Vulnerability to sexually transmitted disease: street children in Accra.

A street child is someone under age 18 years who spends a considerable amount of time living or working on the street. Street children may have either run away from the home without their parents' permission, been forced onto the streets by their parents, or be orphans. Data are presented on 1147 street children aged 8-19 years interviewed between May 13 and June 9, 1997, in four market areas of Accra. Respondents also participated in focus group discussions. They were of mean age 16.1 years with 75% aged 15-19 years and only 2% under age 10. 60% of the sample is male. The street children were from all regions of Ghana, although the highest proportion of 22.1% was from the Ashanti Region, 20.1% from the Northern Region, and 14.6% from the Eastern Region. Most respondents are sexually active and typically had their first sexual experience on the street and with prostitutes. Most have multiple sex partners, some engage in homosexual activity, and they rarely and inconsistently use condoms despite being aware of AIDS. The children were more ignorant of other sexually transmitted diseases (STDs) against which they tend to self-medicate. Some girls provide sex in exchange for money. Street children are therefore at high risk for contracting and transmitting HIV and other STDs. They are also exposed to physical and social elements which may adversely affect their health, have repeated illness and infections which receive inadequate treatment, and consume recreational drugs.