Street Life and Drug Risk Behaviors Associated with Exchanging Sex Among Male Street Children in Lahore, Pakistan

doi:10.1016/j.jadohealth.2008.09.003

Journal of Adolescent Health

Volume 44, Issue 3, March 2009, Pages 222-228

https://doi.org/10.1016/j.jadohealth.2008.09.003 Get rights and content

Abstract

Background

Throughout the developing world, children living on urban streets is a byproduct of economic deprivation. In Lahore, Pakistan, there are an estimated 5,000–7,000 street children.

Purpose

The study examined HIV risk behaviors and factors associated with exchanging sex among male street children in Lahore, Pakistan.

Methods

The survey was conducted from August 2003 to March 2004 among 565 registrants, ages 5–19, of Project Smile, a program that aimed to enhance the lives of street children in Lahore. We analyzed the frequency of and correlates of recent (past 3 months) sex exchange for money, drugs, or goods. Multivariate log–binomial regression was used to evaluate the independent effect of covariates on exchange sex.

Results

Approximately 40% of participants reported having exchanged sex during the past 3 months. In multivariate analysis, the factors associated with exchanging sex were living on the street for longer than 48 months (Prevalence Ratio [PR]=1.36, 95% Confidence Interval [CI]: 0.99–1.85), reporting ever having used drugs (PR=1.87, 1.10–3.16), cutting one's self (PR=1.66, 95% CI: 1.26–2.19), and having heard of HIV/AIDS (PR=1.36, 95% CI: 1.03–1.80) after adjusting for demographic and street life variables.

Conclusions

We found high rates of sex exchange among a sample of street children in Lahore, Pakistan. The finding that children who have heard about HIV/AIDS are more likely to exchange sex suggests that children at HIV risk talk about HIV, but accuracy of their conversations is unclear. Street children in Pakistan are in great need of HIV education and safe alternatives for generating income.

Section snippets

Study Population

The current study occurred among the first registrants of a project targeting street children in Lahore Pakistan, Project Smile (N=604). The study population has been previously detailed by Sherman et al [5]. Project Smile was established in August 2003 and aimed to enhance street children's quality of life by providing basic health care, nutrition, and clothing and reducing drug use and HIV–related risk behaviors associated with living on the streets. To this end, it provides social and

Results

Univariate analyses are displayed in Table 1. Higher rates of exchange sex were reported by: 2 categories of older children (29.3% vs. 19.9% of 15–19 yr olds, p < .0001 and 21.4% vs. 15.5% of 14 year olds, p = .007), those making more than 70 rupees (US $1.14) a day (30.1% vs. 19.9%, p = .007), those reporting more education (completed grades one or two, 30.6% vs. 23.8%, p = .03), those who reported living on the street for longer than 48 months (27.9% vs. 9.2%, p < .0001), those who reported

Discussion

The aims of this paper were to examine the potential risk of HIV/AIDS among street children in Lahore, Pakistan and to identify what factors were associated with exchange sex. We focused on the outcome of exchange sex because it is considered one of the riskiest forms of sexual behavior associated with HIV infection [33], [41], [42]. The principal findings of this study showed that a very high proportion of street children in Lahore, Pakistan reported engaging in high risk drug use and sexual

Acknowledgements

We acknowledge and thank Muhammad Ayub and S.M. Saeed for collecting all of the registration data.

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Citation Excerpt :
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: This research was supported by a grant from the National Institute of Drug Abuse (DA14702). Project Smile is funded by the European Commission.

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Original articleStreet Life and Drug Risk Behaviors Associated with Exchanging Sex Among Male Street Children in Lahore, Pakistan

Abstract

Background

Purpose

Methods

Results

Conclusions

Section snippets

Study Population

Results

Discussion

Acknowledgements

Drug use, street survival, and risk behaviors among street children in Lahore, Pakistan

J Urban Health

Sexual and drug use risk behaviors among children and youth in street circumstances in Porto Alegre, Brazil

AIDS Behav

Street and working children of Delhi, India, misusing toluene: an ethnographic exploration

Subst Use Misuse

Life on streets

The Indian Journal of Pediatrics

Children in the streets of Brazil: drug use, crime, violence, and HIV risks

Subst Use Misuse

Street children and their relationship with the police

Int Nurs Rev

Food insecurity among homeless and runaway adolescents

Public Health Nutr

Health problems of street children in Eldoret, Kenya

East Afr Med J

Eating rough: food sources and acquisition practices of homeless young people in Adelaide, South Australia

Public Health Nutr

A descriptive study on street children living in a southern city of Turkey

Turk J Pediatr

The frequency of sexual abuse and depression in a sample of street children of one of deprived districts of Tehran

J Child Sex Abus

Coping and suicidality among homeless youth

J Adolesc

Human immunodeficiency syndrome and hepatitis B and C infections among homeless adolescents

Semin Pediatr Infect Dis

Hepatitis B virus infection among street youths in Montreal

CMAJ

Growth and health status of street children in Dhaka, Bangladesh

Am J Hum Biol

The health and well-being of neglected, abused and exploited children: the Kyiv Street Children Project

Child Abuse Negl

Mental health status of runaway adolescents

The Indian Journal of Pediatrics

[Street child work in Latin American capitals]

Salud Publica Mex

Street children and child labour around the world

Lancet

Street children of Bombay: Their stresses and strategies of coping

Children and Youth Services Review

Use of drugs among street children in Brazil

J Psychoactive Drugs

Original article
Street Life and Drug Risk Behaviors Associated with Exchanging Sex Among Male Street Children in Lahore, Pakistan