2011年-世界发展银行全球_Glue_Sniffing_and_Other_Risky_Practices_Among_Street_Children_in_Urban_Bangladesh_63页_853kb

Summary of "GLUE SNIFFING & OTHER RISKY PRACTICES AMONG STREET CHILDREN IN URBAN BANGLADESH"

Core Content

This report examines the issue of glue sniffing and other risky practices among street children in urban Bangladesh, with a focus on HIV vulnerability and prevention. It highlights the growing concern of solvent abuse in the region, particularly among adolescents aged 11 to 19, and its potential link to injecting drug use and HIV transmission.

Main Findings

1. HIV Prevalence and Risk Among Drug Users

• Bangladesh has maintained a low overall HIV prevalence (<0.1%), largely due to effective prevention programs and high male circumcision rates.
• However, there is a concentrated HIV epidemic among injecting drug users (IDU), especially in Dhaka, with prevalence rising from 4% in 2002 to 7% in 2007/08, and slightly declining to 5.3% in 2010.
• Injecting drug use (IDU) is linked to high-risk behaviors such as sex work and unprotected sex, increasing the likelihood of HIV transmission.

2. Glue Sniffing Among Street Children

• Glue sniffing is a common practice among street children and adolescents in Dhaka and Chittagong.
• Adhesive solvents are the most frequently used, followed by thinners and balm, while cannabis and cigarette/biri smoking are also prevalent.
• Glue sniffing is associated with:
  • Early initiation into drug use
  • Transition to injecting drug use
  • Risky sexual practices
  • Low condom use and awareness of HIV/STD transmission
  • Poor health-seeking behavior

3. Demographics and Risk Behaviors

• Most respondents were slum dwellers with low educational attainment and limited income-generating activities.
• Poverty and lack of food were the primary reasons for being on the streets.
• Three-quarters of respondents identified poverty and lack of food as the main causes of street life.
• Risky sexual practices were widespread:
  • One-third of respondents reported ever having sex.
  • 60% of those who had sex were in the 11–15 age group.
  • Females were more likely to engage in sex work than males.
  • Male glue sniffers were more likely to engage in risky sexual behavior than non-sniffers.

4. Condom Use and Health Awareness

• Condom use was low among both glue sniffers and non-sniffers.
• Only 31% of male glue sniffers used condoms during their last sexual act, compared to 46% of non-sniffers.
• Female glue sniffers had 64% of them report selling sex.
• Knowledge of HIV/STD symptoms and transmission was low among the respondents, with less than half able to identify common symptoms of gonorrhoea.
• Only 19% of respondents who had heard of STDs recognized sex between men as a transmission route.

5. Health and Behavioral Consequences

• Glue sniffers were more likely to sleep in public places (25% vs. 13% of non-sniffers).
• Health complications from glue sniffing include cardiac, pulmonary, hepatic, neurological, and renal issues, as well as sudden death.
• Cannabis use leads to euphoria, relaxation, and impaired coordination, with long-term risks such as dependency, memory loss, and worsening mental health.

Key Points and Recommendations

Key Points

• Early solvent abuse is a significant risk factor for injecting drug use and HIV vulnerability.
• Street children face high levels of abuse (physical and verbal), poverty, and lack of social protection.
• Glue sniffing is cheaper, easier to access, and quick to produce a high, making it a common choice for recreational use.
• Sexual activity among street children is high, with most engaging in unprotected sex.
• Multi-sectoral interventions are needed to address the root causes of street life and prevent HIV transmission.

Recommendations

• Community mobilization and family engagement should be prioritized to prevent early drug use.
• Shelters with targeted interventions for solvent users and peer outreach should be established.
• Public education on HIV/STD prevention and awareness should be expanded.
• Targeted HIV prevention programs for street children should be developed, focusing on early intervention and safer practices.

Conclusion

The study underscores the urgent need for early intervention to prevent the transition from glue sniffing to injecting drug use, which increases HIV vulnerability. It emphasizes the importance of multi-sectoral approaches in addressing the complex issues faced by street children, including poverty, abuse, and lack of social protection. Educational and health interventions should be integrated to reduce risky behaviors and promote safer practices among adolescents and children in urban Bangladesh.