Street Children in Nepal Struggling with AIDS; Effective prevention must be targeted
By: Rupa Kharel / OhmyNews
16 May 2006
Every minute of every day a child contracts HIV and more than 500,000 children under 15 are dying each year due to AIDS. It is estimated that worldwide 2.2 million children under 15 are currently living with AIDS.
The HIV/AIDS problem in Nepal is now almost two decades old. The first case of HIV was reported in Nepal in 1988, and, in less than 20 years, approximately 61,000 adults and children have become infected. HIV/AIDS infection rates are rapidly increasing due to unawareness and lack of knowledge among vulnerable groups.
Street based children are understood to be those whose diverse lives have a significant relationship to the street as a space and/or culture. They are unaccompanied, experiencing a dysfunctional family situation or spending most of their time outside of responsible parental or adult supervision.
It is well documented that street-based children share an environment and practices that make them vulnerable to HIV infection. Furthermore, two independent tests conducted by an NGO in Kathmandu in 2002 identified the existence of HIV infection among this sub-population. In these tests, 25 out of 80 (31 percent) street children were HIV positive, and 16 out of 32 (50 percent) "high-risk" street children were HIV positive.
These children have knowledge about condoms, but refuse to wear them. In answer to the question why, one of the street children said, "It's like wearing a plastic bag on the tongue when eating vegetables that have no taste."
Needle sharing is also common. One rag picker said, "When I don't get a needle, what else can I do?" He added, "I have no other way to do it except injecting from a friend's needle."
Street children are at risk from HIV/AIDS because they are vulnerable to sexual abuse, unprotected sex, early sexual initiation, and injecting drugs.
To be effective, HIV prevention must be targeted, addressing the contexts in which these children live, their lives and based on an understanding of their psychosocial situation. If risk behaviors exist but are not recorded, the opportunity to plan risk-reducing programs before this virus explodes through a high-risk population is lost. An in-depth and systematic understanding of the vulnerabilities and risk behaviors of street-based children is vital in order to develop targeted interventions.
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[Meindert: I very much agree with this last paragraph of the article, THE reason why the APSA Sexual Health Intervention Programme for Street and Slum Children wants to be thoroughly evidence-based!]
[AND... I fear that the HIV prevalences mentioned in this Nepali example may not be very different from the Indian hardcore street teenager's infection rates (though injecting drug use fortunately is still rather uncommon in many/most parts of India)...]
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