Background Parwaz Male Health Society is implementing GFATM’s Regional Grant R-9 to empower MSM/TG communities in Pakistan to prevent HIV/AIDS, under the technical assistance provided by Naz Male Health Alliance, Pakistan. Participatory research methods is used to reach MSM and understand community needs to effectively design prevention-programmes in Karachi, where MSM’s are engaged in high risk behaviours to an alarmingly high level which makes them vulnerable to HIV/AIDS.

Methods A case study approach was used to analyse data involving the MSM community members; Malishias, truck/cab/drivers, migrant, labour, and self identified gay people etc. visiting the Drop in Center. 12 cases were studied and Data was collected through In-depth interviews, participant’s observation and data verification, done through the field workers, Community counsellor and the Doctor. Ethical standards mentioned in NMHA’s Institutional manual.

Results Ranging between the age group 16–50 years, MSM’s have been subjected to labelizing, stigmatisation, discrimination since childhood within home and the external world, whether educated or uneducated, financially stable or not, low self esteem, lack of understanding and knowledge on self identity and human rights, facing violence/bullying from around, forced decisions about marriage, career and religious practises, altered mental and physical development and a damaged personality, hampering their productivity and efficiency to contribute to society in a healthy way.

Conclusion An urgent need for an all age group focused programming covering Psycho social and sexual health, strategies to cope with bullying and pressure inflicted including counselling and self help group therapy, acceptance of self identity, socio-economic empowerment, education and awareness along HIV and Sexually Transmitted Infections prevention. Further qualitative and quantitative evidence is required to effectively design programmes.