Assessment of HIV and STI vulnerabilities and associated factors among street children in Islamabad capital territory, Pakistan

Purpose: Pakistan like most developing countries is challenged by the issue of street children, which has not been addressed optimally. This study assessed HIV (Human immunodeficiency virus) and other STI (Sexually transmitted infection) vulnerabilities and its associated factors among street children in Islamabad Capital Territory (ICT) in Pakistan. Methods: Using an analytical cross-sectional design, structured questionnaires were administered to 450 street children between 12-18 years to explore HIV and STI vulnerabilities (particularly focusing on unprotected sex and injecting drug use). Data were collected by trained interviewers from randomly selected street boys recruited from various street spots. HIV and STI vulnerability were defined as anyone who had unprotected sex and/or had history of injecting drug use. Multivariable logistic regression was conducted to identify factors associated with HIV and STIs vulnerability. All ethical protocols including taking assent were followed ensuring the safety and protection of all children. Results: A high level of HIV and STI vulnerability (73%) was reported among street children in ICT. Various factors found to have an independent association with this vulnerability included children of older age (aOR 4.5; 95% CI 2.5 - 8.3), those having higher income [aOR 2.6 (1.4 - 4.8)] for middle income group and [aOR 5.1 (2.3-11)] for highest income group, those who work for more than 10 h on the street [aOR 1.9 (1.1-3.3)], initiated work at young age [aOR 2.2 (1.3-3.8)], and children who sleep on the street at night (aOR 1.9; 95% CI 1.0-4.8). Conclusions: This study has highlighted a high level of HIV and STIs vulnerability among street boys in ICT, which underscores the importance of intensified and coordinated efforts for this extremely vulnerable population.