related behaviour among 756 pupils from two government secondary schools in Malawi. On average, pupils gave the correct answers to more than 70% of the items on the survey. Seventy-two pupils from one of the schools subsequently participated in playing an educational board game about AIDS, once a week, over four weeks. The percentage of correct responses given while playing the board game significantly increased each time the board game was played, and a one-month follow-up questionnaire showed that a significant improvement had been maintained in comparison with the initial questionnaire survey. Pupils who attended the school where the board game was trialed, but Who did not participate in the board game, scored slightly, but significantly, higher than pupils from the other 'no-board game' control school. This result was tentatively interpreted as a 'trickle down' effect. The benefits of introducing active learning methods into schools, of focusing on local understandings of health problems, and of establishing an accurate knowledge base for health promotion are discussed.