India, home to the third-highest HIV burden globally, faces new challenges as a recent Programmatic Mapping and Population Size Estimation (PMPSE) report reveals alarming figures regarding sex work concentration in certain states. According to the study, Telangana and Andhra Pradesh register some of the most densely packed sex work hubs in the country.

Karnataka leads with the largest share of female sex workers (FSWs) at 15.4% of the national estimate of 9.95 lakh. It is closely trailed by Andhra Pradesh (12%), Maharashtra (9.6%), Delhi (8.9%), and Telangana (7.6%). Together, these five states account for over half of the country’s total FSW population.

The report, based on mapping across 651 districts, reveals that Telangana averages 38 FSWs per location, while Andhra Pradesh follows with 29—both far above the national average of 8. Out of 43,579 identified hotspots, 642 districts and over 16,000 villages recorded FSW activity.

A majority—55%—operate from homes, while 14% are linked with nearly 10,700 identified network facilitators. Telangana, notably, had 568 such operators, indicating an extensive underground network.

The study also drew attention to high-risk populations, such as transgender individuals and MSM (men who have sex with men). Telangana again topped the charts with 25 transgender persons and 50 MSM per hotspot, pointing to concentrated vulnerability.

Researchers call for regular community-driven mapping to support targeted HIV prevention programmes in these areas.