Table 1

Demographic, behavioural and biological parameters for the model to assess cost effectiveness of FSW targeted interventions in India

Parameter	Base value	Range		Source (see Reference list)
Parameter	Base value	Lower	Upper	Source (see Reference list)
Intervention parameters
Efficacy of condom use				35–37
Vaginal	0.8	0.75	0.85
Anal	0.7	0.65	0.75
Oral	0.9	0.85	0.95
Annual increase in condom use among FSW	0.091	0.073	0.099	21
Enrolment of FSW in targeted intervention projects (1995)	0.02			2
Enrolment of FSW in targeted intervention projects (2008)	0.53			38
Coverage of enrolled FSW for STI treatment (1995)	0.262			2
Effectiveness of STI treatment	0.85	0.68	0.98	39
Annual decline in risk behaviour				20 21 32
N (FSW)	0.02
M (FSW)	0.03
Behavioural parameters
Proportion of female population involved in commercial sex	0.0056	0.039	0.006	21
Proportion of male population
15–50 years sexually active	0.105	0.09	0.12	21
15–50 years having non-regular partner who reported commercial sex in 1 year	0.034	0.026	0.042
Type of FSW-client sex acts				40 41
Vaginal	0.9	0.85	0.992
Anal	0.05	0.003	0.08
Oral	0.05	0011	0.1
Proportion condom use (1995)
FSW	0.23	0.19	0.32	14
Married GP	0.022	0.009	0.06	30 33 34
Unmarried GP	0.014	0.01	0.018
Annual change in condom use among married GP	0.09	0.05	0.14	30 34
Mean sex acts per FSW per client per year	3	2.25	3.75	Calculation based on IBBA, BSS-1, 2
Mean no of client per FSW per year (1995)	205	179	226	Calculation based on IBBA, Dandona et al29
Mean sex acts per client per FSW per year (1995)	2.81	2.5	3.0	Calculation based on IBBA, Dandona et al29
Mean no of FSW per client per year	16			Calculation based on IBBA, BSS-1, 2
Mean sex acts per partner per married GP per year	45			42
Mean sex acts per partner per unmarried GP per year	10			43
Mean no. of partners per married GP per year	1.019			31
Mean no. of partners per unmarried GP per year	0.046			31
Proportion of GP married-client sex act type				31
Vaginal	0.89
Anal	0.009
Oral	0.094
Proportion of GP unmarried-client sex act type				31
Vaginal	0.89
Anal	0.009
Oral	0.094
Biological parameters
Proportion of FSW with				44 45
HIV	0.097	0.05	0.46	45
STI	0.42	0.35	0.47	46
Odds for STI among HIV infected	0.8
Proportion of adolescent females with STI	0.041	0.004	0.162	31
Proportion of clients with
HIV	0.047			Author analysis using HSS data
STI	0.26			21
Odds for STI among HIV infected	0.8			46
Probability of HIV transmission:				Range according to authors' estimates25 27
Male to female
Vaginal	0.0014	0.0007	0.0021
Anal	0.01	0.005	0.015
Oral	0.0004	0.0002	0.0005
Female to male
Vaginal	0.0007	0.00035	0.0015
Anal	0.001	0.0005	0.0015
STI cofactor multiplicative effect	3	2	5	25 28
Probability of STI transmission:			0.3	47–50
Male to female			0.15
Vaginal	0.25	0.2	0.5
Anal	0.4	0.3	0.5
Oral	0.1	0.05	0.15
Female to male
Vaginal	0.25
Anal	0.4
Proportion of female population (15–45 years) with
HIV	0.002	0.2	0.3	Author analysis based on HSS data44
STI	0.2	0.3	0.5	Author analysis based on HSS data44
Cost parameters
Total NACP budget				1
NACP-1 (1995–6)	80 crore
NACP-2	1425 crore
NACP-3	11583 crore
Proportion of budget to mass media				1
No FSW intervention scenario
NACP-1 (1995–6)	0.45
NACP-2	0.25
NACP-3	0.25
FSW intervention scenario
NACP-1 (1995–6)	0.45
NACP-2	0.25
NACP-3	0.1
Average cost per FSW enrolled under targeted intervention				2 11 12 29 51–54(Bill and Melinda Gates Foundation and KHPT. Personal communication, 2010 and NACO. Personal communication, 2009)
NACP-1	794	773	1606
NACP-2	1208	1612	3419
NACP-3	2559
Average cost per beneficiary for ART treatment				55
1995	15 168
2008	9806
Coverage of ART treatment				55 56
1995	0.01
2008	0.34

ART, antiretroviral therapy; BSS, behavioural sentinel surveillance; FSW, female sex worker; GP, general population; HSS, HIV sentinel surveillance; IBBA, integrated biological and behavioural surveillance; KHPT, Karnataka Health Promotion Trust; M (FSW) is the mean number of clients per FSW; N (FSW) is the mean sex acts per client per FSW per year; NACO, National AIDS Control Organization; NACP, National AIDS Control Programme; SRS, sample registration survey; STI, sexually transmitted infection.