The spread of HIV is affected by a wide range of factors including household income, domestic divisions of labour, seasonal workloads and expenditure, communication, relationships, gender violence, and sexual pleasure or dissatisfaction. Drawing on material from North and South America and Africa, the author concludes that the links between these issues are both universally experienced and critical to HIV prevention and mitigation. The author also challenges the rejection of ‘anecdote’ in formal research settings, particularly when the stories told by women – and men – are so similar and so widespread. The Stepping Stones training methodology supports participants’ own analyses of these links in their lives, and has enabled them to work out their own mutually agreeable solutions. The trainings have also created opportunities to learn about pleasure and develop closer, more loving, respectful and satisfying relationships whatever a person’s HIV status.