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 Saturday 02 August 2008
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KENYA: HIV services are scarce on the street

Photo: Allan Gichigi/IRIN
It's easier for street people to get drugs than healthcare
MOMBASA, 29 July 2008 (PlusNews) - In the next four months, Rashid Mwaneno Dona will become the father of a baby that he and his girlfriend, Fatma Chelimo, conceived while living on the streets of Mombasa, on the Kenyan coast.

The excited couple have already chosen names: if it is a boy, he will be named DJ, in honour of Dona's dream career; if a girl, she will be named Tamara, after a benefactor of local street children.

Before starting a sexual relationship, Dona and Chelimo went to a local voluntary counselling and testing centre for an HIV test. "This test changed our lives; we have decided that we have nothing to do with other people, we are going to stick together until we get our baby and think seriously about how to bring it up," Dona told IRIN/PlusNews.

They are an exception rather than the rule; few people living on the street choose to take HIV tests before sexual activity.

"They have become hardened by life on the streets and their main priorities are finding food and day-to-day survival - they rarely think about the implications of unprotected sex," said Dinah Wairimu, a justice and human rights officer for Youth Alive, a Kenyan NGO working with young people.

A high-risk life

"These people have to make a living, so the girls often turn to sex work and will easily have sex without protection; they are also unprotected from sexual violence," Wairimu said. "They are especially vulnerable because many are children orphaned by HIV and have had no real family structures around them when they were growing up."

Illegal drugs were widely available on the streets, and while high on glue and other substances, young people often made unsafe sexual choices or shared needles, putting themselves at greater risk of contracting HIV.

"The majority of the street families in Mombasa and elsewhere have succumbed to HIV due to the 'don't care' lifestyle practiced on the streets," Dona said, adding that people living on the street were extremely sexually active.

A 2004 study on the sexual behaviour of street children in Kenya's capital, Nairobi, by The Society of People with AIDS in Kenya, found that street children began sexual activity between 12 and 14 years of age, and about 80 percent of them were drug users; they also reported being sexually abused.

The researchers found that although most boys and girls knew about the possible consequences of unprotected sex - including pregnancy and sexually transmitted infections - they rarely took this into consideration before engaging in sex, and only a minority used contraceptives.

In Mombasa, child sex tourism is extremely common, and according to a 2006 study by the government and the United Nations Children's Fund, many of the city's child sex workers had spent part of their lives on the street.

Not welcome in hospitals

"There are no programmes directly targeting these people for HIV education - most programmes are geared towards getting them off the street," said Wairimu. "At the group homes they go to they may get HIV education, but not on the streets."

Moreover, street people found it hard to get medical care. "Many hospitals don't accept them; if they get pregnant they give birth on the street and raise their babies on the street," she said.

''Many hospitals don't accept them; if they get pregnant they give birth on the street and raise their babies on the street.''
Many teenagers, children and even families living on the streets found it difficult to access counselling, testing for sexually transmitted infections and treatment, including life-saving ARV [antiretroviral] drugs and the necessary support to ensure that those who were not infected remained uninfected.

"The most common problem street families face is that they suffer TB [tuberculosis], which could be [related to] HIV, but they do not want to come out in the open to seek treatment," Dona said.

Chelimo had learned about HIV before she started living on the streets in early adulthood and sought the help of social workers at the local Tonoka Social Hall as soon as she discovered she was pregnant, and began attending the antenatal clinic.

Soon after, a fire gutted "Maboxini", a construction of cardboard boxes behind a local bank that she and Dona called home, and her clinic records were burnt. "Since these vital documents were destroyed it has become extremely difficult to receive the care I need because I do not have the records for my pre-natal clinic," she said. The records are required for attending the clinic.

However, she Dona and were lucky; they were able to find accommodation at Tonoka Social Hall, where they get cooked meals every day and have a bed and blanket.

Wairimu said because only a small number of people on the street managed to permanently rejoin mainstream society, there was a need for HIV education among them, and for hospitals to be more sensitive to their needs.

Kenya has an estimated 300,000 street children, 60,000 of whom live in the capital, Nairobi. Mombasa and the western city of Kisumu also have large numbers of children and young adults living on the streets.


Theme(s): (IRIN) Children, (IRIN) HIV/AIDS (PlusNews), (IRIN) Urban Risk


[This report does not necessarily reflect the views of the United Nations]
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This material comes to you via IRIN, the humanitarian news and analysis service of the UN Office for the Coordination of Humanitarian Affairs. The opinions expressed do not necessarily reflect those of the United Nations or its Member States. Republication is subject to terms and conditions as set out in the IRIN copyright page.