Although HIV in the Middle East and North Africa is currently characterized as a low seroprevalence epidemic, there are numerous factors that are present in the region that could prevent—or exacerbate—the epidemic. The time to invest substantially in prevention—and gender-specific prevention in particular—is now. Given that most policy makers do not make gender-specific plans as epidemics progress, our research team—which draws upon expertise from both within and outside the region—worked together to make programmatic and policy suggestions in the Middle East and North Africa region in 5 key areas: (1) gender-specific and gender transformative HIV prevention interventions; (2) access to quality education and improvements in life skills and sex education; (3) economic empowerment; (4) property rights; and (5) antiviolence. In short, this work builds upon many ongoing efforts in the region and elucidates some of the links between gendered empowerment and health outcomes around the world, particularly HIV and AIDS.

Inspired by the vision of the Millennium Declaration, CARE and ICRW (International Centre for Research on Women) partnered with the Inner Spaces, Outer Faces Initiative (ISOFI) to learn how to more effectively integrate gender and sexuality into CARE's sexual and reproductive health programmes. Drawing from lessons learned from gender mainstreaming, ISOFI focuses initially on fostering personal change among staff, helping them to explore their own gender and sexuality 'baggage' and supporting transformation of their 'inner space'. ISOFI then gradually integrates mechanisms to promote organizational change, and finally extends to community development practice, the 'outer face'. As a system promoting change in organizational culture and practice, ISOFI features structured iterative loops of reflection and learning, action and experimentation, and analysis and assimilation. This article describes the ISOFI Innovation System, and reports on ISOFI-generated learning and innovation in sex positive HIV prevention programming for truckers and reproductive health interventions for women in India.

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Gender and sexuality inequalities lie at the root of poor sexual and reproductive health (SRH). An India-based non-governmental organization (NGO) implemented a field-based methodology to integrate gender and sexuality into existing SRH projects in two states. Personal and organizational change occurred through critical analysis and experiential exercises which normalized topics on sexuality for program staff and communities. Staff learned how biases prevented them from engaging with communities. Community women came to understand sexual pleasure as an important aspect of strengthening the family and community. Mapping women's mobility revealed the link between sexuality, mobility and family honour. Gender myths, portraying men as oppressors, made explicit the narrow and biased picture of men that perpetuates through social norms maintained by staff and not only by communities in which they work. Methods improved social relations and prompted both behaviour and social changes at the community level.