Background Donor–nongovernmental organisation (NGO) partnerships may enable earlier infusion of implementation science principles into developing evidence-based interventions. Yet, donors and NGOs often report difficulty leveraging resources, personnel and expertise to create beneficial outcomes for all. Drawing from a PhD thesis, the authors report how the asymmetrical nature of the relationships manifests in practice in the work of NGOs. The study focused on human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV and AIDS) NGOs in Gauteng province in South Africa.Objectives This study examines whether the asymmetrical relationships can be termed partnerships and highlights the potential for such a discourse to reinforce existing relationship inequalities.Method Qualitative data were collected through in-depth individual interviews with key informants from five purposively selected HIV and AIDS NGOs. A total of 28 interviews were analysed deductively using thematic analysis. The Dóchas Partnership Assessment and Development Process framework guided this analysis. The NGOs under study have implemented various HIV and AIDS programmes and policies in their workspace.Results The findings have revealed that ‘partnership’ is a false representation of the actual relationships between donors and NGOs.Conclusion The study concluded that although the notion of partnerships accurately describes the intention of ‘donors’ and ‘NGOs’ to collaborate in ways that ensure improved services and outcomes, the unintended consequences of how partnerships are managed and run inhibit that common agenda. The article concludes with suggestions to build and sustain effective working relationships between partners.Contribution Assessing how donor-NGO partnerships are operationalised can assist in determining the extent to which their relationship is operating and point to areas where partnerships practice can be further developed.