Since the early 1990s, life skills education has benefitted substantially from international agency advocacy and support, linked to its implementation in several countries as a key component of the education sector response to sexual health and HIV. The concept of life skills was first promoted by the World Health Organization through its programme on mental health as a means of promoting psychosocial competence. Since then, it has been extended to address a wider range of issues. Life skills-based HIV and sex education has proved to be a durable concept in education sector policy discourse on HIV and AIDS, despite a growing literature on the shortcomings in terms of its effectiveness in implementation in schools and delivering intended learning outcomes. Using a literature review, this paper aims to re-examine the adequacy of the life skills-based HIV education approach including empirical evidence for its effectiveness in educating about and preventing HIV infection among young people. Findings suggest that bureaucratic acceptance and advocacy for life skills-based HIV education has outstripped the theoretical adequacy and empirical evidence base for its effectiveness. Its current position among core indicators for the education sector response to HIV can be considered indicative of frozen thinking or inter-agency group-think.