National AIDS Control Programme was established in 1986-87 with a focus on diagnosis of cases that came to hospitals, but progressively began to shift towards a community focus. Since that The Government of Pakistan (GoP) has maintained a sustained response to the HIV epidemic through a close collaboration between the National AIDS Control Programme (NACP), Provincial and AJK AIDS Control Programmes, UN agencies, bilateral and multilateral donors, and a consortium of NGOs and CSOs, including PLHIV representative organizations, operating at national, provincial and grass-root levels. Since 2005 under the EHACP Pakistan has been following an investment approach, programming strategically according to its concentrated epidemic. Excluding HIV treatment, services to PLHIV and key populations are provide through 2 primary mechanisms: Global Fund through public-private partnerships between Government and NGOs and CSOs. Currently NACP is working along with National Institutes of Health as a parallel program to fulfill its objectives

Pakistan is the second largest country in South Asia that stands only a few steps behind India and Nepal in terms of HIV epidemic. Despite many efforts, the HIV infection rate has increased significantly over the past few years and in fact, the country has moved from a low prevalence to concentrated epidemic with HIV prevalence of more than 5% among injecting drug users (IDUs) in at least eight major cities. Other high‐risk groups, such as men who have sex with men (MSM), hijra sex workers (HSWs) and female sex workers (FSWs), also look set to reach this threshold level. Many bridging populations, totaling almost five million persons, are in direct sexual contact with these groups and are exposed to HIV infection through unprotected sexual activity. The heterogeneity and interlinking of high risk injecting and sexual behavior, combined with low levels of HIV knowledge and prevention, and high levels of other sexually transmitted infections (STIs), indicates that HIV could spread rapidly to marriage partners or sex clients and result in generalized epidemic.