Background: The magnitude and depth of HIV/AIDS impacts in sub-Saharan Africa are staggering.rnOver 36 million individuals are currently living with HIV/AIDS, 95% of whom are from developingrncountries. In the past, rates of HIV/AIDS in urban populations were greater than in rural areas; morernrecently, improved and expanded surveillance has shown that HIV prevalence in rural areas is lowerrnthan anticipated. Nevertheless, the differences in infection levels between rural and urban areas willrnbe narrowed over time. The absolute number of HIV-infected persons in rural areas may equal orrnsurpass the number in urban areas. In Ethiopia most of the studies on HIV/AIDS focused on urbanrncenters; however, on the other hand, evidence has shown that the prevalence of HIV infection isrnincreasing rapidly in rural areas.rnPastoralists are among the marginalized people with diverse cultures, and these cultural practicesrnhave been cited to be fueling HIV transmission in pastoralist areas. Surma is pastoralist woredarnfound in Bench Maji zone (SNNPR), 750km from Addis Ababa. Different socio-cultural practicesrnare predominantly performed in the community which may facilitate HIV in the community.rnObjective: This study aimed to identify socio-cultural risk factors for the transmission of HIVrninfection in pastoral communities of Surma woreda, SNNPR.rnMethods: A cross-sectional study was conducted using quantitative method involving 447 studyrnparticipants in the age range of 15-49 who are residing 18 kebeles in Surma woreda. A qualitativernmethod was also applied involving elders, influential peoples, traditional healers and communityrnleaders. The study was conducted from Dec 2005 to Feb 2006, in surma woreda, Bench Maji zone,rnSNNPR.rnvirnResults: The result of the study was based on 416 respondents who adequately responded to thernquestionnaire interview. Findings revealed over 88.2% of the study population were illiterate andrn41.9% of married males involved causal sex during the post natal period of their wives. Over fiftyrntwo percent of respondents never heard about HIVAIDS. 90.4% and 90.1 % of the respondents hadrnbeen pierced skin and body tattooing respectively.rnAccording to the graded risk practices score, 70.4% of participants were among the high risk whilern29.6% were at low risk category. Their awareness and knowledge about HIVAIDS was less. Inrnaddition, the identified socio-cultural practices (skin piercing, body tattooing, tooth extraction, hairrnshaving, traditional surgery and cultural rituals) were found to fuel the transmission among the studyrnpopulation .Their sexual behavior also had a grave consequence for the wide spread of HIVAIDS.rnThe awareness towards VCT and willingness to undergo VCT was also low.rnConclusions: The nearly created linkage, which is starting sex some of the surma people with nonendogenousrnpeople, will make the identified socio-cultural practices to play a considerable role inrnthe transmission of HIV spread. In addition lower status of awareness and knowledge aboutrnHIVAIDS, as well as dreadfully high illiteracy level made the study population at critical level forrnHIV spread. The liberal sexual practices with the recently amplifying level of alcoholism madernhorrible the probability of HIV spread in the community.rnRecommendation: Multidisciplinary survey teams urgently need to raise local awareness andrnknowledge of HIVAIDS using culturally appropriate methods, and reduce high-risk behaviors tornprevent the spread of HIV.