Since HIV/AIDS has been recognised as a global concern, domestic HIV/ AIDS policy is formulated in a global context. Due to the perception of the epidemic as a threat to international security and development, national governments have become more and more prepared to support these new governance arrangements and to adjust their decisions to international policy recommendations. The global governance framework has thus a major impact on domestic policy-making in the field of HIV/AIDS. Obviously, the interaction between the international health community and national governments is not free of friction and conflict. National governments engage differently with global governance institutions. They are, to different degrees, receptive or resistant to international recommendations, depending on their own convictions and objectives concerning the response to the epidemic. The global governance of HIV/AIDS is thus shaped by a variety of different stakeholders and their interaction with one another. Civil society actors, such as international HIV/AIDS NGOs and communitybased associations, are among these stakeholders. Their role in the response is constructed within the international policy framework of HIV/AIDS. According to Hakan Seckinelgin (2006), the importance of civil society is emphasised within the global governance of HIV/AIDS, with NGOs being assigned to fulfil central functions in the response to the epidemic. International health agencies, such as UNAIDS or the Global Fund to Fight AIDS, Tuberculosis and Malaria, recognise NGOs as programme implementers and policy actors and thereby strengthen their position vis-à-vis the state. Positive perceptions of NGO capabilities within the international policy framework of HIV/AIDS have thus empowered their actions in the domestic realm. Therefore, in order to understand the opportunity structures for HIV/AIDS NGOs in Russia, the international policy framework and the role it provides for civil society actors need to be taken into account. The objective of this chapter is to explain the emergence of global HIV/AIDS governance and its impact on the Russian response to the epidemic. The chapter will thereby provide the international context for the later discussion of NGO capabilities in influencing HIV/AIDS policy-making in Russia. The structure of the chapter is as follows. After characterising the Russian HIV/AIDS epidemic from an international perspective, it will examine theoretical approaches to global governance and outline the development of the international policy framework of HIV/AIDS. Next, the chapter will focus on the role of civil society actors within this policy framework. Here, the objective is to understand how the functions of civil society organisations are shaped by international perception and support. The chapter will then explore how HIV/AIDS governance frames the interaction between states and civil society at the global, national and local levels. It will conclude with a discussion of Russian HIV/AIDS politics at the intersection of global norms, domestic politics and local response.