A number of studies have shown that HIV awareness is very high among Malawians and yet infection rates are rising. Local cultural practices have been identified as contributing to this contradictory situation. Using data from 12 focus-group discussions collected in Balaka, Zomba, Machinga and Mangochi, the paper explores the reformulation of nine cultural practices as a preventive measure against HIV. The study reveals that cultural practices that involve sexual acts for completion are mediated through condoms and HIV tests. The study also shows that traditional herbs known for healing ailments are repurposed to symbolise sexual acts. We conclude that the idea of repurposing offers an avenue in which initiation and cleansing rites that involve sexual acts are replaced by other semiotics such as a traditional medicine called mtela. We also conclude that the modifications to cultural practices do not indicate complete abandonment of associated traditions, rather, they constitute the renegotiation of cultural practices and meanings associated with particular rites of passage. Lastly, we propose that a comprehensive prevention programme needs to be part of a wider national HIV-prevention effort combining a women and child rights and empowerment agenda and, critically, lifestyle lessons in a process of cultural renegotiation. IntroductionThe paper is motivated by the rising HIV epidemiological profile in Malawi and in the eastern region of the country in particular. This is happening despite the high number of local and international agencies involved in implementing initiatives for behaviour change communication. Although the data for this paper are drawn from the Eastern Region, which traditionally is seen as a Yao area, several other ethnic groups such as the Cewa, Lomwe and even the Tumbuka from the north have migrated to the area in search of job opportunities along Lake Malawi. The area also boasts major tourist attractions and cross-border trade with Mozambique and Tanzania. The region is therefore at the confluence of tourism, the transborder sex trade and the fish industry.