Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) remain significant global public health concerns despite substantial advances in prevention, diagnosis, treatment, and healthcare management. Although Sri Lanka continues to report a comparatively low HIV prevalence within South Asia, recent national surveillance indicates a gradual increase in newly diagnosed HIV infections, highlighting the continuing need for effective communication strategies to strengthen awareness, reduce stigma, and promote preventive behaviours. This narrative review examines the communication strategies employed in HIV/AIDS awareness programmes in Sri Lanka between 2015 and 2024, with particular emphasis on traditional communication approaches, digital health communication, behaviour change communication, stigma reduction, and the contribution of the National STD/AIDS Control Programme (NSACP). A qualitative narrative review design was adopted using secondary data obtained from peer-reviewed journal articles, policy documents, and publications issued by the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), the Ministry of Health, and the NSACP. Twelve primary publications were purposively selected and analysed using thematic analysis guided by the Health Belief Model and Behaviour Change Communication Theory. The review found that traditional communication approaches, including school-based education, counselling services, community outreach programmes, workplace awareness initiatives, and mass media campaigns, continue to form the foundation of HIV prevention efforts in Sri Lanka. The evidence further suggests that digital communication strategies, including social media, online awareness campaigns, webinars, educational videos, and web-based communication platforms, have become increasingly important, particularly following the COVID-19 pandemic. However, persistent challenges such as HIV-related stigma, misinformation, cultural sensitivities, unequal digital access, and variations in health literacy continue to influence the effectiveness of communication initiatives. The review concludes that integrated communication approaches combining traditional interpersonal communication with digital communication technologies provide the most effective strategy for strengthening HIV/AIDS awareness programmes in Sri Lanka. The findings contribute to the field of health communication by providing evidence-based recommendations for policymakers, healthcare professionals, communication practitioners, and researchers involved in HIV prevention and health promotion.