Street children worldwide do not have the information, skills, health services, and support they need to go through sexual development during adolescence. This study is undertaken to systematically investigate the fit between street children’s sexual and reproductive health needs and the existing services. A cross-sectional study was conducted among 422 street children and four service providers. About 72.5% of the respondents were sexually active during data collection and 84.3% of males and 85.7% of females tended to have multiple sexual partners. More than two-thirds (67.3%) of the participants had used at least one type of substance. History of substance use (OR = 2.5; 95% CI = 1.42–4.56) and being on the street for the first one to three years (OR = 5.9; 95% CI = 1.41–7.22) increased the likelihood of having sexual activity. More than half (64.9%) of the street children did not attend any kind of sexual or reproductive health education programs. Lack of information on available services (26.5%) was the biggest barrier for utilization of local sexual and reproductive health services. From the individual interview with coordinator, the financial and networking problems were hindering the service delivery for street children. In conclusion, street children who are special high risk group have not been targeted and hence continue to remain vulnerable and lacking in sexual and reproductive health services and sexual health services are poorly advertised and delivered to them. 1. Introduction The problem of street children is becoming a worldwide phenomenon since these children exist in every part of the world. The vast majorities of these children work and live in large urban areas of developing countries [1]. Like many underdeveloped nations challenges facing the Ethiopian children are diverse and immense. Thousands of children live under difficult circumstances and are exposed to various forms of abuse and exploitation [2]. Street children in this study include those children aged between 10 and 18 years. The family may have neglected them or may have no family members left alive. Such children have to struggle for survival and might move from friend to friend or live in shelters such as abandoned buildings, plastic shelters, and public phone rooms [3]. Though street children are hard to count, estimates of the number of street children range from about 20 million to over 100 million worldwide. What is certainly known is that their numbers are increasing for various reasons including the global population growth, poverty, rapid urbanization, and AIDS
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