AIDS-risk among street children and youth: implications for intervention
Richter, L.M.; Swart-kruger, J.
South African Journal of Psychology 25(1): 31-38
1995
ISSN/ISBN: 0081-2463 PMID: 12290759 DOI: 10.1177/008124639502500105Document Number: 294623
141 males aged 11-18 years (mean age, 15 years), 79 of whom were enrolled in shelter programs and the remainder living independently on the streets, participated in 14 focus group discussions held in Pietermaritzburg, Johannesburg, Soweto, Pretoria, East London, Cape Town, Durban, and Bloemfontein, South Africa. The discussions focused upon knowledge about the transmission of AIDS and prevention, attitudes toward AIDS and people with AIDS, and sexual and other behaviors related to AIDS risk. Each group comprised 8-10 boys, each person remaining anonymous except for providing his age and a first name to use in the group discussions. All but two participants had heard of AIDS and knew that it was incurable and sexually transmitted. 93% endorsed the idea that condoms can prevent infection, but all were overwhelmingly negative about condom use and people with AIDS. None had heard of HIV and none were able to specify sperm and blood as the media for transmission. Vulnerability to AIDS was attributed to casual sex and sex with particular groups of people, but not to the act of unprotected penetrative sex. 68% were certain that they could not get AIDS from someone who looks healthy. The boys harbored other misinformation on how one may contract AIDS. All agreed that selling sex, to both men and women, is the best way to get money on the streets. They reported earning R10-200 per day depending upon the city, the customer's gender, and other circumstances. Their clients usually insisted upon unprotected penetrative oral, anal, or vaginal sex. They also engaged in survival sex to enlist or mollify powerful others, in exchange for protection, accommodation, or other goods and services; had sex with their girlfriends, many of whom also work as prostitutes; and commonly used alcohol and other drugs. Once intoxicated, the boys are more likely to have risky sex; their vulnerability to being raped also increases. These youths are neither more nor less informed or misinformed about the transmission of AIDS than their counterparts in other countries. Information alone, however, is unlikely to induce behavior change. Study results are discussed in terms of their implications for intervention and the inadequacies of the Health Belief Model and related theories as the sole theoretical foundation for the design of intervention programs.