Purpose: Despite high HIV prevalence rates in Ivory Coast, the formal K-12 curriculum was not developed to address HIV/AIDS information completely for many African students. The purpose of this study was to identify factors that influenced Ivorian teachers' teaching of the HIV/AIDS curriculum in middle school science curricula in nine middle schools in Abidjan, Ivory Coast. Methods: Data collection in this mixed-methods study included a survey and individual interviews with teachers. 140 teachers were surveyed and 39 teachers were interviewed. Results: The results indicate that the formal curriculum, teachers' personal beliefs, and lack of teacher preparation in addressing controversial science topics limited the effectiveness of HIV/AIDS education in schools. Conclusions: Overall, findings suggest that science teacher education must play a more immediate, fundamental and emancipatory role in shifting science teacher preparation practices to directly address how to teach controversial science topics in ways that are culturally relevant to students. In sum the challenge for pre-service science Ivorian teachers is to receive a decent training that would allow them to handle the responsibilities brought by HIV/AIDS. Recommendations: A number of initiatives to consider were presented for in-service teachers and pre-service teachers, including professional development about how to use HIV/AIDS language in a classroom and formal preparation on topics like how to teach in culturally relevant ways about safer sex practices, condom use, and HIV/AIDS in an African classroom context.