Despite the scale, reach, and global impact of the human immunodeficiency virus (HIV), its study has remained largely at the purview of various micro-level analyses (e.g., Gutmann 2007; Levi and Vitória 2002). However, differences in prevalence rates at the national level suggest that other forces might be at work. Following the work of McIntosh and Thomas (2004), the only cross-national study of HIV/AIDS published to our knowledge, we conduct a cross-national analysis that examines world polity ideas that higher levels of health and women’s non-governmental organizations (NGOs) should be associated with lower levels of HIV prevalence. Initially, we find no support for these hypotheses. However, we respecify our models to test a political opportunity structure hypothesis that democracy enhances the ability of health and women’s NGOs to deal with HIV. We test this line of reasoning by including an interaction term between democracy and the health and women’s NGO variables. In doing so, we find that health and women’s NGOs are associated with lower levels of HIV prevalence in democratic rather than repressive nations.