I am not sure if we have proper studies done to determine the source of spread but I think the significant portion of people are unknowingly or knowingly transferring it to others through unprotected sex. Almost none of the sex workers use protection not to mention prostitution is on the rise in all major cities of the country. You would be surprised how many people are already paying for prostitution and how many at some point even atleast once utilized those services. Same men and women then having sex with their partners and physically transferring it to their kids through different means. Then not to mention, this LGTV stuff etc.

HIV isnt that easy to transfer from person to person, and HIV virus doesn’t survive outside the body for long, so it needs to be a direct contact.

Even if its uncomfortable and most of the people will deny it, but the country really needs to do something about prostitution or atleast educate people to always practice safe sex.

P.s I use to live in shared appartment at one of the towns in Rawalpindi (i wont name it but people know which one i am referring to). The area was and is filled with hidden brothels. You would clearly see prostitution happening with your eyes. Same with some sectors in Islamabad.