Brazilians Fear AIDS ‘Time Bomb’ for Street Children

The AIDS virus is spreading among the legions of ragged street children in Brazil, and experts fear that these offspring of urban poverty may suffer a disastrous epidemic of the disease.

According to estimates based on census data, Brazil has 7 million minors with little or no adult supervision, 3 million of them in the metropolitan areas of Rio de Janeiro and Sao Paulo. These abandoned children are seen as an AIDS risk group because of sexual promiscuity and drug abuse.

“I believe that this group, if not given special treatment, will become an atomic bomb loose in the city,” said Dr. Carlos Jose Carvalho, medical director of the National Foundation for the Welfare of Minors.

The foundation, known as FUNABEM, has tested the blood of 4,200 children since 1987 and found 70 of them between the ages of 12 and 18 to be infected with the HIV virus associated with acquired immune deficiency syndrome.

The Sao Paulo state agency for child welfare, called FEBEM, has detected the virus in more than 500 minors.

The states of Rio de Janeiro and Sao Paulo account for the greater part of the AIDS cases in Brazil. In periodic reporting on AIDS around the world, Brazil often has the third-highest number of cases, after the United States and France.

Of the 6,421 Brazilian AIDS cases reported by the end of April, 224 involved children of 14 or younger. But that number does not reflect the extent of HIV infection among street children, most of them teen-agers.

Dr. Pedro Chequer, assistant director of an AIDS task force in the national Health Ministry, said HIV infection among street youths “is worrisome and requires immediate measures by the government for prevention and education.”

Special Programs

He said the ministry is working with welfare agencies and private groups to develop special anti-AIDS programs for abandoned minors.

“It is a risk group not because they are abandoned minors but because of the question of drugs and sex in exchange for money,” Chequer told a reporter.

Maria Thereza Moura, Rio coordinator for a private group called the National Movement for Street Children, said money is an overriding concern for the abandoned child, whose sexual inhibitions are weak.

“If he can sell his body, he sells it without any problem,” Moura said. She said it will take “an immense campaign” to provide such children with the knowledge, self-discipline and means to protect themselves from AIDS.

Neglected or abandoned children are a common sight in Rio and Sao Paulo streets. Many beg, steal or work at odd jobs such as selling candy and fruit. When they are picked up by the police, juvenile courts send them to FUNABEM in Rio or FEBEM in Sao Paulo. Both agencies operate detention homes, boarding schools, hospitals and other services for needy and delinquent minors.

Adilson Luiz Estevan, a press spokesman at FEBEM, estimated that the Sao Paulo agency deals with 15,000 children a year. When recommended by physicians, the children are tested for AIDS and other diseases.

Estevan said 505 minors tested between the end of 1987 and April of this year were infected with HIV. Twenty of those have developed AIDS, and 11 have died.

He said the majority of those carrying the virus received it from injecting drugs with contaminated needles. Six of them, he said, were infants who received the virus from their mothers. He gave no further breakdown.

“There is no discrimination against those children,” Estevan said. “They live together with other children in the institution.”

As a precaution against sexual transmission of the virus, infected children are subject to “redoubled vigilance” by dormitory monitors, he said. FEBEM currently has about 9,000 children living in its dormitories.

In Rio de Janeiro state, FUNABEM has about 3,000 boarders. But Carvalho, the medical director, said that no one infected with HIV is permitted to live in the institution’s dormitories.

When the virus is detected in a child’s blood, the child is returned to his home, if he has one, or taken to a private boarding house. FUNABEM keeps track of infected children, providing them with counseling and medical care and helping them find jobs, Carvalho said.

The institution distributes condoms free in controlled quantities to youths who request them, except its own boarders.

“If we distributed condoms inside the schools, we would be conniving with homosexual activity inside the schools,” Carvalho said.

He said sex education programs are partly successful in preventing sexual relations between boys in the schools, and boarders are tested every three months for HIV.

Most of the 70 cases of HIV infection have been detected among children arriving at the institution from the street, Carvalho said. So far, only one has developed AIDS.

Carvalho said 90% of the 70 were between the ages of 16 and 18, and the remaining 10% were between 12 and 15. About 20% of those infected were girls. According to a study of the infected children, about 90% received the virus through sexual contact.

“All maintain homosexual relations on a commercial basis regardless of their instincts,” according to a report prepared by Carvalho.

The Brazilian Interdisciplinary AIDS Assn., a private group that works in AIDS prevention, criticizes FUNABEM policy on the disease. The association argues that children should not be sent back to the street because they are infected with HIV and that youths in FUNABEM dormitories should not be denied condoms.

“That policy, besides being discriminatory, is absolutely inefficient and wrong,” said psychologist Silvia Ramos, the association’s coordinator.

She contends that it will be impossible to keep HIV from spreading in the dormitories because of intense sexual activity, especially among adolescents but also with younger boarders.

“Street children are afraid of being sent to FUNABEM because they think they will get AIDS there,” Ramos said. “In FUNABEM, they are obligated to have sex without protection because FUNABEM doesn’t permit the means.”

Ramos also criticized FUNABEM for conducting HIV tests without telling those tested and without proper authorization. Carvalho said the institution recently obtained court authorization for AIDS testing as long as children are given the opportunity to refuse the test.

The Interdisciplinary AIDS Assn. and other private organizations are preparing materials for anti-AIDS campaigns among street children. In Sao Paulo, the state Department of Minors has been teaching anti-AIDS material for over a year. But Ramos said preventing the spread of AIDS among street children will not be easy.

“AIDS is starting to enter that group, and when it starts it is difficult to stop,” she said. “It is an extremely serious problem. We are seeing today the tip of what can be imagined as a tragic thing for Brazil.”