This article builds on the author's book, Global Sex, to consider how globalization has impinged upon changing sexual mores and behaviours, and how these, in turn, are related to the spread and control of HIV and AIDS. AIDS has made the sexual possibilities of social and economic change more central to public policy, and concentrated political attention on the 'breakdown' of traditional cultural and social structures, whether these are the idealized nuclear family in the west or more traditional extended families in many non-western societies. Both the needs for effective public health and a respect for human rights require an insistence on the right to sexual diversity as part of a wider move towards the recognition of difference as an essential part of the human condition.