The stakes are high for sex education in South Africa: it has been estimated that 8.7% of young people live with HIV. Within primarily US and UK contexts, there has been much debate over the relative merits of abstinence-only and comprehensive sexual education programmes. These perspectives have largely been presented as irreconcilable, but in-depth interviews with 25 life orientation teachers across the Free State Province of South Africa reveal that teachers may attempt to reconcile aspects of the two into a hybridised perspective. They promote abstinence as the only appropriate choice for young people while recognising the value of some of the broader issues of comprehensive sexuality such as relationships and safe sex. We attempt to make meaning of this hybridisation and present two arguments: that the specific South African context challenges the idea that these two contradictory positions cannot be mixed and that they might be strategically combined to promote a comprehensive sexuality education that builds a sense of agency and responsibility without alienating young people through moralism. We conclude with a brief description of future directions that classroom practice and teacher preparation might take.