Dear Friends,
Today I stumbled upon a total of 11 good research abstracts related to street children and their sexual health & AIDS, internationally (published between 2006 and 2009). Though I am working in this field for the last 9 years, again these data are shocking to me. I have copied the first 4 of these article abstracts below. To each article I have added a few lines of personal thought [in italics and bold, and coded with my initials "MS:"]. In the next few weeks, I will share the remaining 7 abstracts with you, including my reflections.
I know that not all of you are used to reading these type of research abstracts. Unfortunately, they often are written in a highly condensed and difficult style. Still, I hope you will read them. They contain a lot of important information. (If you do not feel like reading the abstracts, I suggest to only read my personal reflections on them).
I would love to hear your reactions to these abstracts, and to my comments. I have started a FORUM-topic on them, to which you can reply. Also, feel free to ask questions or clarifications. [NOTE: to reply to the forum-post you will need to log in with the email-ID you used to register for the website (see top of the page).]
*** Click HERE to go to the FORUM-TOPIC ***
Best regards,
Meindert.
P.S. In addition to the research abstracts: One of our website member NGOs in Lahore, Pakistan, has sent me an article about the general situation of street children in Lahore. You can read this article through the WORD-FILE LINK at the end of this news-message (see below).
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ABSTRACT 1:
HIV/AIDS risk behavior and practices among children living in the streets of India and Pakistan
A. Sultana, H. Maqsood, H. Hussain, G. Sethi
Background:
Increasing number of Street children is one of the emerging Public health threats faced by Pakistan & India. Anecdotal data suggests that these children are among the most vulnerable populations at risk of acquiring and spreading HIV infection, due to lacking awareness and extremely risky sexual practices. This cross sectional study was therefore conducted to assess the HIV awareness and related risk practices among street living children in Pakistan and india
Methods:
7000 children living on the street were interviewed in 30 cities reported to have maximum number of street children,18 in India and12 in Pakistan. Data were collected from December 2004 to December 2005, by trained interviewers, using pre-tested questionnaire on various socio-demographic & personal characteristics, HIV knowledge, Injection drug use and sexual practices.
Results:
Data analysis of 7000 subjects showed that half of the respondents have heard of the disease. Among these, 58% had an idea about sex-related while only 9% knew about IDU-related transmission of the disease. However, knowledge regarding ways to protect infection was negligible. More than 70% of the children reported of rape and sexual assault by older men. The median age of initiation of sexual activity was 10 yrs, and 66% of the children interviewed were sexually active currently having both male (4.7 ± 2.1) and female (1.8 ± 2.0) sexual partners. 31% of the sexually active children reported having had sex with Female sex workers and Transvestites in the past year. Condom use during the last sexual intercourse was reported to be only 12% (only female partner). 33% of the children had exchanged money for sex.
Conclusions: We propose a comprehensive national program on HIV/AIDS & STD prevention to create awareness and impart skills and services to practice safe sex. Steps need to be taken to rehabilitate these children and place them back in their families.
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[MS: What strikes me in this study is that out of the 7,000 street children only HALF had heard about HIV/AIDS, and that of these children who knew the disease almost half did NOT know that the disease was sex-related... This means that only about one in every four children knew that you can get HIV from sexual contacts. This is shocking information, especially when coupled with the finding that two-thirds (66%) of these children were found to be sexually active, having sex with an average of about 5 different male partners and about 2 different female partners, and without regular use of condoms... This again proves the enormous need for information and behaviour change programs!
Another shocking number is that 70% of the children reported rape or sexual assault by men. These children are really vulnerable.
Last, I am not too sure about the proposed 'solution' to place these children back in their families. Though this is a common approach in street children organisations, my experience is that it does not work for children who have been on the streets for more than a year and who are already involved in street habits like sex and substance use... I would like to hear your ideas on this. Feel free to respond. Meindert.]
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ABSTRACT 2:
Integrating soccer into HIV/AIDS prevention for urban street children in east Jakarta [MS: 'soccer' is the football game played with a round ball]
R. Mellantika, T. Rejeki, Y. Kapitan, M. Bloem
Issues: Indonesia is a country that is vulnerable to increased HIV/AIDS prevalence. A large proportion of PLWHA are in the productive health age range (19 to 50 years old). HIV/AIDS vulnerability is heightened among street children due to their lack of knowledge, limited access to health facilities and disenfranchisement. CWS Indonesia began working with urban street children in East Jakarta through the Soccer 4 Children On Road 2 Empowerment (SCORE ) Program.
Description: SCORE’s objective is to empower street children and communities to reduce HIV/AIDS vulnerability. SCORE uses soccer as an entry point as many children enjoy this sport. The program began with the formation of 25 peer educators (PE) and HIV/AIDS training. Each PE is enabled to present HIV/AIDS/drugs/reproductive health information to 30 of their friends. The street children receive training once a week leading up to a soccer tournament, with information sessions conducted before each training.
A youth center was established for open discussion of soccer and health issues in a non-threatening environment. SCORE also provides counseling, and STD check-up and treatment. To improve their life skills, the children are given the chance of an internship according to their topic of interest.
Lessons learned: Soccer activities have attracted more than 300 street children to HIV/AIDS information sessions. At present, 34 soccer teams have been formed. 50% of PEs decided to have VCT after five months of intervention. These PEs also helped to ensure treatment compliance among friends undergoing STI treatment.
Recommendations:
Soccer is a great method to reach street children, especially boys. Support from other stakeholders (parents/guardians) is necessary to achieve ideal behavior change. Street children’s groups have different sub-cultures that require specifically tailored interventions. Introduction of soccer activities to reach more girls should be explored.
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[MS: I like this abstract because it shows that a LOT is possible, especially if you try to reach the children through recreative activities, and combine FUN with HIV prevention. That is also the approach of our APSA-SHIP Intervention Programme. Our slogan is: "HAPPY, Healthy, Responsible!" I wish I would have seen this article earlier. I could have then built in some Cricket into our programme ;-) I am sure that the boys would have loved that. Any good ideas for girls' activities? Let me know (for example in our Discussion Forum)! Meindert.]
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ABSTRACT 3:
STI/HIV intervention among street children and experience from Dhaka, Bangladesh
M M Haque
NGO, Dhaka, Bangladesh
Issues: More than 300,000 children roam in the streets of Dhaka City. They are highly mobile, deprived of shelter and protection, and are frequently sexually abused by people at rish of HIV/AIDS. 50% of abused girls suffer from STIs. They have no information about HIV/AIDS, its risks, means of protection and prevention
Description: A project was undertaken with UNDP funding for awareness building among these children during July 2000 to June 2001. A baseline survey with 303 street children showed poor knowledge level. Only 23.10%of children had some idea about HIV/AIDS, but none to any reasonable level .26 children were involved in commercial sex, but only 2 used condom. 14,443 children and 25,080 community people were made aware through training, individual contact, peer education, mass campaign, drama, film show etc. Training was conducted at open-air or indoor premises with around 30 boys and girls 9 to 16 years in each group. At project end 86.8% of children could recall about 70% of basic information. Commercial sex practice reduced by 93.3 % and STIs by 58.33%.
Lessons learnt: Outdoor training environment, bigger groups with various ages were not favorable and attractive. Enhancement of knowledge level does not proportionately change behavior. 82 children involved in sex, but only 12 children (14.63%)used condoms. 68% children know benefits and proper use of condom but only 12% used them during sex.
Appropriate size of condom for the children is not available in the country. ‘Child Brigade’ (Peer educators) was highly effective.
Recommendations: Organize daylong attractive training sessions in ‘child friendly’ environments, smaller groups of similar age with energizer games. Ensure children get easy and free access to healthcare. Enhance community interaction & participation. Promote availibility of appropriate condoms for children in Bangladesh. Find means to reduce the gap between knowledge and practice.
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[MS: Again, this research shows the shockingly low knowledge levels street children have on HIV and AIDS: only 23% had some idea about HIV/AIDS, but NONE to a reasonable level... Though it is true - as the abstract also states - that knowledge alone will not lead to behaviour change, it MUST be the first step. When it comes to HIV prevention, street children are just missed out. They have no access to proper information.
Another topic that is raised in this abstract, is the availability of smaller-size condoms that are suitable to (younger) teenage boys. This is a sensitive topic, related to many taboos, but important to discuss. If we believe that condoms are one of the effective ways to prevent HIV, this issue needs to be addressed. What do you think? Maybe we can discuss this on the Discussion Forum)! Hoping to hear from you, Meindert.]
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ABSTRACT 4:
Determinants of high risk sexual behaviours among street children
M. Sajnani, S. Sengupta
Background: Determining the vulnerability of Street and Working Children with respect to STI/HIV, by assessing the complex of socio-economic, cultural and power determinants of high-risk sexual behaviours.
Methods: The study was undertaken for 8 months covering 120 street children (72 boys and 48 girls) in Calcutta. The methodology included In-depth interviews (120), Case studies, Focused group discussions, Role plays and Diagramming/Body Mapping.
Results: 4% of the girls reported history of sexual abuse/rape by a near or distant family member. 21% of the girls were engaged in regular transactional sex / sex work. Lack of toilet facilities compels girls to seek secluded places for defecation, where they are often raped/molested. Street boys reported being picked up by women for sex. Children also have sex among themselves for comfort. Street children have violent initiation ceremonies for gaining entry into the street “gangs”, wherein new entrants are raped by 4-5 older boys. 5% of boys and 8% of girls reported having sex with male migrant laborers. Myths like: “forced sex with virgins or young boys increases vigour and cures an adult of STIs”, “discharge of menstrual blood results in cleansing of the body of STIs” promote high risk behaviour. 76% of children (age group of 8-16) reported penetrative sexual activity while 61% reported sexual abuse. Anal sex is very common amongst boys (46%). 12 % of the girls and 10 % of the boys reported genital discharge and ulcers in the last six months.
Conclusions: Sexual activity and abuse, associated with coercion and violence are common among street children. Hence many children suffer from rupture of anal and vaginal membrane and bleeding during forced sex. Risk behaviours are governed by complex of survival pressures, environmental factors, economic constraints, shared beliefs, cultural perceptions and power relations. An assessment of these determinants is important in developing appropriate STD/HIV prevention programs.
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[MS: This research on street boys and girls in Calcutta shows that these children ARE at risk. For example, 1 in 5 girls were involved in exchanging sex for money or goods, and overall 76% (!) of the children - ages 8 to 16! - reported penetrative sexual activity, with anal sex being very common among boys. Also, the level of sexual abuse found in this study is very high: 61%. These children need assistance.
Still, what I miss in this abstract is the role of pleasure. What became very clear from my own research is that pleasure is one of the children's main motives for sex. Not surprising, as this is probably true for most people. And street children may be even more keen to have short-term pleasures to forget about the hardships of their lives. However, this pleasure factor is - in my opinion - too often not spoken about. Is it because we do not allow ourselves to think of children and teenagers as sexual beings? And will we be able to achieve effective behaviour change if we do not address the pleasure part of sex? Feel free to react! Meindert.]
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HOPING TO HEAR FROM YOU!
Regards,
Meindert.
| Related downloads: |  | Description of Street Children in Lahore, Pakistan by ECHD, Lahore |
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