Western-led discussions of sexual health have foregrounded warnings of the dangers of sex. Yet, pleasure is one important reason why people have sex. Sexual health work must open up discussion of how pleasure can be experienced with less risk. There are challenges in addressing pleasure in work on safer sex. Power structures such as gender, age, class and race, as well as the globalised media, influence how people experience pleasure. Safer sex and HIV prevention work thus need to take account of how pleasure is constructed, as well as the diversity in what people find pleasurable. Giving examples from the numerous safer sex trainings and community initiatives they themselves have facilitated, the authors show that such discussions of pleasure are possible in practice and indeed welcomed by many.