Mainstreaming of HIV/AIDS is not just about adapting NGO programmes, but involves adapting partnerships. Working in a context of high HIV/AIDS prevalence has a considerable organisational impact on implementing NGOs. As staff, or relatives of staff, fall sick there is more time off work, declining work performance, increased medical costs, and extra training and recruitment costs. Simply to maintain capacity, NGOs will have to invest in changes to their staff planning, training and awareness programmes, health policies, and financial management.