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Objective: To assess the level of acceptability of oral pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) and transwomen (TW) in Pakistan., Study Design: Cross-sectional study. Place and Duration of the Study: Online study portal from September to November 2021., Methodology: The study participants were recruited through snowball sampling. Consenting individuals who were >13 years and were identified as MSM or TW were included in the study. Data were analysed using SPSS version 25. Frequencies, percentages and correlation coefficients were computed., Results: A total of 347 participants were recruited. The mean age of all participants was 29.8 ± 6.7 years. Fifty-eight (19.7%) of the participants had chemsex with amphetamine-type stimulants (ATS) at least once in preceding six months of the study, and 58 (19.7%) had a sexually transmitted infection (STI) in preceding six months whereas 10 (3.4%) participants had used drugs via injection. Two hundred and thirty-eight (72%) of the participants were aware of PrEP, 30 (11.7%) had used PrEP in the past, and 3.88% were currently using PrEP. The willingness to use PrEP, free of cost, was shown by 300 participants (86.45%) and by 180 (54.5%), if available at a low cost., Conclusion: There was a high prevalence of risk factors posing them at considerable risk of human immunodeficiency virus (HIV). The majority was aware of PrEP for HIV prevention. The willingness to use PrEP was high when PrEP was offered free of cost but dropped down when participants were asked to pay for PrEP. Based on this finding, PrEP should be available free of cost at the community preferred outlets., Key Words: Gay, Men who have sex with men, HIV, Pre-exposure prophylaxis Pakistan, Transwomen, Chemsex, People living with HIV.

The World Health Organisation (WHO) has set an ambitious target to eliminate hepatitis C virus (HCV) by 2030. Pakistan is one of the focused countries because of the high prevalence of HCV. The prices of direct-acting antiviral drugs(DAA)have significantly reduced to between 11-25 dollars for a month's treatment. To achieve the 2030 elimination target, Pakistan has to provide treatment to one million HCV-infected patients every year, beginning from 2018. This short report highlights a key barrier to achieve this target,i.e. the unsafe practices by regulated and unregulated healthcare delivery system comprising trained and untrained healthcare providers who can continue to churn out new patients with their unsafe healthcare practices and increase the possibility of reinfection in those who have been treated. Only the government has the power and authority to regulate and control the healthcare delivery system. Elimination of Hepatitis in Pakistan will remain a distant dream unless the healthcare delivery system is tamed.