Epidemiological landscape of Human Immunodeficiency Virus in Pakistan

Objective: To summarize the epidemiological trends of HIV Pakistan and address the major gaps in the prevention and access to treatment among key populations of HIV. Methodology: This narrative review was conducted between March-June 2025. PubMed, Scopus, The Lancet, Google Scholar, UNAIDS, the National AIDS Control Programme (NACP), WHO, and World Bank databases, as well as national and provincial reports were also searched to support evidence. The data were tabulated according to key populations, province, and chronology to identify the trends and treatment gaps. Pakistan focused sources that addressed prevalence, epidemiology, and access to care of interest to Pakistan were taken into considerations. Results: The HIV prevalence in Pakistan is approximately 0.1% with the estimated number of PLHIV being 260,000 though very high prevalence rates of HIV are reported among key populations of individuals at high risk, including transgender people and sex workers. The healthcare system is skewed towards metropolitan sites, and the antiretroviral therapy (ART) is more easily accessible there than in rural areas. The progress towards UNAIDS goals is insufficient and there is a significant gap in diagnosis, initiation of ART, and viral suppression, especially among vulnerable groups. Conclusion: The HIV epidemic in Pakistan is a high public health challenge and disproportionately affects key populations, and it rapidly affects marginalized populations despite the country having a low national prevalence. The persistence stigmatization, uneven access to ART, and health system limitations need to be addressed with decentralized rights-based HIV care and targeted preventive strategies to prevent further expansion of the epidemics.