It is clear that urgent action and consistent monitoring of HIV in KP are needed to turn the tide of the epidemics facing these KP, as well as populations connected through sexual networks. The significance of KP in Swaziland’s generalized epidemic should be addressed through surveillance that includes specific KP measures. Additionally, as both MSM and FSW face unique social and structural hurdles such as high levels of stigma and discrimination, prevention programs and policies must take into account the social and political context of HIV infection in these populations.