Robinson argues that African countries’ responses to the HIV/AIDS crisis have been largely determined by their previous experiences in implementing family-planning programs. Based on careful case studies of Malawi, Nigeria, and Senegal, she documents how the same local nongovernmental organizations and technocrats that had gained experience and developed working relationships with international family-planning organizations, such as Family Health International (now FHI 360) and the International Planned Parenthood Federation, were typically the same actors who spearheaded efforts to combat HIV/AIDS. Preventing pregnancies and preventing the spread of HIV require the same ability to intervene in intimate relations and influence sexual practices. Robinson convincingly demonstrates that the effectiveness of a given family-planning program depended on whether the political conditions allowed for the development of relatively strong nonstate actors with links to transnational agencies. Against conventional wisdom, this fine study conveys an abiding optimism about the ability of large international aid organizations to help smaller local groups build skills in one area and then apply them to other challenges.