Surviving on the streets: Sexuality and HIV/AIDS among Male Street youth

in Dessie, Ethiopia

Getnet Tadele
Abstract

This study in Dessie, a provincial town in Ethiopia, is part of the research findings of my ongoing
PhD project titled Ethnography of Sex: An Exploration of the Socio-economic and Cultural
Context of Sexuality and HIV/AIDS among Ethiopian Youth. Three focus group discussions
(FGDs) with a total of 30 street children were conducted, and a lot of informal talks and
discussions were held during the entire fieldwork period that took place between October 2001February 2002. The study revealed that street children and youth gain very little from their daily
activities. They feel bored and frustrated with life because they cannot engage in gainful
employment through which they could earn money. Given their preoccupation with unemployment
and lack of money, the problem of HIV/AIDS was not raised in discussions about difficulties and
worries in their daily life. Their knowledge about HIV/AIDS was fragmented, but they were aware
of the necessity to use condoms. Contrary to popular beliefs, the informants remarked that it is
safer to have sex with prostitutes than with 'ordinary' girls or female students, because the former
are more careful and insist on the use of condoms. The paper argues that the context should be
specified in order to claim that prostitutes consistently use condoms.

Key words: sexuality, HIV/AIDS, street children, adolescents, Ethiopia

There is no place where we can find work and we are forced to think of other undesirable
alternatives which we would have previously been glad to avoid, things like theft and the like. We
are under great worry right now. We have no parents or relatives or any one who can take care of
us. Our labour is our only means (our father and mother are our labour) and now that we have
been prevented even from earning our bread from our own labour, we can only make a living out
of theft. This is your work [he said pointing to the microphone he was holding while being
interviewed], if the government prevents you from doing it and even goes as far as chasing you,
you will surely be in great mess about how you are going to make a living. What you will do and
where you will find work and that isnt easy if you were in our condition. So you will be forced to
feel that you are isolated, and you will not feel any respect for society, and wont be at peace with
it. You might even be forced to go into politics [he likely meant forceful opposition of the
government] rather than thinking of how you could learn or improve your condition or how you
can contribute to your country. All your plans and goals will be disrupted. Why should I be made
to lose all hope of one day becoming a person at such an early age? The government should
have been extending its helpful hands to us and should have provided us with education so that
we can in turn contribute to our country. But look what it is doing to us; it is making it hard for us
even to lead a life of hand to mouth (keje wode afe) by our own labour. In place of being given
hope and encouragement, we are being forced to give up all our hopes of improvement, and lead
a careless and hopeless life. And only the government is the cause for it because if possible it
should have helped us to be productive, but we understand that our country is poor and such help
couldnt come and we dont just sit demanding it. But then it shouldnt be cutting us short of any
limited incomes we previously had by doing such activities. Some one has to do something about
this, but we do not even find the chance to voice our concerns and problems even when we are
oppressed as much as this.
The above quotation was spontaneously expressed by one of the street boys in Dessie, a
provincial town in Ethiopia, in response to a question about their day-to-day concerns and
problems. All of the other participants in FGDs agreed with his view.

The street children and youth involved in the study used to work in the bus station, helping
passengers with their luggage (loading and unloading luggage) from buses and washing cars.
But at the time of the interview, they had been barred from entering the station; they had to do
whatever work they could find outside (and there wasnt much). They explained that the
administration of the local bus station had selected 15 workers and allowed only them into the
bus station. This action had caused great difficulties for those who were not selected to work
inside. Those working outside are finding it very difficult even to get money. Some of them spend
a day or a night without any food.
When they were asked to air their concerns and problems in their daily life, it became clear that
the fear of HIV/AIDS and efforts to protect themselves from being infected had no urgency for
them. Further, when they were asked how AIDS compares to other problems, and how significant
it is in their daily lives, they replied that they are more worried about how they can satisfy their
daily need for food than they are about AIDS. One boy said we are much more worried about the
conditions of our daily lives (than AIDS). We dont even find food enough to satisfy our stomachs
and what we worry about is usually what will we eat today and you cannot eat if you dont work.
Therefore, even trying just to live is becoming a great problem to us and worries us a lot.
Obtaining food, money and improving their appalling living conditions were what preoccupied
them most.
The street children that are engaged in shoe shining also expressed similar feelings of
helplessness, despair and frustration. One shoeshine boy, for instance, said I want to quit shoeshining and want to do something else because students at school treat me as an inferior just
because I clean peoples shoes, and it really enrages me. Therefore, I am worried about how I
can find another source of livelihood and quit shoe-shining. I have enough of being a shoe-shiner
(listro) and wont hesitate to quit, but only if I find another job. What worries me more is whether I
can do anything better than shining shoes, and not AIDS. We are worried about our lives. We
usually do not find enough to eat (while one eats the other starves). 
All the other street children agreed that HIV does not worry them, and what concerns them is how
1
they can improve their miserable lives. One informant (Seyoum) in one of the focus group
discussions voiced a worry that had not been hitherto expressed in the discussion with street
children. He began by saying what worries us very much is AIDS, but did not proceed any further
because most of the participants who did not think of AIDS as a worry urged him to speak for
himself and to stop pretending to be their spokesperson. It appeared that for most street children,
unemployment, lack of money and other problems of mere survival overshadow the fear of
HIV/AIDS infection.
The objective of this paper is not to depict the predicament of street children to attract sympathy
for their plight. I, however, started with the above quotation to inform the readers how street
children downgraded HIV/AIDS as problem in their lives due to preoccupation with immediate
survival concerns. This paper mainly focuses on how male street children understand and
express sexuality and HIV/AIDS in their daily lives. I decided to write on male street children only,
as the data obtained from female street children was not comparable. Most of the female street
children included in this study are engaged in different kinds of peddling during the day, and stay
with their families during the night. Additionally, almost all of them attend school half-days. As a
result, the information obtained from them closely resembles that of other informants attending
school (non-street children). Compared to male street children, the street girls appeared well
informed about HIV/AIDS and sexuality.
Background

Dessie, with a population of 97,314 (1994 census), is situated 400 kilometres from Addis Ababa
on the road that runs north to Mekele in Tigray. Because it is located on a main trucking route,
1

Pseudonyms are used to protect the identity of the participants

there are many hotels and bars; these form an important centre of business life. There are a
number of prostitutes who cater to passengers and drivers who pass through the town, as well as
to local residents. There are also a lot of illegal video houses that operate underground to avoid
legal action, and young people frequently visit such places. Therefore, hotels, bars and sex work
are an integral part of the towns formal and informal economy along with small retail business. 
Dessie is a town with cold weather, surrounded by mountains and a rocky landscape. Previous
rulers opted to establish Dessie not for the sake of building a town but for its suitability to defend
themselves from enemies. Many past regimes have used the town of Dessie as their
administrative capital for the province of Wollo. Until the 1974 revolution, the town served as a
seat for the crown princes and governors who were assigned by the Emperor to administer the
region. Between 1974 and 1991, it served as the administrative capital of what was then the
Wollo province (kifle-hager) and also housed the regional headquarters of the then ruling party.
From 1991 onwards, although its scope of administration has diminished, it continues to serve as
the administrative capital for the South Wollo Administrative Zone, and houses a number of civil,
non-government, religious and administrative offices.
Owing to its terrain and its fast growing population, the town of Dessie is more prone to a host of
socio-economic problems than other towns in the region. Due to its location between mountains,
much of the towns land is hilly, and the water that runs down the surrounding mountains has
eroded much of the towns land. Landslides, which frequently occur in many neighbourhoods of
the town, account for a major portion of these problems. In addition to damaging and/or
destroying buildings, houses and other infrastructure, the frequent landslides discourage
investment activities. Still another acute problem witnessed in Dessie is the problem of urban
poverty. The growing size of congested neighbourhoods chiefly populated by low-income
families, the deteriorating condition of the towns roads and its sanitation and the ever-growing
number of street people/children/ as a whole are all evidence of the increase in urban poverty.
The increasing number of street children is one of the most serious urban social problems facing
Ethiopia today. It has been estimated that as many as 100,000 children are engaged, to varying
degrees, in street-life activities (Veal and Adefresew, 1993). This is perhaps a conservative figure;
recent unofficial reports estimate up to 200,000 street children in the country. The majority of these
children are living in conditions of severe deprivation, which place them at all kinds of health risks.
Inadequate nutrition, long working hours, exposure to adverse weather conditions and physical
abuse while on the streets endanger their physical, mental and social development.
Since the fall of the Derg regime in May 1991, there have been widespread fears that the number of
children coming to live on urban streets has further increased. The number of street children has
been exacerbated by high inflation rates, structural adjustment programs, increased urban poverty
and the lifting of restrictions on the movements of individuals, which has resulted in an influx of
economic migrants and the displaced to Addis Ababa and other major urban centres of the country.
During this period of instability, family members were dispersed, parents and children were
separated, and many children were abandoned or simply went missing, which contributed heavily to
the prevalence of the problem of street children (Veal and Adefresew, 1993). The problem of street
children is worsening because of the AIDS pandemic, which is reported to have killed an estimated
300,000 people of the country's population. As a result, there are about one million AIDS orphans,
and many of these children have ended up on the streets, or will eventually end up there.
Current Research

Richens (1994) indicated the prevalence of STDs, little knowledge about HIV/AIDS and the part
played by sex in exchange for favours, in terms of goods and money among street children. Other
studies also emphasised the need for more research that focuses on cultural and contextual
understanding of the circumstances in which street children pursue and engage in sex (UNAIDS,
1999). A South African study on street children noted the inadequacy of rational choice models of

risk assessment and decision making (like the Health Belief Model and the theory of Reasoned
Action) in the face of coercive sexual contexts, pointing to social conditions of risk taking beyond
the control of the individual (Swart-Kruger and Richter, 1997). That study further noted that fear
of HIV infection did not appear in a list of day-to-day priorities constructed by the children, a list
dominated by survival concerns with food, money and clothes. Ruiz (1994) stressed the
importance of understanding street life as a culture that contextualises risk-taking behaviour in
Colombia. Raffaelli et al (1993), using a combination of qualitative and quantitative methods,
have described the integrated nature of sex in exchange for goods, services, and sexual pleasure
(an important and often neglected aspect) in street life in a study of the early and diverse sexual
experiences of street children in Brazil. Overall, these and other studies underlined the
importance of understanding sexual behaviour among street children, not as isolated and
individual risk-taking, but as aspects of collective behaviour deeply embedded in their way of life
(UNAIDS, 1999).
Available data showed that HIV sero-prevalence rates for street children are 10-25 times higher than
other groups of adolescents in many countries. This is because street children are reported to
become sexually active earlier than most other groups of adolescents (Rotheram-Borus et al., 1991
in Swart-Kruger and Richter, 1997), engage in sex with many sexual partners (Luna and RotheramBorus, 1992 in Swart-Kruger and Richter, 1997), are likely to be raped or forced into sexual
relationships to ensure their survival, use condoms infrequently and inconsistently and get
inadequate information about sexuality and protection due to illiteracy and non-attendance of school
(Filgueiras, 1993 in Swart-Kruger and Richter, 1997).
In Ethiopia, almost all studies on sexuality and HIV/AIDS have been conducted among high
school and college students. The less accessible group of young people (out of school and street
children) have been neglected (Fantahun and Chala, 1996; Taffa, 1998). In Africa in general and
in Ethiopia in particular, where the proportion of school-aged youth enrolled in school is only
about one-third of that age group, out-of-school adolescents are overlooked and deserve more
attention. To date, little is known about the sexuality of street children and youth, how HIV affects
this group, whether they have access to AIDS prevention information and, if so, to what extent
(Carballo & Kenya, 1994). This study aims at filling this lacuna.

Sources and Methods

For the purpose of this study, the terms street children and street youth will be used
interchangeably to mean young street children/youth in the broad age group of 15 to 27 years of
age. The majority of street children were recruited randomly from around the towns bus station
2
on the basis of their willingness to participate in the study. Asrat (a peer research assistant) and I
went to the bus station and enquired for volunteers to participate in the study. We succeeded in
getting many volunteers since we promised to pay them about 1.17 USD for the time they spent
with us. As for recruiting shoe shiners, I befriended with one shoe shiner and he recruited all of
the other participants engaged in shoe shining (listro) in the central square of the town called the
piazza.
Almost all of the informants recruited from the bus station were marked with the signs of street
life. Their tattered and dirt-encrusted clothes looked as if they have been rinsed in tar. Their
hands were dirty, and their fingernails were filled with black filth. Their hair was overgrown and
dirty, their mouths and lips were dry and cracked, and their bare feet were covered in scaly skin.
Some of them, especially the older ones, were better dressed, but their clothes, hands and
fingernails were also packed with filth. Some had fresh scratches all over their faces. They
themselves have become as black as the dirt that seems to swallow them. Their general physical
condition clearly reflected the life they were leading, a careless life that proceeds precariously
from day to day. 
2

When I use we in the text, I am referring to Asrat and myself

The informants in this study have been on the streets for three to nine years. None have
completed their schooling or have gone beyond Elementary school. Some of them were born and
grew up in Dessie, others have come to the town from other places. They were very mobile
because they sometimes worked on lorries and buses as assistants. Washing cars, assisting
drivers and performing a number of odd (sometimes backbreaking) tasks are the main means of
survival on the streets for the majority of the participants. Their dependence on the transport sector
and their closeness to drivers is even expressed in the language they use to express sexual
issues. Some of the terms they use have their origins in the name of spare parts for cars.
Most of the participants have lost one or both of their parents. The majority were homeless, and
they spent the night in dangerous, unsheltered and cold environments. Some of them slept in the
streets while others slept in floors rented for 6 cents US per night. They noted that they sleep on
the streets very close to one another to feel warm at night, but when one of them wakes up in the
middle of the night to urinate, he exposes the others close to him to the cold (berde). Most of
them smoke while the number of those chewing catha adulis (chat) increases. All but one were
sexually active and engaged in sex relationship with prostitutes whenever they could afford to.
Unstructured interview questions were designed to guide data collection in FGDs. With some
limitations, FGDs are an effective way to explore in-depth attitudes about sensitive and complex
issues pertaining to sex and sexual behaviour. This method is particularly effective when dealing with
delicate, intimate topics among Africans with strong oral traditions. If moderators can arrange open
and informal discussions, FGDs encourage spontaneous expression of individual ideas, as well as
exchange of ideas between group members (Irwin et al., 1991). The discussions covered sources
of general information about sexuality and HIV/AIDS, young peoples perceptions of problems
and difficulties and perceptions of future life. The discussions also addressed the start of boy-girl
relationships, marriage and pre-marital sex, sexual socialisation, the act of sex, sexual norms,
values and deviance, safe sex, condoms and condom use and other issues related with
HIV/AIDS.
Three FGDs with a total of 30 street children were conducted on the premises of the branch office
of Family Guidance Association of Ethiopia. The members in each FGD showed signs of intimate
knowledge of each others behaviour. When the participants were not pleased with what one of
the participants said, they told him to stop lying and tell the truth. For instance, when Adera said
he drinks, smokes and chews chat but that he does not go to women, one participant joked with
him, speculating with disbelieving face if he was still a virgin. Adera replied coldly, I have a
girlfriend. I go out with her. Further, when two of the participants (Hussien and Tadese) claimed
they had no sexual experience at all, Husseins statement was dismissed as a lie by the other
participants, whereas Tadeses claim was endorsed when some mentioned that the rest of the
group called him the priest (qesu).
All the discussions were in Amharic (the official language of the country). They were taperecorded, transcribed and translated. Further, notes were taken about group dynamics, particular
reactions and number of informants endorsing a particular position. These were latter
incorporated into the transcriptions. All FGDs were conducted in two sessions, and each
discussion session lasted for about two hours. At the end of the second discussion, the
informants were given the chance to raise issues and concerns surrounding sexuality and
HIV/AIDS that need clarification. In addition to formal FGDs, a lot of informal talks and
discussions were held during the entire fieldwork period that took place between October 2001February 2002. What follows is the presentations of these discussions.
Sexual Morals, Manners and Taboos

When the participants were asked if there was such a thing as normal sex, and how they felt
about anal and oral eroticism, some of them argued that unrestrained (liqe) sexual intercourse is
not normal sex. Asked what they meant by the term liqe, some of the informants noted that it

meant very free or loose sex that may not be imagined to be committed by human beings, for
example sucking the penis or licking the vagina. Others pointed that homosexuality is also liqe.
Still others replied liqe sexual intercourse means when a married man goes to prostitutes and has
sex with them while keeping his wife waiting for him in his house. And still others said liqe sexual
intercourse is sex without condoms.
When probed further about other sexual values and norms, some debated that they wouldnt
mind it if the opposite sexes had sex in whatever way that pleases them. However, homosexuality
or lesbianism was not a good thing in their opinion. Others, however, disagreed that any kind of
sex that pleases couples was acceptable. They said even married couples have to stick to the
usual methods of having sex because sex has only two purposes: to satisfy ones sexual desires
and reproduction, and both purposes can be satisfied through vaginal-penal intercourse. They
added that it wouldnt be good for children to grow up hearing or seeing oral or anal sex within
their families. One informant said that he heard that when semen is released inside the rectum
during anal sex, worms begin to grow internally, and then the person who received it will be a
homo and anal sex would have the same effect on girls (it makes them lesbians). 
Other informants said that they have heard reports of oral and anal sex but have not seen any or
experienced it themselves. They voiced that such practices are abnormal/impolite/indecent
(newere), and added that licking the vagina with the same mouth that eats bread and injera (flat
bread which is staple food in the country) is absolutely newere and that God does not like it. One
participant added that he had seen such things only in pornographic films and that he opposes
such practices because they are against culture and against nature. He added that both the man
and woman have organs designated by nature for sexual intercourse and they should use them
appropriately.
Pornographic movies can be seen in a number of movie houses in Dessie. We visited a couple
of such places, and the size of the audience, which consisted of boys as young as eleven and
twelve years old, was really surprising. During one visit, there were about a hundred and fifty
boys crammed in a very small, untidy room that even lacked proper chairs. We sat on very long
logs with not more than 20 cm between each row. We were relatively comfortable, as there were
many more people who were standing. The room was filled beyond its capacity; every centimetre
of ground that could hold a standing boy was occupied. Many others had to be told to return
another time because there was no more space in the room; everyone was already standing on
their toes to be able to see the film. We watched the film for a while; masturbation, sucking,
licking, anal sex and various sex positions that seemed more like circus acts filled the screen one
after the other. One of our informants had taken us there. He was a student, and was wearing his
school uniform. We inquired if he felt ashamed to go into such a movie house wearing his
uniform. It is no odd thing for a student to see a porn movie. Why would it make me feel
ashamed? he answered.
When our informants, both street children and students, were asked about occasions and
circumstances that stimulate and facilitate first-time sexual intercourse among youth, they were
quick to mention video houses and the cinema as places where young people learn the ways of
sex and where they imitate western decadent culture. One boy, for instance, emphasised the
role played by video films in encouraging young people to engage in sex. He said that young
people do not draw a line between what should be taken as educational, what should be seen as
entertaining and what should be deemed as crap from films dumped there by the Western world.
He said that video films serve as the main initiators of rushing into sex- to see in practice what
they have seen on video. The key informants involved in the study also emphasised how such
pornographic films negatively affected sexuality of young people. Perhaps due to such discourse,
the government closed most of these underground pornographic houses in early 2002, and I am
not aware of the situation of those porno houses now. 
As far as sexual positions were concerned, the informants identified thirteen different ones. All
these positions were considered to be sexual deviancies, and not as part of what is called
normal sex, in which the man penetrates while the woman lies on in her back as our fathers and
forefathers have done. The other positions were described as harmful to the women because of

potential damage to the uterus. Prostitutes submit to them for money and not because they like it,
and are sometimes even forced into them. Such positions are also not good for males because
they exhaust and harm them. Another negative effect of using non-conventional positions was
said to be the very emotional situation that may cause pneumonia due to draft or cold. A final
reason is that they involve much struggle and friction between the two bodies, which usually
cause condoms to be torn in the process. Most of them said that these positions should better be
avoided and are usually done under the influence of alcohol.
As far as dressing revealingly was concerned, some asserted that they see no problem if girls
wear clothes that expose their bodies, saying that their body is part of their beauty and they have
the right to display it. Other participants did not agree and said girls do that to attract men and
that sometimes causes some men to do what they wouldnt have done otherwise. They said
some men come to the piazza to see womens bodies and that is not good. Especially in the
evenings, part-time students (evening students as they call them) wear very exposing clothes.
This induce men to have unplanned sex, and leads to the spread of HIV.
All the participants agreed that masturbation (sega) is not a good thing to do. They have heard
that it leads to sterility, mental disturbances, causes spinal deformation, reduces interest in the
opposite sex and causes difficulties with seeing. When hinted that some young people consider
masturbation as the best means of abstaining from sex, and that it reduces their chances of
contracting HIV/AIDS, they asked how it can be seen as an alternative, if it shatters ones hope of
one day living with a wife and children by causing sterility, madness and reducing ones interest in
girls. They added that sega is not good because it will make one loose weight (losing sperm is
usually understood to lead to the losing of body weight) if frequently done. One boy said that if
you buy sex, you will not do it frequently because you need money to do it, but sega requires no
money and if you are used to it you are likely to do it often and loose weight pretty quickly. He
only tried it once, and that was enough to convince him never to do it again because, as he
claimed, it made him feel so drowsy that he couldnt even walk properly. Furthermore, they didnt
see any need for it while there are enough prostitutes out there.
All the participants agreed that they have heard of homosexuals and homosexuality (both gay
and lesbian), but they have never met any such people. They unanimously remarked that it is an
detestable practice and had never engaged in it. In discussing these sorts of matters, one
encounters one of the shortcomings of FGDs. One problem with a FGD is that taboo behaviours
might be practised by individuals, but not revealed in the group setting. Homosexuality and
masturbation are possible examples. Masturbation particularly may be more prevalent than the
boys admitted to, but the group norm was clearly anti-homosexuality and anti-masturbation. It
would be worthwhile checking whether homosexuality and masturbation are more commonly
practised through individual interviews.
Circumcision was considered necessary because it was considered to be a culture of our fathers
and a hygienic imperative. They added that they have heard that uncircumcised (woshela) men
cannot impregnate women and such men easily contract STDs because their semen remains in
the foreskin and can develop into fungus or even STDs. Moreover, women were said not to
consider uncircumcised men as masculine.
Love and relationships among street children

Almost none of the street children informants knew anything about boy-girl relationships, except
for buying sex from prostitutes when the need arises. Desperate boys hungry for sex go to
women/girls equally desperate for some cash. Unlike the students involved in this study, street
children didnt report having same-aged girlfriends with whom they had a romantic relationship.
The reasons given for not having girlfriends were related to the boys low self-esteem and social
status in society. The informants argued that what the girls (of their age) often consider when
accepting or rejecting a relationship with a boy is his socio-economic status and his family

background. It is only until they ascertain such things that they may not consent, but once these
facts have been verified they will for sure say yes. They noted that some people treat them as
inferiors just because they polished their shoes for them. Some people consider us as if we are
under the soles of their shoes. Such people consider us of less value than the shoes we clean
and I hate being a listro. The view that having a girlfriend requires looking good, dressing well
and having some cash in the pockets was strongly expressed by the participants. When asked,
what people like them who do not meet these requirements would do if they wanted girlfriends;
they replied that no girl would be willing to be a girlfriend of a listro. If they wanted girls, their only
choice was to go to a far neighbourhood and seek girls there and convince them real quick (sex)
before their backgrounds could be revealed by some misfortune. Bekele expressed the same
view. He said that in school, for example, I want to approach some girls but when they hear that I
clean shoes in the piazza they consider me as if I was less of a man and treat me as an inferior.
He further said that there might be some girls for whom being a listro may not matter and he is
waiting for such a girl to come his way, but added many of them (girls) even avoid him based on
what they have heard. He, therefore, said that no girl would be willing to start a relationship with a
listro knowingly. One has to assume a more pleasant persona and approach a distant girl who
wont be likely to know ones backgrounds. They reported that they would rather buy sex from a
prostitute than go through all the trouble. Even if you convince one girl by telling her things that
you are not, the time will come when she sees you cleaning shoes and that is the end of you.
Therefore, it is better to buy sex.
Almost all of the informants feel that even the general public has adopted a negative attitude
towards them. The following quote illustrates this point: Since most of us [street children] smoke
or chew chat or because our clothes are dirty, people think of us as hoodlum (durie) and thieves,
and even the drivers wont allow us to work with them if they see you smoke and chew chat.
Further, the common people (the passengers who come to the bus station (menaheria) to board
buses) do not even consider us as humans and treat us with contempt and call us names: you
robbers, thieves, wayward.
Levels of Awareness About HIV/AIDS

When we asked the participants to tell us what they knew about HIV/AIDS and how it is
transmitted, we did not get very detailed answers. What we received were fragments and half
sentences spoken with uncertain looks, such as:
-

I have heard that AIDS causes one to loose weight and be as thin as a skeleton

It is transmitted through things like toothpicks

It is transmitted through sexual intercourse

It is a really bad/ugly disease and is transmitted through sex and things like
needles and razors, blood contact.

If the blood of HIV patient is poured it has the power to penetrate and enter your
body

One can get the disease if he drinks raw eggs thinking of curing a cough if the hen
that laid the egg had eaten the sputum (aketa) of a person who has HIV

It is a very ugly disease and will make people as thin as bones and kill them after
they have suffered for a long time.

It appeared that almost all of the informants had heard of HIV/AIDS and knew it was an incurable
disease. However, most of them didnt clearly understand how the disease is transmitted and how
it can be prevented. When asked what they knew about AIDS, some of them demanded that we
quit throwing all these questions at them and start teaching them all about AIDS, that is how
they said it-all about AIDSnothing what they already knew and what they didnt. They
demanded someone (most thought the government) should do something for them. They even
went as far as making us pledge to inform the concerned authorities that they needed education,
and not only about AIDS, but formal school education. We pitied them, if that was of any value,
and told them again that we were not there to teach them but rather to understand their views.
We volunteered to answer any queries and clarify any unclear information as much as we could
after the FGD. They turned down our offer saying that they wanted to learn more; they wanted to
learn what is there to be learned about AIDS. It is only then that they claimed they could
effectively protect themselves from this horrific epidemic.
Moreover, knowledge about HIV/AIDS was not uniform within the group. Some of the participants
were relatively well informed (at least on the ways HIV is transmitted) while some couldnt say
nothing more than that AIDS is chastising (qesafi) disease. In general, knowledge about AIDS is
relatively low and very fragmented. The participants seemed to have only picked up fragments of
discussions about HIV/AIDS, and not any details as to its nature and how it is transmitted. Most of
the participants explicitly stated that they didnt know anything for sure about HIV/AIDS, other
than what they have heard people saying about it, that it is the worst disease of all and kills after it
has wasted the body and made one a sack of bones. Even the ones who were vocal did not give
details of information on HIV/AIDS. One informant simply stated a fragment of a sentence here
and another one adds another fragment to it.
The ignorance of the group on the subject of HIV/AIDS was clearly expressed by one boys nave
query: Since there is no blood contact, why is it that AIDS can catch me if I have sex without
condoms. Another one followed this question with one of his own: Since there is nothing other
than sexual impulse/urge (semate) during sex, how is AIDS transmitted through sex? Still another
informant, whom we thought better informed than the others, asked: Why cant the virus be seen
and how does it enter the body during sex? And where did AIDS come from? He added that he
has heard AIDS came from America but asked how? Another informant amused himself by
responding to him may be it came by foot!
Since AIDS is closely associated with sexual intercourse, it is difficult to discuss openly, and
therefore misconceptions and rumours are likely to prevail. Jackson (1992:55) argued that
people are often more interested in discussing minor or unproven routes of HIV transmission
than the main one. Different sorts of misconceptions about HIV/AIDS came up in the discussions
with street children and youth in Dessie, as seen below.
The participants agreed that HIV and AIDS were just two different ways of calling the same
disease. Misinformation and miseducation is one of the roots of the misunderstanding of the
disease, and their inability to distinguish between being infected with HIV and developing AIDS
can be attributed to a consistent failure of public information campaigns and other commercials to
distinguish between an HIV infection and AIDS. Some of them also claimed to have been told by
health educators that HIV could be contracted by eating a chicken that had swallowed a condom
used by an HIV positive person. Further, another street youth claimed that I learned that it is not
AIDS itself that eventually kills those who contracted it, rather a poison of some kind that AIDS
produces in the body. Further, the informants associated AIDS with bodily appearance, such that
healthy looking persons were thought to be HIV negative. They strongly believed that people with
AIDS are supposed to show symptoms such as weight loss, sparse or balding hair, coughing,
lesions on the lips and the like. One informant said I have seen one girl teaching in the church as
an HIV positive person. I felt I myself had the virus too when I saw her because she did not look
any different from any healthy girl and I was very shocked. A large number of mundane activities
were also considered to have infective potential. The informants thought that one could get the

virus from the food if infected maids accidentally cut a finger and blood spilled onto food. Some
even wanted to know if they could get the virus from local beer known as tella if they by chance
drink from the same glass used by an infected person with chapped lips.
The informants also expressed serious misconceptions related to sexually transmitted diseases
(STDs) other than HIV/AIDS. When asked to name STDs, one of the informants named several
(gonorrhoea, LGV, and chanchroid) and invited others to add to the list if they knew more. No
additions were made. He then proceeded to tell how he got gonorrhoea when he was 16 years
old. He said that STDs result from poor vaginal hygiene, and develop in women who do not wash
their vagina properly. There was a general consensus that STDs develop in women as a result of
3
poor vaginal hygiene . One informant was of the opinion that STDs cannot be transmitted from
the male to the female since, as he put it the company has its base in the vagina. Another
informant thought that a man could not pass on STDs to a woman, because if he was infected he
wouldnt be able to perform sexually in the first place. Seyoum told him that is possible, because
he has done it himself. I have had intercourse (bedechealehu) at a time I was infected with
gonorrhoea. There was no problem except that it irritated me a bit during ejaculation. Most of the
informants reported that they had contracted an STD at least once.

Origins of HIV/AIDS

When asked about the origins of HIV/AIDS, some informants considered AIDS as a disease sent
to black people by ferengi (foreigners- particularly Americans). One informant said that AIDS was
the result of the restless hands of the white man. There wasnt anything close to AIDS in our
country. It was a certain white man (ferengi) who wanted to do some sexual research with the
apes that first got AIDS when he had sex with some ape. But then he didnt know he had
contracted any such disease and went on to have sex with some females who got the virus from
him and who in turn transmitted it to others. That way it even came to this country through the
ferengi. 
Another explanation is that AIDS may have been in existence since time immemorial, but under a
different name. One of the informants said that there was a disease in the old days, which the
people then called amenmin (that makes skinny); it is that same disease, which the scientists now
have named, AIDS. Another informant objected to the above line of reasoning by claiming that
the people then called any disease that severely wastes body weight before eventual death
amenmin, it could be TB or it may have been AIDS or any other disease that was called under the
same name amenmin. There is no clear evidence that amenmin was just only AIDS although
AIDS might have been one of these diseases that used to be called amenmin.
Some perceived HIV/AIDS as wrath or punishment sent from God for undesirable behaviour.
Look at all that is happening, look at the women, they are supposed to wear long dresses but
they go around with tight trousers that seem to have been fitted on their skin. That is what has
triggered Gods wrath. This is only a little punishment compared to all the sins of people. This
participant dismissed the view that HIV came from apes by pointing out that if that was the case,
it would have also occurred in them. He reasons that because AIDS only occurs in human beings,
that rules out any claims of its origins in the animal kingdom. But proponents of a primate origin
argued that God would not destroy his own creation. Why would God want to kill his own people?
Gods thoughts for us are kind thoughts, and He doesnt want us to die. Despite such debates,
religious discourse about the origin of HIV/AIDS was an important part of the informants debate.
Reactions to Being HIV Positive

It is a custom in Ethiopia (particularly in rural areas) that women should wash their vagina twice
a day (in the morning and evening). This custom is waning in urban areas.

During the course of our interviews we asked participants what they would do if they were
diagnosed as HIV positive. With the exception of very few, strongly negative feelings were
expressed at the thought of themselves being infected. Some said that they would commit suicide
rather than slowly succumb to the disease. Legese said that I would commit suicide because I
see no other choice and wouldnt face the grim possibility of lying down sick one day along a
sidewalk without anyone to take care of me. It will be better to die that way than wait for the
disease to take root and lead to a pitiful death. Some of them expressed that they would not
reveal their HIV-positive status to others for fear of disrupting existing social relationships,
resulting in embarrassment, isolation and discrimination. In this regard, Andualem said that I
would live anonymously without disclosing the fact to any one, and would be more careful and
take care not to get any other diseases, which would take me hurting down to the grave. 
A common reaction to this question was a concern not to pass the virus on to other people by
abstaining from sex. Some of the participants said that they would teach the public not to end up
like them by speaking publicly about their infection. One of these informants, when probed further
if he wont feel any anger if the virus infected him at such a young age, said that why should I be
angry, death is something that awaits me anyway.
Still others reported that they would appeal to God for healing. They said that they would frequent
the church, cleanse themselves by holy water (tsebel), solicit God and confess their situation in
the church. These informants argued that they would turn their attention to God so that having
lost their life in this world; they wouldnt loose their chances of good life in the world to come.
Others reactions are contingent upon the governments response to their situation. Terefe
expressed his rage against the government as follows: I would go and seek assistance from the
government. If I am assisted I would have no problem in exposing myself and teaching the public
to be aware of the disease. But if I am neglected, I wouldnt feel any guilt in taking my revenge on
as many people as I could by passing the virus onto them by any means I found suitable. Asked
why he decided to take vengeance on people, he said that he does not see any difference
between the government and the people, for the people make the government. Another
informant, Teka, displayed an unshakeable fatalism by stating that his days were numbered and
the day and hour of his death was a thing already decided by God, and that he will die at that
hour with or without AIDS. The hour will not come any sooner because he has HIV nor will it be
delayed if he doesnt. Therefore, if he discovered he is carrying the HIV virus, he would just
continue living until his last day and hour came. However, most of the informants preferred not to
have their HIV status confirmed, as sero-positivity was believed to be a most horrifying thing.
Dynamics of HIV/AIDS Among Different Groups

Throughout human history, many epidemic diseases have been blamed on the others, on
outsiders. Epidemic diseases have also been considered as the problems of marginal members
of affected societies (Kane, 1993; Setel, 1999). Similarly, AIDS is considered as the problem of
the others throughout its history, and has been a metaphor for human differentiation by race,
class, sexual identity and gender (Murray and Robinson, 1996). 
Poverty and other socio-political predicaments have created favourable conditions for the
HIV/AIDS epidemic and prevented an effective response. In line with this argument, Farmer
(1992:242) noted that AIDS is indeed a disorder of poor people, and becoming more so.
Schoepfs study also demonstrates the link between poverty and the HIV/AIDS epidemic in Zaire.
Research in Zaire linking macro-level political economy to micro-level socio-cultural analysis
shows how poverty and hopelessness born of prolonged crisis and increasing disparities in
wealth contributed to a burgeoning HIV/epidemic (1995:30). In view of the poverty discourse in
HIV infection, informants were asked if they thought the rich or the poor were more exposed to
AIDS. Most of them argued that the rich people are more exposed because they have the money
to do what they want and entertain and win whatever girl they like. The poor have no more
thoughts (of sex) than how they can earn for their lunches and dinner and cannot afford to go out

with women often. The students (non-street children) involved in the study also shared the same
opinion.
Interestingly enough, the participants all agreed that ordinary girls or home girls (ye bet lijoch) as
they put it, particularly students, are more exposed to HIV than prostitutes are. They all remarked
that it is safer to have sex with prostitutes (sheles) than ordinary girls because the former are
more careful and make sure condoms are worn before consenting for sex while the ye bet-lijoch
were described as messy. It is, however, my impression that impoverished prostitutes may not
refuse sex without a condom for fear of losing clients. Such prostitutes have to succumb to
clients demands for sex without a condom in order to make money and to remain alive. It is
obvious that the street children cannot afford to visit high-class prostitutes who consistently insist
that their clients use a condom.
Perceptions of Condoms and Condom Use

Since most of the street children involved in the study reported using condoms, they were asked
if they liked using condoms or if they only used them out of sheer necessity and whether they felt
condoms made a difference to the sexual experience for either partner. There was a general
consensus that sex with condoms is not as enjoyable as sex without, and that sex is more
natural without a condom. Abebe (a street boy) said that he only uses condoms because there is
HIV and there is nothing he can do to protect himself other than wearing condoms. It would be
much more pleasant if he had sex without condoms. This impolite (balege) disease [AIDS]
forced me to use it; otherwise sex would have been more enjoyable without it. He made these
statements with a lot of disgust on his face, and he latter added that using a condom is messy
(mechemaleq) while putting it on and taking it off. He added that even using condoms might not
be safe, only God knows if they can really protect one from AIDS. We can only use them and say
God save us and we should also select the women we sleep with. He says that the axle
(differntiashalum) (the name of the spare part of a car equated with the part of the body from the
waist to the lower thighs) should be very beautiful. And this seemed the basis on which a safe
partner should be chosen. The other participants more or less expressed the same disgust over
using condoms, but they use them because that is the only safe way. Although dominant religions
in the country (Islam and Christianity) do not condone condom use, none of our informants
associated condom use with sinning.
Asked if they feel any shame when buying condoms, they reported that there are some situations
where buying a condom would be shameful, for example, they said they would be too ashamed to
ask for condoms in a shop (suq) where there are many older people within earshot. One
informant said that I roam around for suitable shops whenever I want to buy a condom. When
asked what types of shops are suitable, he replied that shops where a young boy or man sells
things then I would go and feel no shame when saying condoms please.
Some of the informants were very quick to mention problems associated with condom use.
Condoms are sometimes torn or punctured during sex and they sometimes even wear two at a
time to ensure safety. Some condoms are torn even when you insert them/wear them in the first
place. Others, however, expressed that many such problems come from not knowing the proper
way of wearing condoms. Some wear it inside out, which causes a lot of friction during sex
because the lubrication is on the inside.
Asked if they have friends who do not use condoms and what reasons they give for their non-use,
they replied that there are people who naturally dislike condoms and are heard saying who will
struggle with condom, I will do it without it! Some people dont use condoms because they do not
believe that they can protect them, some for fear that their girlfriends will consider them unfaithful
or untrusting and some because they think condoms reduce pleasure. One of the informants said
that he had friends who do not use condoms. They said that flesh-to-flesh sex is very enjoyable.
Sex with condoms is like childhood sex, and it is also messy.

All of the informants agreed that they did not have complete confidence in condoms, but used
them with the belief that it is better than going-in-bare. Bekele equates sex with fire, and a
condom with a pair of shoes. It is much safer to step on fire with your shoes on than with bare
feet. Same with condoms, he said, much safer to put them on than to have sex without them.
Some said that they use them only because they are used to thinking condom use and sex is
associated without any deliberate thoughts of protection. Teka added that he personally sees
condoms as equivalent to AIDS and only uses them because the prostitutes (sheles) do not
consent to sex if he doesnt wear one.
Substance Abuse and Unsafe Sexual Behaviour

Most of the informants admitted that they use chat, alcohol and smoke cigarettes. Even during
the focus group discussions, we saw one informant trying to sneak some chat leaves into his
mouth without being seen. We told him it was okay with us if he wanted to use it there. He smiled
and brought out a very small bundle of leaves from his pocket. Another participant followed his
lead, and then many started chewing. We objected when they lit cigarettes. However, they
countered that we had to allow them to smoke if we wanted them to keep talking. We were not
left with any choices and let them smoke.
Intravenous drug use is something they neither engaged in nor even heard about. Asked if they
used hashish or any other drugs (other than chat) they all broke into fits of sarcastic laughter and
one of them put it on to words saying that one only does that when he has money enough to eat
well and get satisfied and still has some more left to spend. The implication was that they dont
even have enough money to feed themselves properly, let alone use hashish, which they
perceived as a luxury. Life on the street is very stressful, and they explained that they usually
take chat to overcome their loneliness and escape the harsh realities of their lives.
The participants were asked if they felt that the use of alcohol or other drugs might influence a
persons decision and/or ability to use condoms, or their sexuality in general. Strong associations
was discussed between alcohol, chat, cigarettes and unrestrained sex. Seyoum said that I have
to drink first and I also have to have money in my pocket to pay for her (the prostitute). I then go
to her and we bargain and when we agree I take her to a room in a hotel (albergo). Another street
boy stated that he only thinks of sex after he has taken chat and has had a few drinks. Asked
about how often they engage in sex, they replied that it all depends on how often they drink and
chew chat. If they chew chat and drink, sex would necessarily follow.
Furthermore, the informants felt that alcohol, chat and smoking made them careless about using
condoms and gave them more confidence, such that they would be more likely to have sex.
Some boys said that when they are drunk they forget to wear a condom or do not use it properly.
Some of the informants even suggested that the government should ban all drinking places and
ban the production and distribution of alcohol regardless of the effects on the economy, as men
are usually lured into having unprotected sex under the influences of alcohol. Terefe narrated as
follows: You go to a certain hotel (buna-bet) just to have a drink or two and then you see those
pretty girls in those clothes that leave half their body naked for you to see. When they come and
arouse you with all their sex looks and touches, what you knew about AIDS just leaves your mind
and you end up in an albergo bed with one of them. I am sure if alcohol was banned, AIDS would
cease to be a problem. Overall, it appears that the informants denied agency, and associated
unsafe as an outcome of taking alcohol or chewing chat

Discussion and Conclusion

Male street children are preoccupied with issues of unemployment almost to the total exclusion of
the problems posed to them by AIDS. The first discussion held with each focus group was of a
general nature about concerns and problems in their daily life, and when the street children were

asked what their problems were, it is dismaying to note that no spontaneous mention was made
of AIDS. It appeared that they already have so many other worries and have nothing to look
forward to due to poverty. This sharply contrasts with young people attending school who were
very quick to bring up the issue of HIV/AIDS as a burning concern without it being hinted at by the
facilitator. 
Furthermore, street children and youth in Dessie are not well informed about all aspects of
HIV/AIDS transmission and prevention. Even those few who showed some understanding and
awareness of the ways in which they can minimise their own risks of infection, their
comprehension is still laced with confusion and misconceptions. It also appeared that the level of
knowledge about HIV/AIDS among street children in Dessie is very low as compared to those
attending schools in the same town (involved in the study). The comparison with other countries
(like that of South Africa) also indicates that street children and youth in South Africa are better
informed about HIV/AIDS than those in Dessie (Swart-Kruger and Richter, 1997).
The many public HIV/AIDS prevention campaigns on the radio, television and posters that
encourage one to stay abstinent, be monogamous or use a condom are not appropriate to this
group with the exception of condom use. Given their precarious living conditions, it is unrealistic
to expect them to abstain from sex. Given their low social status in the society, it is very difficult to
have a girlfriend of a similar age or to enter into marriage and thereby maintain a monogamous
relationship. All the participants agreed that marriage is not such an easy thing to be enter into;
one has to have a good source of income before thinking of a marriage. Otherwise, they feel that
if a listro marries a jobless girl, it wont be a marriage at all. 
The informants also admitted that they did not use condom in the past when AIDS was not so
much talked in the community. These days, there are problems with purchasing condoms,
knowledge of how to use one, and myths surrounding them. Even those who appear to have
adequate knowledge about HIV/AIDS may lack the skills to use condoms correctly or to negotiate
safe sex with a partner. It is, therefore, clear that education programs should not only focus on
changing knowledge but also on providing these young people with the skills to negotiate safe
sex and to use condoms correctly. Further education alone is not enough. Strategies to improve
the acceptability and accessibility of condoms to the youth need to be implemented. The majority
of informants reported that condoms are not 100 percent effective means of prevention of
HIV/AIDS. This contrasts with the studies from South Africa and Zimbabwe (Ministry of Education
and Culture (Zimbabwe) and UNICEF, 1993; Swart-Kruger & Richter, 1997). Not only do they
consider condoms as ineffective, but also expressed negative attitudes towards condoms and
their use. Some of them said that they did not like condoms and would prefer not to use them had
they not been forced to use them by their partners (prostitutes). Besides, they have a suspicion
that the lubrication in them is impregnated with HIV, so one could get infected with the virus
through using condoms. There seems to be a need for education programs targeting young
people that deal with misconceptions, myths and effectiveness of condoms.
Furthermore, it seems that the street children and youth involved in this study feel helpless and
frustrated with their sexuality due to the strong suspicion of being unsafe from HIV infection. The
majority of informants admitted engaging in sexual activities with prostitutes without a condom
that may have put them at risk for HIV infection in the past when AIDS was not so much talked in
the society. As such, it was with uncertainty and fear that they described their situation as
possibly living with the virus. This discourages them to such an extent that they become careless
in their present sexual relationship. Likewise, they prefer to live with uncertainty rather than
undergoing serological test and to know their HIV status. It is, therefore, very essential that
educational programs should focus on encouraging young people to undergo serological tests. 
It appeared, therefore, that all options for preventing HIV/AIDS are envisaged with problems one
way or another. Abstinence practically seems impossible solution for these young people with no
clear vision in their life. Although very few boys mentioned masturbation as a solution, most of the
street childrens reaction to masturbation was negative. They considered that masturbation is
childhood sex, and it is usually done in the early years of attaining puberty and is done by more
grown up people only when there are no women around (for example, in prisons and in the
Army). Further, one or more of the informants has expressed a number of ill effects of

masturbation. Thus, for most informants, masturbation did not seem to be a good alternative to
sex.
Almost all of FGD participants attending school feel themselves to be at risk of contracting HIV,
not because of sexual intercourse, but rather through other external factors. They asserted that
even if they abstain from sex, it is highly likely to get infected via mundane practices like sharing
sharp utensils and toothbrushes. They believed that any one can get AIDS, and therefore, AIDS
is viewed as a problem for all ages. Whereas street children and youth were quite open about
their sexual lives, and they believed that AIDS could happen to them mainly through sexual
intercourse (though exogenous factors were mention.
Moreover, common sense may cause us to assume that street children and youth are a spoilt lot
and engage in sexual deviancies (such as experimenting with different positions). This study
seems to refute such an assumption, for the informants uphold the general societal values and
norms related to sexuality with the way they talk about sexuality. However, how the informants
came to know the different positions (if they have not had tried themselves) is a question that
begs an answer. This leads to believe that their discourse was a public display, but their private
behaviour was different.
Contrary to the public discourse in Ethiopia (and perhaps elsewhere), the street children and
youth in Dessie argued that prostitutes are not risky sexual partners. Since prostitutes
consistently force their clients to use condom, the informants perceive them as a safer group than
to schoolgirls. This sharply contrasts with other studies in Africa. For instance, a study of young
people in Zimbabwe revealed that prostitutes are the group most strongly associated with AIDS
(Ministry of Education and Culture (Zimbabwe) and UNICEF, 1993). Further, there seems to be a
lot of literature that links prostitution with the spread of HIV/AIDS; prostitutes are often labelled as
source of HIV transmission. Particularly in Africa and other Pattern II areas, where initial and
subsequent epidemic phases are attributed to heterosexual transmission (Kane, 1993), the urban
prostitute-client relationship is considered to be the critical bridge of transmission into the wider
heterosexual population. The prostitutes (particularly in Africa) are considered as the core carriers
of the virus and potential source of infection for other healthy citizens of the society. This blame
deflected attention away from the more complex realities of the epidemic, and AIDS prevention
itself was caught up in these meanings (Day, 1988; Gil, Wang, Anderson, Guo, and Zongjian,
1996; Kane, 1993; Murray and Robinson, 1996; Neequaye, 1990; Peracca, Knodel, and
Saengtienchai, 1998; Scambler & Grham-Smith, 1992; Standing, 1992; Talle, 1995; Ward and
Day, 1997). There are many others who consider prostitutes as the most vulnerable groups for
HIV/AIDS (Peracca et al, 1998; Talle, 1995; Sturdevant and Stoltzfus, 1992). Therefore,
prostitution became a hot issue in the 1980s because of its strong presumed association with
HIV/AIDS. Reports from different parts of the world (particularly from Africa) indicated a high
prevalence of HIV among prostitutes (Van de Perre, 1985; Piot et al 1987 in Ward and Day,
1997). Van de Perre (1985) reported a prevalence of over 80 percent among prostitutes in
Rwanda. Similarly, Piot et al (1987) reported a rise in the prevalence of HIV-I in prostitutes in
Nairobi, Kenya from 4 percent in 1981 to 61 percent in 1985. In 1992, two major newspapers
carried a report that 75 percent of prostitutes working in the Kings Cross-area of London had HIV
(Ward & Day, 1997 quoting Delgado, 1992 and Sunday Express, 1992). Since prostitutes in most
societies are labelled as a high-risk group, this thwarted any preventive efforts as it encouraged
other women and men to assume that they are not at risk of HIV infection (Day, 1988; Scambler
& Graham-Smith, 1992).
In line with the views of street children involved in the study, one often come across literature
arguing that visible prostitutes are safer from HIV/AIDS as compared to the clandestine
practitioners and other non- prostitutes (Kane, 1993; Murray and Robinson, 1996; Standing,
1992). Many researchers revealed that fewer prostitutes than some had first supposed were HIV
sero-positive (May, 1988; Scambler & Grham-Smith, 1992). Day (1988) contested that the
context should be specified when considering prostitution as a risk factor for HIV infection.
Prostitutes and their clients may play an important local role in transmission in some areas, but

not in all societies. Due to the professionalisation of prostitution, prostitutes tend to create a
marked distance between their working and private lives, and this clear cut demarcation may
have implications for the transmission of HIV. Condom use by prostitutes not only provides
protection from AIDS but also creates a symbolic barrier between a womans self and her work.
Women who are not prostitutes may consider condoms and other protective devices as
inappropriate and unnatural. This unnatural nature of condoms motivate prostitutes to use it
when they are making unnatural love, and thus it help them separate a natural sex life at home
from work (Day, 1988). Thus, studies have reported high and rising condom use with commercial
sex contacts, and significant decline with boyfriends (Scambler & Graham-Smith, 1992; Ward and
Day, 1997). Murray and Robinson (1996) dismissed the necessary connection between sex as
commercial transaction and unsafe sex, which puts one at risk of HIV infection. They further
argue that the rate of HIV infection among sex workers in Sydney is found to be lower than that of
non-sex workers. Provided that all other conditions being equal, Kane also supported the ideas of
the above authors:
One could expect that the explicitly professional nature of a sexual exchange enhances
the probability that condoms will be used to prevent transmission of STDs including HIV. In
contrast, where sexual exchange is non-professional, or where the professional nature of
sexual exchange is not recognised, one could expect a reduction in the probability that
condoms will be used to prevent infection, and in consequence, expect an increase in the
risk of HIV infection (Kane, 1993:976).
However, the consensus among the participants that prostitutes are less risky sexual partners
than home girls, including students, may constitute another misconception that increases the risk
of HIV infection in street children. Prostitutes in developing countries like Ethiopia are believed to
be powerless in forcing their clients to use condoms. In a situation where most prostitutes in
developing countries like Ethiopia work in bars and hotels, and where prostitution and alcoholic
drinks usually go together, consistent condom use by either party is not expected. Excessive
alcohol consumption coupled with their intention to maximise economic profit leaves prostitutes in
a very weak position to negotiate safe sex (Talle, 1995). Commercial sex in developing countries
also involves a mix of emotional attachment, and even exchange of gifts and steady relationship.
Such a relationship to a large extent jeopardises the use of condoms. As most permanent
partners could also be promiscuous, steady relationships are as dangerous as more temporary
ones. Moreover, condom use in some societies (like Ethiopia) is an issue surrounded by cultural
ambivalence, and regarded as a negative object even by some prostitutes. Therefore, condoms
are used when they are easily accessible, free of negative values, and when there is the capacity
(economic or social) to negotiate its use. Unsafe sex would be common in an environment like
Dessie where prostitutes barely survive by selling sexual labour and are not free to insist on safe
sex because of fears of losing their clients. Further, the complexity of the sex industry involves
many more people than sex workers, and there is a possibility to be coerced by pimps or owners
of bars who expect unsafe sex for their own maximum financial gain (Murray and Robinson,
1996).
Overall, it seems that street children and youth in Dessie are living in a precarious environment
and are at risk of contracting HIV partly because they are not well equipped with basic information
on ways of avoiding HIV infection. They expressed feelings of helplessness and frustration about
protecting themselves from HIV/AIDS infection. As a solution to the problem, many of them
suggested that people living with HIV/AIDS should be involved in the AIDS prevention campaign.
They also emphasised that more vigorous and more personal face-to-face approaches should be
adopted. In other words, the educational programs should not be limited to television, radio and
newspapers since street children and other poor people do not have access to them. They
remarked that they would prefer to hear from knowledgeable people or from people living with
HIV face-to-face rather than read about it or any other way. And there seems consensus about
the preference of this approach between street children and school pupils. Using peer educators
to spread awareness about HIV/AIDS, and involving street children in the program structure at all

levels including policy making level, may also be an effective method of reducing risk of HIV
infection among street children and youth.
While not wanting to exaggerate the generalisability of the results, it is reasonable to say that they
have some relevance in increasing general understanding of sexuality and HIV/AIDS among
street children and youth in Ethiopia.

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