Karnataka & Andhra Pradesh top in female sex worker population, Maharashtra third with 9.6%

HYDERABAD: As India fights to shed its HIV burden — currently third highest in the world — the latest Programmatic Mapping and Population Size Estimation (PMPSE) study has found that Telangana and Andhra Pradesh have among the highest concentration of female sex workers — per hotspot — in the country. Overall, though, Karnataka emerged at the top of the charts with 15.4% of India's total FSW population. It was followed by Andhra Pradesh (12%), Maharashtra (9.6%), Delhi (8.9%), and Telangana (7.6%). Together, these five states accounted for over half (53%) of India's estimated 9,95,499 female sex workers.The study, published in PLOS Global Health, covered 651 districts across 32 states and UTs. Led by Pradeep Kumar of the National AIDS Control Society, it calls for periodic, community-led PMPSE to enable responsive public health strategies.The mapping exercise identified 43,579 FSW hotspots across India with presence of FSWs in 642 districts, including 34 with over 5,000 FSWs. AP was found to have five such districts, and Telangana six. FSWs were also reported in 16,095 villages. Telangana recorded the highest concentration of FSWs per hotspot — 38 per location —followed by AP with 29.In contrast, most states had a lower density, averaging 8 FSWs per hotspot nationally. Home-based sex work dominated the landscape, accounting for 55.1% of all FSW hotspots. Around 14% of FSWs were found operating exclusively through 10,718 network operators, and 9% in Link Worker Scheme (LWS) villages. There were as many as 568 mapped network operators in Telangana, one of the highest in the country. In AP, each LWS village had an average of 10 FSWs operating exclusively within the village, while in Telangana, it was 8. The PMPSE also underscored Telangana's transgender (H/TG) individuals per hotspot —around 25 — again the highest in India. It surpassed Delhi (24), Gujarat (21), AP and Maharashtra (20 each). Although Delhi had the highest overall H/TG population (18.6%), Telangana stood out for its concentrated presence at identified locations. Nationally, 96,193 H/TG individuals were estimated, with 90.8% found at hotspots. Telangana's share came from fewer mapped hotspots but with higher density. In total, 6,585 H/TG hotspots were identified, with key informant data gathered from 15,231 individuals within the community. For men who have sex with men (MSM), Telangana reported the highest density again —50 MSM per hotspot — followed by Delhi (29) and Goa (27). Though AP contributed 6.3% to the national MSM population, Telangana's role in terms of hotspot concentration points to a more complex landscape of risk.