Criminalisation is but one of the tools employed by governments to regulate sex and sexuality. Other types of regulation can equally have an impact on health and well-being and thus merit consideration. While restrictive laws related to sexuality are often driven by moral argumentation, public health evidence and human rights norms highlight the need for supportive legal and policy environments. International legal commitments can serve as a check against national laws and policies which do not conform to international consensus. Reporting mechanisms which draw attention to affected populations in the context of HIV have provided a lens through which governments can begin to see the harms to health and well-being caused by their own regulation of sexuality. A review of 2008 self-reported legal and policy data from the 133 countries reporting under the Declaration of Commitment on HIV/AIDS offers important insights. International and national legal and policy environments relating to sexuality are evolving. By identifying dissonance between international standards and national laws and policies, a refocusing of efforts is possible, aiding governments to meet their international obligations and ensuring an appropriate environment for the free and safe expression of sexuality.