RESUMO
METHODS: From June 1989 to April 1991, 394 adolescents aged 10-18 years randomly selected upon admission at a state shelter in Belo Horizonte, Brazil underwent health history interview, physical examination, serology for HIV, hepatitis B, and syphilis, and stool examination. Participants were classified as street-based youths (n = 195) or home-based youths (n = 199). The age distribution was similar in both groups, although males were overrepresented among street-based youths (79.5% versus 62.3%). RESULTS: Compared with home-based youths, street-based youths reported earlier onset (p = 0.009) and higher rates of sexual activity (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.4-3.3), sexual abuse (OR, 3.7; 95% CI, 1.2-10.1), and sexually transmitted diseases (OR, 2.9; 95% CI, 1.3-6.6). Overall condom use was low in both groups. Street-based youths were 7.8 times more likely to use drugs than home-based youths (95% CI, 4.9-12.7). Inhalants and marijuana were the more commonly used drugs. Intravenous drug use was low. CONCLUSIONS: Although chronic malnutrition and multiple parasitosis were common findings in both groups, street-based youths were more likely to present disorders related to trauma and poor hygienic conditions. Antibodies to HIV were detected in four (2%) street-based youths and in none of the home-based youths. This study confirms that street youths are at higher risk for HIV infection than their home-based peers and indicates a need for HIV prevention programs targeting this population.
Assuntos
Comportamento do Adolescente , Infecções por HIV/epidemiologia , Comportamentos Relacionados com a Saúde , Nível de Saúde , Pessoas Mal Alojadas , Pobreza , Assunção de Riscos , Adolescente , Distribuição por Idade , Brasil/epidemiologia , Criança , Intervalos de Confiança , Feminino , Infecções por HIV/prevenção & controle , Infecções por HIV/transmissão , Necessidades e Demandas de Serviços de Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Morbidade , Razão de Chances , Fatores de RiscoRESUMO
PIP: Physicians at the Federal University of Minas Gerais, Brazil, in 1989 teamed up with the Archdiocese Street Youth Ministry to finance Clinica Ammor, the Street Kids' Clinic of Belo Horizonte. Belo Horizonte is the third largest city in Brazil, with a population of 3.5 million. Although the clinic was established to study risk behavior for HIV, a far greater need was found for medical care and education of which HIV is only a small part. A doctor and a nurse offer drop-in care to children and adolescents who live on the street. More than 600 children came for an average of four visits during the first three years ranging in age from the newborn to over 20 years. 80% of clients, however, have been aged 12-18; 75% are male. The staff encourages complete check-ups, including HIV testing, as part of an ongoing program to develop body and health awareness. Medication and laboratory examinations are provided to the extent that available resources permit. When appropriate, clients are referred to various specialized medical facilities in the city. Sex and drug education focus upon the prevention of HIV infection and other sexually transmitted diseases. Special attention is given to street girls and their babies. The clinic since March 1991 has participated in the Integrated Plan for Attention to Street Youth in Belo Horizonte, a group of 17 governmental and nongovernmental organizations which work with street youth in the city. The clinic would like to add a social worker, a part-time pediatrician, and a part-time gynecologist-obstetrician. Funding is needed to continue and expand services. The author stresses that successful AIDS prevention must be linked to projects concerned with the reality and reasons for the marginalization of street children and promote changes at that level. Intimate staff-client interaction at the clinic conveys to the youths a message of commitment, respect, and self value.^ieng