What are Hijras? Are they male or female? Hijras believe that they are neither male nor female (Patel, 2010). Hijras struggle with their social status, some are accepted and some are excluded, it depends on the position (Patel, 2010). Due to the struggle with social status, some Hijras engage in sex work, which brings HIV and sexually transmitted infections into play. According to Abdullah, Hijras are a major source of spread of various sexually transmitted diseases (Abdullah, et al., 2012). In 1999, there were between 2.5 and three million people living with HIV or AIDS in India (Patel, 2010). Within this, the prevalence of HIV or AIDS among Hijras was higher than that of other men who had sex with men (Patel, 2010). This is a global health issue; the spread of HIV or AIDS among the Hijras is notable (Patel, 2010). This article will argue that because of Hijras' difficulties with social status, they are at greater risk of contracting HIV or AIDS and are at greater risk of spreading it. Hijras are born male, but identify as female (Patel, 2010). . They adopt the dress and mannerisms that women have (Patel, 2010). Hijras are known as the “intersex gender” because they do not identify as either male or female (Patel, 2010). Many Hijras feel like incomplete beings, claiming to have “a female soul trapped in a man's body” (Abdullah, et al., 2012). Some Hijras choose to make their “spiritual connection to the female form physically complete through a ritualized castration process called 'nivan'” (Patel, 2010). Those who maintain their male genitalia continue to discard their male sexuality (Patel, 2010). Early 20th century ethnographers in Punjab noted that Hijras described themselves as powerless (Lal, 1999). Many Hijras are Zananapan, who are m...... middle of paper ......, N., Hassan, Z., Jan, A., et al. (2012). Is social exclusion pushing Pakistani Hijras (transgenders) into commercial sex work? A qualitative study. BMC International Health and Human Rights, 12, 1-9. Altaf, A., Zahidie, A., & Agha, A. (2012). Comparison of HIV risk factors among Hijra sex workers in Larkana and other cities of Pakistan: A cross-sectional analytical study. BMC Public Health, 12, 279. Khan, A., Rehan, N., Qayyum, K., & Khan, A. (2008). Correlates and prevalence of HIV and sexually transmitted infections among Hijra (transgender males) in Pakistan. International Journal of Sexually Transmitted Diseases and AIDS, 19, 817-820.Lal, V. (1999). Not this, not that The Hijras of India and the cultural politics of sexuality. Social Text, 17 (4), 119.Patel, A. (2010). Hijra Indians: The case of transgender rights. International Law Review George Washington , 42 (4), 835-863.