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Risks and vulnerability to HIV, STIs and AIDS among street children in Nepal: public health approach

Karki, Sangeeta (2013) Risks and vulnerability to HIV, STIs and AIDS among street children in Nepal: public health approach. Doctoral thesis, University of Huddersfield.

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Street children are a population highly at risk of HIV/AIDS/STIs, which is becoming an overriding concern. Due to the critical importance of the problem under investigation, this study focuses on the causes and consequences of risks involved in the dynamics of HIV/STIs transmission and the occurrence of AIDS. The study utilised a qualitative paradigm, with two methods of data collection from children and young people in the street; these were observation and in-depth interviews, which emerged as the most appropriate methods for investigating the HIV/AIDS risks and vulnerability of street children. The study was guided throughout by a public health theoretical framework.

The study revealed that children leave home due to parental mistreatment; they engage in risky sexual behaviour living in the street, they have little or no understanding of HIV, AIDS and STIs or of the respective relationship between these, and they have negative attitudes towards HIV/ STIs treatment and people affected by HIV/AIDS. Four domains of HIV/STIs and AIDS risks and vulnerability of street children were identified: parental mistreatment (causing vulnerability to exposure and thus the likelihood of acquiring HIV and STIs); high risk-taking sexual behaviour (creating vulnerability to infection); lack of knowledge regarding HIV, AIDS and STIs (vulnerability to re-infection); negative attitudes towards HIV/STIs treatment and people affected by HIV/AIDS (resulting in denial, failure to seek treatment and contributing to the perpetuation of the problem); and the effects of living in the street (increasing vulnerability to progression from HIV to AIDS). By exploring the prime and subsequent root risk factors, these complex interlinking risks have been analytically conceptualised, providing a model which explicates the complete phenomenon of risks and vulnerability to HIV/STIs and AIDS for street children, as well as for broader society, in a cyclical manner. Hence, HIV/STIs and AIDS is not a health problem among street children only, it is a public health problem in the broader society in Nepal.

Having identified these problems for street children, this study offers an intervention plan, the CAP model. This model extends previous public health approaches and argues for targeted action to prevent risk and vulnerability for children in the street, and suggestions for policy and legislation which would enable the implementation of the model are offered.

Item Type: Thesis (Doctoral)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Depositing User: Elizabeth Boulton
Date Deposited: 17 Feb 2015 10:30
Last Modified: 05 Nov 2015 01:46


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