Injecting drug use

Injecting drug use

In central and Eastern Europe, where injecting drug use fuels the spread of HIV, young people living on the street are found to be especially vulnerable to HIV through injecting drug use. In St Petersburg, a study of more than three hundred 15-19 year olds living on the street found that 40 percent of them were HIV positive.¹⁷ In Ukraine, one study found a variety of HIV risk behaviours like sharing needles and unprotected and forced sex were prevalent among 10-19 year old street children,¹⁸ while a multicity study found an HIV prevalence of 18 % among street youth (aged 15-24).¹⁹ Police harassment and the general attitude of society that sees street children as ‘outcasts’ and ‘criminals’ means that that they are difficult to reach with health and social services.

Sexual transmission

Sexual transmission does not account for a high proportion of child infections but in some countries children are sexually active at an early age. This is potentially conducive to the sexual spread of HIV among children, especially in areas where condom use is low and HIV prevalence is high. In sub-Saharan Africa 16% of young females (aged 15-19) and 12% of young males reported having sex before they were 15 in 2007. In Lesotho, these figures are 16% and 30%, respectively; in Kenya, 15% and 31%.²⁰ In developing countries overall it is estimated that 6% of boys and 11% of girls have had sex by age 15.²¹

The lower the age of first sex, the higher the lifetime risk of HIV infection. This is because early sexual debut is often associated with older lifetime partners, higher rates of coerced sex and lower rates of condom usage.²²

Children are also at risk of becoming infected with HIV through sexual abuse and rape. In some parts of Africa, the myth that HIV can be cured through sex with a virgin has led to rapes, sometimes of very young children by infected men - although whether or not this is a significant factor in child sexual abuse in the region is disputed.^{23 24 25 26} In some cases, young children are trafficked into sex work, which can put them at a very high risk of becoming infected with HIV