Street Children Vulnerable to HIV

18/08/2012 – Girls and boys who live on the streets, some just eleven years old or younger, must fend off the advances of men seeking to sexually exploit their vulnerability.

They are the world’s invisible children. People look past them or through and "shoo" them on a daily basis. The world’s 100 million or so street children eke out a living either with their families or without parental care on the streets of some of the world’s busiest cities.

According to the Times of India, the city of Kolkata may be in danger of rapidly rising numbers of HIV. The worry comes from surprising rates of illness among street children.

One per cent of the Indian city’s 15,000 street children, aged five to fourteen, are living with  HIV. These children are unaware of their status, according to a survey conducted by the National Institute of Cholera and Enteric Diseases (NICED). Without medical attention, they risk their own health and that of others.

Researchers say there is a potential for a “health hazard.”

Most of the children contracted the virus in suffering act of sexual abuse. One-in-ten children had been sexually abused before they reached age 16, says The Times, covering the story of the survey, titled Non-tobacco Substance Use, Sexual Abuse, HIV and Sexually Transmitted Infection Among Street Children. Just over a quarter of boys faced such abuse before their 15th birthdays.

A total of 550 street children without parents or family connections were interviewed and monitored for two years (2007-2009). Random blood samples were tested for HIV, hepatitis B and other sexually transmitted diseases. Four per cent of the children also tested positive for syphilis.

Most of the children acquired HIV as a result of the extreme vulnerabilities and risky behaviours associated with living on the street.

Meanwhile, in neighbouring Pakistan, health authorities reported an HIV outbreak among drug-using street children at a residential treatment centre in Malir. In addition to drug abuse, sexual abuse was the cause of infection. Almost 39 per cent of the 26 tested for HIV were found to be positive.

The facility is run by the charity, Alleviate Addiction Suffering Trust. Other non-governmental groups and health authorities are working with the Trust to help protect and provide care for the youth.

Steet children’s lifestyles, living conditions and socioeconomic status expose them to a number of hazards, AAS Trust’s Fauzia Pesnani told DAWN.

“It is quite possible that they passed it on to others since both sexual abuse and promiscuity was common among street children. It is unlikely that any had got the virus from their parents,” said NICED Epidemiology Director Kamalesh Sarkar about the Kolkata study in The Times.

The NICED survey shows that inadequate food intake and substance abuse were common hazards for street youth in Kolkata. Most—four-fifths—had no shelter and spent their nights sleeping in public places. NICED is looking to erect shelters and support services for the city’s most vulnerable youth.

In Kenya’s cities and towns, designing programmes to reach the 150,000 street families and 450,000 street children is a difficult task, reported the IRIN news source this week.

“Reaching them is a challenge because you will never find them aggregated in one place, and we have no strategies currently that we can use to take services to them," said Joseph Sitienei of the National AIDS Control Programme.

According to a 2006 report published by the United Nations and PAU Education, Street Children and HIV & AIDS: Methodological Guide for Facilitators, “Low parental income, failure at school, family conflicts and parental negligence are a number of reasons that lead to children living partially or permanently on the street.”

Strategies for addressing street children’s vulnerability to HIV include: increasing the children’s knowledge about HIV and risky behaviours, as well as increasing their capacity to apply this knowledge and change their behaviours.

“The facilitators called to deal with the issue of HIV with street children should observe the fundamental attitudes, which are: empathy, respect and authenticity,” said one expert from Niger quoted in the report.

Of the estimated 34 million people living with HIV in 2011, about 3.4 million are thought to be under 15 years old, shows United Nations data. Ninety per cent of these children (3.1 million) live in sub-Saharan Africa. The second-largest population, 160,000, lives in South and Southeast Asia.