South Asia has 584 million children, the largest number under the age of 18 of any region in the world. Of these, 330 million suffer from poverty and deprivation, according to a Unicef report.
Street children constitute a marginalised group in most societies. The harsh environments in which they live and the nature of their lifestyles make them vulnerable to drug abuse.
This threatens their mental, physical, social and spiritual health. Most of these children use alcohol and other drugs. Due to their experiences, they view health and social services with suspicion.
Some aspects of street life such as extreme mobility, low knowledge of HIV, recreational sex, lack of adequate responsible adult protection and supervision compound the vulnerability of street children.
Very little data is available on street children living with HIV/AIDS in South Asia. The latest HIV/AIDS estimates prepared by Unicef indicate that in 2005 there were 36,000 new infections among the children in South Asia less than 14 years old.
Street children are vulnerable to HIV and other sexually transmitted infections primarily due to sexual contacts with multiple partners, forced sex, drug abuse, related risky behaviour and injecting drug use.
Intravenous drug users (IDUs) are at risk of contracting HIV and can pass it on to their sexual partners. Drug users are also more likely to engage in risky sexual behaviour.
Street children spend a lot of time in settings where casual sexual encounters occur. They run more risk of being infected because they often have sex with persons who practice risky behaviour themselves, like having multiple sexual partners or sharing injecting equipment.
Any intervention by anybody trying to help street children is a challenge.
To start with, these children are hard to reach. Voluntary groups who work with street children often find they are unable to carry out follow-up activities because they simply cannot find the children.
There is no comprehensive package of services for addressing HIV prevention for street children, such as voluntary counselling and testing centres or appropriate outreach. There are very few drug detoxification facilities for children. The few facilities that exist are expensive. As a result, it is a huge challenge to motivate street children to opt for detoxification.
The United Nations Office for Drugs and Crime (UNODC) has been advocating an approach in which the friends of the street children take the lead in all intervention activities. The intervention should be designed to bring about a change at individual and community levels.
Any prevention strategy for street children should create awareness on risks associated with drug use and HIV by delivering 'key messages' on how to reduce risk. It should use the peer network to provide information on drugs, HIV and life skills. The information should be child friendly. Drug treatment centres also need to be made more child-friendly and approachable, UNODC suggests.
A long-term approach to working with street children has to take into account basic needs like food, clothing, shelter and access to health services. Such an approach should include vocational training so that these children can lead productive lives.
Voluntary groups working with street children should be specially trained to address issues of drug abuse and HIV.
Each year, June 26 is observed as the International Day against Drug Abuse and Illicit Trafficking. It provides an opportunity to focus on a largely neglected population that needs urgent attention.