Thirty years into combating the spread of HIV through behaviour change interventions experience has grown in the application of multiple approaches from one-for-one counseling and small group workshops, information sessions, and activities to large-scale rallies and mass media campaigns with reducing the spread of HIV. These approaches have been variously guided by best field practice and theoretical frameworks developed to understand health-related behaviours and behaviour change. This article reviews the dominant theoretical approaches used to develop behaviour change interventions and strategies and presents the theoretical frameworks guiding the multi-level strategy to reduce youth vulnerability in Edo State, Nigeria known as HIV Prevention for Rural Youth (HP4RY). HP4RY is set within the multi-level Ecological Framework and specifically uses Sexual Scripting Theory and the AIDS Competent Community theoretical framework to guide an Action Research project that uses research to enhance the Family Life and HIV Education (FLHE) programme delivered in Junior Secondary Schools and a Community Mobilization programme led by members of the National Youth Service Corps. The benefits to using these theories and their fit with contemporary thinking in the field of HIV prevention through behaviour change are reviewed here.