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Men who have sex with men remain conspicuously absent from the HIV policy and programme agendas of the majority of developing countries despite efforts by activists and community groups to draw attention to their existence and needs. This paper charts the existence of male to male sex across much of central and south America, Africa and Asia and describes governmental and international responses to date. In contrast with the denial and homophobia which have characterized most official responses are the actions of some non-governmental and community organizations which have struggled hard with often limited resources to undertake HIV and AIDS-related health promotion, and to draw attention to the as yet unmet needs of homosexually active men in developing countries across the world. Effective approaches to HIV prevention are discussed. [ABSTRACT FROM AUTHOR]