This research reveals how the experienced “tokenism” by sex workers’ representatives who take part in HIV prevention and care partnerships hinges on a lack of expertise by “technical experts” to make use of the different types of knowledge brought to the policy table by them. The article further explores other tensions and opportunities within HIV prevention and care partnerships in Kenya, including the effect of criminalization and devolution on the partnerships. Recent strategic frameworks developed by the government explicitly mention the need for horizontal partnerships between sex workers and government as a crucial step to achieve a more unified and effective response to HIV/AIDS. In addition, during several conversations, government representatives also maintained that more horizontal partnerships can only be achieved through community participation. They defined this as taking sex workers as equal partners in policy development and program implementations. In practice, however, such partnerships have yet to become fully established. All this leads to the main question: where and why do gaps exist between policy visions and actual practices in HIV prevention and care partnerships between government and sex worker-led organizations in Kenya?