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Pakistan still has a window of opportunity to act decisively to prevent the spread of HIV/AIDS. According to UNAIDS estimates HIV prevalence is 0.1 percent among adult population in Pakistan. The officially reported cases are, however, much lower than the estimated cases. As in many countries, underreporting is due mainly to the social stigma attached to the infection, limited surveillance and voluntary counseling and testing systems, as well as the lack of knowledge among the general population and health practitioners. Until recently, Pakistan was classified as a low-prevalence country with many risk factors that could lead to the rapid development of an epidemic. The presence of significant risk factors such as the very low use of condoms among vulnerable populations including female sex workers (FSW), men who have sex with men (MSMs), truckers, and Hijras, low use of sterile syringes among injecting drug users (IDUs), inadequate blood transfusion screening and high level of professional donors, large numbers of migrants and refugees may lead to an epidemic situation of HIV/AIDS in Pakistan.