
Karnataka, Delhi, AP among 5 states with highest number of female sex workers, says study
Karnataka is at the top of the list with 15.4 per cent, followed by Andhra Pradesh (12.0 per cent), Maharashtra (9.6 per cent), Delhi (8.9 per cent) and Telangana (7.6 per cent), the programmatic mapping and population size estimation (PMPSE) said.
The five "were States with highest size of FSW contributing around 53.0 per cent of total FSW key population size in the country," it said.
The number of FSW per 1000 adult women was highest in Arunachal Pradesh (17.24), followed by Delhi (15.46), Goa (11.67), Chandigarh (10.10) and Karnataka (8.34).
Observing that India has the world's second-largest HIV burden, the study said key populations of female sex workers (FSW), men who have sex with men (MSM), hijra/transgender (H/TG) people, and people who inject drugs (PWID), are disproportionately affected by the HIV epidemic.
The community-led PMPSE was carried out in 651 districts of 32 states and Union Territories of India. The goal was to identify the hotspots, network operators, and estimate the size of key population groups, said the study, published in PLOS Global Public Health.
The PMPSE estimated a total of 9,95,499 FSWs, 3,51,020 MSM, 2,88,717 PWIDs, and 96,193 H/TG individuals. PMPSE for FSWs identified 43,579 hotspots and 10,718 network operators.
FSWs were further reported in a total of 16,095 villages, it said. Slightly more than half (55.1 per cent) of the hotspots were home-based, followed by 16.1 per cent street-based locations and 5.9 per cent brothel-based.
Highest number of hotspots in PMPSE were mapped in Karnataka (around 20.0 per cent of the total hotspots), followed by Andhra Pradesh and Maharashtra (around 8.0 per cent each), Madhya Pradesh (around 7.0 per cent) and Tamil Nadu (around 6.0 per cent). In Telangana, there were around 38 FSWs per hotspot, highest in the country followed by 29 FSWs per hotspot in Andhra Pradesh and 26 FSWs per hotspot in Delhi, Meghalaya and West Bengal, it said.
The PMPSE reported presence of FSWs in 642 districts of the country. With an estimated 2.54 million people living with HIV (PLHIV), India ranks as the country with the second largest population of PLHIV globally, the study said. The National AIDS and STD Control Programme (NACP) has successfully responded by restricting the epidemic.
Through its comprehensive and pointed initiatives, nearly 44 per cent reduction in new HIV infections and a remarkable 79 per cent decline in AIDS-related deaths from 2010 to 2023 has been estimated in India.
"Despite the significant success achieved so far, there is no place for complacency and the program implementation must continue with equal vigour and energy in the years to come," it said. HIV prevalence among key populations (KPs) remains significantly higher than the overall adult prevalence, said the study, part of the Surveillance and Epidemiological activities of the National AIDS and STD Control Programme of the central government.
The study further said mapping and population size estimation are pivotal to an evidence-based response to HIV/AIDS in settings with concentrated epidemics.
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles


Indian Express
9 hours ago
- Indian Express
Footfall of 50L in OPD, 3 lakh admissions, reliance on AI, renewable power: Director hails AIIMS on I-Day
The All India Institute Of Medical Sciences (AIIMS) in Delhi has so far this year registered a footfall of around 50 lakh patients in the outpatient department (OPD), 3.5 lakh admissions in the inpatient department (IPD) and has conducted nearly three lakh surgeries, Director Dr M Srinivas said on Friday in his Independence Day address. The Director added that the institute received an approval rating of 95% through an indigenously developed app called SANTUSHT. Dr Srinivas added that the hospital infrastructure has been upgraded with solar energy, water recycling, and carbon accounting systems. AI-powered diagnostics and predictive analytics have been introduced to personalise care and optimise resource utilisation, the Director asserted. AIIMS also helped incubate 26 medical start-ups through the Centre for medical innovation and entrepreneurship, Dr Srinivas said, noting that the institute also published over 4,000 peer-reviewed articles. 'By launching the digital learning hub and conducting 123 examinations for over 11 lakh candidates, AIIMS Delhi became one-of-a-kind institution in India to achieve blockchain deployment for examination records,' he said. Under the drug de-addiction programme and National Action Plan for Drug Demand Reduction, Dr Srinivas said, the hospital offered support to 25 drug treatment clinics and 73 addiction treatment facilities across 20 states in the country. He added that the institute also trained 1,379 professionals to tackle the issue of drug addiction. Highlighting the institute's achievements, Dr Srinivas said, 'AIIMS Delhi increased capacity for critical care by conducting over 15,000 MRIs, and set up India's first HIV Drug Resistance Testing Laboratory approved by National AIDS Control Organisation (NACO).' Work on indigenous bioengineered corneal implants was initiated under the Retinomics Facility at Dr RP Centre for Ophthalmic Sciences. He underlined that the institute also set up Interdisciplinary Centres of Excellence to bridge medicine, engineering, and data science to bring forth holistic innovation in the medical sector.


New Indian Express
a day ago
- New Indian Express
Odisha HC bins plea against OSMCL tender for NAT Testing units in 45 blood centres
However, the petitioner again raised objections, stating that no BIS certification currently exists for the product in question, thereby causing further prejudice to domestic bidders. Following additional representations, the tendering authority clarified that any one of the certifications - USFDA, European CE, or BIS - would be considered valid, and the bid would not be rejected solely for the lack of a specific certification. The deadline for bid submission was also extended to accommodate these changes. However, on August 11, the division bench of Chief Justice and Justice M S Raman declined to interfere, emphasising that the matter involves technical and public health considerations. The tender pertains to equipment used for detecting life-threatening diseases like HIV, HBV, and HCV in blood plasma, and ensuring precision and accuracy is of paramount importance, the bench noted in the order uploaded on Wednesday. Stressing judicial restraint in matters involving technical expertise, especially in the healthcare sector, the bench stated that its role is limited to examining whether the actions of the authorities align with constitutional and statutory provisions, and do not result in discrimination. Since no decision had yet been taken on bid acceptance or rejection, and the deadline for submission was still open, the court observed that the petition was based merely on presumption and apprehension.


The Hindu
2 days ago
- The Hindu
Should HIV/AIDS testing be made mandatory before marriage?
In July, Meghalaya Health and Family Welfare Minister Mazel Ampareen Lyngdoh announced that the State may follow Goa in making HIV/AIDS test mandatory for all before marriage. The problem is multi-disciplinary; it is not merely a question of health, but also involves considerations of human rights, stigma, and free will. Should HIV/AIDS testing be made mandatory? N. Kumarasamy and Jahnabi Goswami discuss the question in a conversation moderated by Ramya Kannan. Edited excerpts: Is it possible to implement mandatory testing for HIV before marriage? What are the advantages of such a move? N. Kumarasamy: Regarding HIV, making anything mandatory is not acceptable. The HIV and AIDS (Prevention and Control) Act, 2017, clearly mandates counselling before testing, and testing only with the consent of a patient. As per the law of the land, once you do the testing, everything must be kept confidential. If they test positive, patients should be linked to the appropriate antiretroviral treatment centres. The next question will be whether they can get married — that has also been dealt with by the 2017 law. Today, based on science, we know that if a HIV-positive person is put on antiretroviral treatment, the viral load goes to an undetectable level within 2-3 months. Studies have shown that a person who has an undetectable level of viral load will not transmit infections sexually to their partners. The person will also not develop any HIV-related complications such as opportunistic infections, tuberculosis (TB), and various other comorbid conditions, and maintain a normal immunity level. Mandatory HIV testing without the consent of such a person will be a human rights violation. And doing so will also increase stigma. For all these reasons, mandatory testing cannot take place. HIV testing should be offered to as many people as possible — mainly to those who are at risk and also people who believe that they may be at risk. It should be offered. Consent is important. And testing, if done, should be done while maintaining appropriate confidentiality. Jahnabi Goswami: Yes, the viral load can be managed with drugs. But I still think HIV testing should be made mandatory before marriage. There are a number of cases we know where people who have been infected, but are not taking antiretrovirals regularly, get married because of family and societal pressure. The spouse finds out only later, or perhaps when she or he tests positive for HIV. The children are likely to be affected too. In India we believe in matching horoscopes before the wedding. Why not a HIV test, to see if the couple are compatible at all? Such a test will also ensure the health of the family. Will this move actually empower women? Jahnabi Goswami: My agenda is not women or male empowerment per se. In the north-east, specifically, there have been a number of cases where the (HIV positive) status was concealed. Injecting drug use is responsible for nearly 64% of HIV infections in the north-east. Men (injecting drug users) clean up for three months, get married and don't inform their wives. A few months later, they bring their wives too to test. Even today, we had such a case. This happens regularly. In fact, I believe that to safeguard women and girls, it is essential to go in for mandatory testing, with counselling. About confidentiality and consent, I want to point out that in practice, doctors are forcefully testing for HIV. Even if you go for a small dental procedure — sometimes they counsel, sometimes they don't, and force you to do HIV test. Sometimes it is good counselling and sometimes it is of bad quality. Will the HIV test, if it comes negative, provide a false sense of security? N. Kumarasamy: While you are doing appropriate testing, you are also counselling a patient to find out the duration of exposure. That also helps you determine the window period when testing should be offered. That is the reason you counsel someone. If you force someone to do a test, they may go to a lab and get it done. The test report can be negative but the person might really be positive (for HIV) leading to transmission of infection. If testing is done with appropriate consent, counselling, and confidentiality, I'm sure people are not going to refuse it. Goa also proposed mandatory testing some years ago, but it is still not a reality... N. Kumarasamy: Yes, it is not implemented in Goa. But there is wide testing happening in the State. There is no mandatory testing before a wedding. The thing is they cannot implement this because this will cause human rights violations. The same thing is happening in Meghalaya. If you look at the reports on rising infections, perhaps the State is ranked 5th or 6th where a significant number of infections is through injecting drug use and also through sexual contact. But I think it is possible to learn from other States, especially from southern India — Tamil Nadu, Kerala, and Andhra Pradesh — as well as Maharashtra. The ideal way to contain this infection is to do appropriate HIV testing as much as possible in a variety of settings with proper consent and then link those tested people to the treatment. That will reduce infectiousness in the country and also lead to a reduction in new infections in Meghalaya. Jahnabi Goswami: I think it will definitely happen because the situation is quite different in Meghalaya. To understand it, you should understand the circumstances and people of the State. In Meghalaya, certain groups in the Christian community still think it is taboo to use a condom even if it is recommended by law. (The HIV Act promotes safe sex practices.) In fact, implementing the HIV/AIDS Act in Meghalaya is really difficult. Also, culturally and socially, they have provisions for extramarital affairs and living together. These are quite common among the youth. Simultaneously, HIV is a big discriminator in Meghalaya and no one has actually accepts HIV-positive men or women. How do we address the stigma that is still associated with HIV? N. Kumarasamy: Stigma started in India because it (HIV) was first detected in a commercial sex worker, so it was attributed to multi-partner sex. But this is not true, as we have seen. HIV is still an incurable disease. The way to address stigma today is to make sure that common people are aware that we now have treatment available. Even if it is not curable, it is permanently controllable. In our research studies in Chennai, we showed that treating one partner will prevent transmission if the viral load goes down. The message U=U (undetectable is untransmittable) does work. Such scientific messages can remove stigma from the community, so that as many people as possible will test and be linked to treatment. Someone who is already on treatment will do well, and not transmit infection to the others. Addressing stigma is not an easy thing. Over 30 years of taking care of people with HIV and their families at our centre here, we realise that each one is different. Much is based on their education, how they were raised, and whether they live in the village or city. All this will have to be wrapped up in several rounds of counselling. Jahnabi Goswami: As Dr. Kumarasamy has said, stigma is associated not with the disease, but with where the infection arises from. The impression is that people who are in sex work will get HIV; people who do drugs will get HIV. That is where the stigma comes from. We should constantly try to reduce stigma. The government, people who are infected, like me, and those working in the field should work hard to erode the stigma. If someone has cancer, they say without any hesitation that their family members died of cancer. If they are diabetic, they say they don't use sugar. And if they have hypertension, they don't mind asking you not to put salt in their food. But people who have HIV or people who have TB do not talk openly about it because these are seen as behavioral issues. We must remove the stigma and make it comfortable for HIV-positive people to talk about their status. I do believe we have to involve counsellors to tell people that they will not transmit because they are on treatment, that U=U; and involve more people with HIV as role models to reduce stigma and discrimination. The quality of counselling should be improved for sure. Listen to the conversation