This paper describes an alternative approach to undertaking and evaluating sexual health promotion, focusing on the notion of "sexual scenes" and "scenarios" and how these can provide a vantage point from which to examine sexual experience. The concept of sexual scenes provides a context within which to analyse many of the behavioural and epidemiological factors associated with sexual practice. In principle, such an approach provides a tool for "conscientization", action and the invention of novel group and individual repertoires that may result in individual and social mobilization for health and/or sexual and reproductive rights. Scenes can be elicited through individual interviews, group interviews and discussions, or through staged and dramatized performance and students' writing. Analysing sexual scenes offers an entry point for dialogue in sexual health promotion programming. Evaluation of these programmes can be part of the process of changing sexual scenarios. Change is witnessed not only through individual changes but, especially in impoverished communities, through challenges to dominant local sexual scenarios and engagement with structural concerns. (Contains 2 tables and 2 figures.)