Young women in Lesotho are a high-risk group for new HIV infections despite a heavy investment in health programs for that demographic. This study investigates sexual rights discourses by both NGOs and local Basotho women to evaluate how much they align to promote women’s sexual empowerment. The underlying assumption is that how women’s rights are framed and incorporated into HIV campaigns reflects, and seeks to effect, certain social mores that may not resonate with Basotho women’s own views on sexual rights, with significant implications for the success of HIV prevention efforts. A critical discourse analysis of interviews and focus group data is used to conclude that NGOs promote discourses on women’s sexual rights that align with the discourses prevalent among local young women. However, both discourses reinforce cultural frames of women’s sexual rights that reinforce women’s sexual subservience and disempowerment, thus accounting for young women’s continued vulnerability to HIV infections.