In addition to the data on drug and alcohol abuse, Medecins Du Monde have also undertaken a survey regarding the sexual behaviour and practices of the children who use the facilities of the MDM Medical Centre. The survey was limited to small number of persons who came regularly to the Medical Centre and with whom the doctors, social workers and psychologists had built a strong relationship. It was felt that these children trusted their interviewers enough to give accurate and honest information.
It should be noted that the legal age of consent in Russia is 16 and that the sexual experiences of those under that age would be registered in legal terms as a form of sexual abuse. It should also be noted that those under the age of 14 had some difficulty in differentiating between when they consented and when sexual acts were committed against their will. Other young children were unwilling to admit to abuse, clearly intimidated by those they perceived to be threatening them.
Given the relatively high levels of sexual activity/abuse surrounding the street children, an AIDS awareness study was undertaken by Medecins Du Monde France with 162 children questioned. To the question : "Do you know what AIDS is ?"
However, when questioned on the ways in which AIDS can be contacted, a majority displayed a deadly ignorance, especially in regard to the intravenous methods which currently pose the greatest risk in terms of the St.Petersburg infection transmission routes.
To the questions : "How can you catch AIDS?", the following answers were checked off by the respondents:
In addition to these surveys, MdM France have also produced a detailed questionnaire which all children who attend their medical centre are requested to complete. Questions include "How often do you change your underwear?" "What was your first sexual experience?", "What kinds of contraception do you use?" and "How many partners have you had?".
Some questions especially those aimed at assessing the level of sexual abuse are less direct: "Did some adults or teenagers ever try to play games with you- like doctors and nurses." Each questionnaire is attached to the file of the child, lodged under an identity code to protect the identity. MdM France have, in this manner amassed data on the 1 000 children attending their medical centre. This covers behavioural activities ranging across a spectrum covering drug abuse, eating habits, vaccinations/immunisations, sexual activity and family background. A disease profile is included, covering blood testing for infectious diseases as well as standard data such as height, wieght etc.
Notable trends identified by MdM France physicians include the observation that prior to 1995, using heroin was extremely rare. Now it is increasingly figuring in the medical records of street children. Another alarming statistic is the level of syphilis, currently running at 14-15% of tested girls. Hepatitis B and C are on the increase in tandem with HIV as intravenous drug use increases.
There is a profound ignorance amongst the children regarding medical matters, including sex education amongst the street children. Many do not know what the word "infection" means, something that has to be explained in great detail when they have tested positive for Hepatitis B, C, HIV or syphilis. A good number have no idea what the term "psychology" means or indeed what a "penis" is. Their vocabulary is often limited to street words which makes the job of medical prevention, treatment and cure all the more difficult.
Initial data from 2000 shows a sharp increase in the rates of Hepatitis B and C, as well as HIV increases. These figures will be released on March 1st 2000 and will be used for the purposes of this report. Médecins du Monde France physicians confirm that there is currently an Hepatitis B and C epidemic. HIV figures from the harm reduction program (mainly adults) coupled with the increases recorded in 2000 strongly indicate the onset of an HIV epidemic in St.Petersburg.
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