Having returned to Australia from the United Kingdom in late 1979, it has been my privilege to witness first-hand the quite dramatic changes in Sexual Health Medicine which have taken place during the final 25 years of my professional life. In this article I give a snapshot of my early experiences at the Melbourne Communicable Diseases Centre, highlighting some of the deficiencies that needed urgent attention. I wish I could say that this picture was an exaggeration to make the article more interesting but unfortunately that is not the case. I also attempt to examine some of the factors that brought about the much-needed improvements, especially the effect human immunodeficiency virus had on sexual health practice. It is impossible to mention all the individuals most involved in initiating change, but I have mentioned a couple of names, only because of close personal knowledge about their contribution.