We detected high levels of risk behaviours, poor HIV-related knowledge, high stigma and lack of prevention programmes. These results must be interpreted in the context of the political situation which prohibited reaching an ideal sample size for FSW. There is urgent need to implement an effective National HIV Strategy informed by the results of this research.
The risk of transmission within different risk groups and to the general population may be high given the recent military events that led to increased violence, migration, and the disruption of essential HIV-related services. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: Dr. The other authors have declared no competing interests exist. An assessment of the HIV prevalence, related risk behaviour and knowledge among men who have sex with men MSM and female sex workers FSW in Libya is urgently needed to inform near-term policy making while the window of opportunity to act is still open [1] , [2]. History has shown that timely collection of necessary information for the design of effective HIV prevention strategies is crucial, in order to confine the epidemic at an early stage [1].
This is particularly important in Libya which has not had a National HIV Strategy, and may face an expansion of the HIV epidemic due to increased migration, violence, and the disruption of services and structures related to recent warfare and socio-political transition [3] , [4] , [5]. Male-to-male sexual contact and transactional heterosexual intercourse have been main modes of HIV transmission in the early stages of the HIV epidemic in many countries [6] , [7].
Recently, new emergence and resurgence of HIV infection among MSM were observed in many parts of the world [7] , [8] , [9]. Male to male sexual intercourse, which exists in diverse cultures and throughout history, is highly stigmatized in many parts of the world, and often criminalized, especially in low and middle income countries [7] , [9].
