Gender and sexuality have long been recognised as key factors affecting the dynamics of the HIV epidemic. Issues vary across communities and countries, but power imbalances, harmful social norms, violence and marginalisation affect women, men, girls, boys and transgender people across the world, limiting their ability to prevent HIV infection. There are a growing number of HIV and broader health initiatives that not only highlight gender issues, but also aim to change harmful norms and practices. These are called "gender-transformative" approaches. However, there are few approaches to achieve gender transformation, and many organisations within and outside the Alliance have struggled to overcome the controversies, sensitivities and structural barriers that impede progress. In May 2010, we carried out a survey of our national Linking Organisations to map our current work; assess capacity, challenges and aspirations around gender and sexuality programming; and better understand the gender and sexuality context in which our partners work. Some 28 organisations from 19 countries responded.