Size Estimation of high-risk groups for hiv infection in india based on data from national integrated bio-behavioral surveillance and targeted interventions.

Background: Targeted interventions (TIs) are one of the most effective strategies to control HIV/AIDS transmission, especially among the high-risk groups (HRGs). Implementation of HIV/AIDS control strategies relies heavily on estimation of the size of HRG population. Size estimation for key populations such as female sex workers (FSWs), men who have sex with men (MSM), and injecting drug users (IDUs) is a crucial component of national HIV strategic planning. Objective: The objective of this study was to estimate the size of FSWs, MSM, and IDUs in various states of India. Methods: The program multiplier method was used to estimate the size of FSWs, MSM, and IDUs across the country using two distinct but overlapping data sources - Integrated Bio-Behavioral Surveillance and TI program from the same geographical area at the same time period. Results: In India, as on 2018-2019, there were nearly 18.2 lakhs estimated FSWs accounting to 0.53% among female population aged 15-49 years, with a highest in West Bengal (4.5 lakhs); 5.7 lakhs estimated MSM accounting to 0.16% among male population aged 15-49 years, with a highest in Gujarat (0.7 lakh); and 3.9 lakhs estimated IDUs accounting to 0.11% among male population aged 15-49 years, with a highest in Uttar Pradesh (0.5 lakh). Conclusions: The current size estimates on HRGs will support the development of projections and estimations of the HIV epidemic at national and state levels. These estimates also help in framing national guidelines such as HIV strategic planning, program design, allocation of resources, prioritizing the interventions, and monitoring and evaluation.