Lesotho has one of the highest rates of HIV / AIDS in the world. The country is also one of the poorest in Africa and has high rates of unemployment. These factors contribute to the vulnerability of women in particular, and their susceptibility to commercial sex work as a survival strategy. National policies and programmatic interventions to address the HIV / AIDS pandemic emphasize the role of information, education and communication. This approach has limited applicability in the context of commercial sex work with regard to sexual mixing patterns, condom use, population group specificity and the top-down nature of public policy-making. This paper suggests that psychological, political and economic empowerment of women are crucial responses to HIV / AIDS transmission, particularly through commercial sex work. The article concludes that the development of more appropriate HIV / AIDS policies in Lesotho should address the weakness of