Início da atividade sexual e sexo protegido em adolescentes

Prevalência de indicadores de saúde sexual e reprodutiva dos adolescentes brasileiros

Objetivo: comparar as estimativas de prevalência de indicadores de saúde sexual e reprodutiva dos adolescentes brasileiros que participaram das edições 2015 e 2019 da Pesquisa Nacional de Saúde do Escolar (PeNSE). Método: estudo transversal que analisou dados de adolescentes escolares de 13 a 17 anos respondentes da PeNSE 2015 e 2019. Estimou-se a prevalência para nove indicadores com intervalos de 95% de confiança de acordo com o sexo, faixa etária, dependência administrativa da escola e região do país. Resultados: observou-se manutenção da maior parte dos indicadores analisados. Destaca-se aumento da prevalência de iniciação sexual precoce, entre os mais novos, 171,2% entre os meninos e 425,2% entre as meninas. Também houve aumento da prevalência de gravidez na adolescência nas regiões Nordeste (376,9%) e Sudeste (416,6%), entre as mais jovens. Entre os adolescentes de 16 e 17 anos, houve redução do uso de preservativo na última relação e aumento na prevalência de recebimento de orientações sobre prevenção de gravidez e sobre HIV/Infecções Sexualmente Transmissíveis, entre os estudantes de escolas públicas. Houve redução na prevalência de acesso a essas orientações nas escolas privadas entre os mais jovens. Em 2019, observou-se redução no uso de pílulas anticoncepcionais entre as adolescentes mais novas das regiões Norte, Sudeste e Centro-Oeste. Conclusão: houve estabilidade para a maioria dos indicadores, porém, com aumento da iniciação sexual precoce, da história de gravidez na adolescência e das orientações recebidas nas escolas, apontando maior risco entre jovens que frequentam as escolas públicas, e que vivem no Nordeste e Norte do país.

Characterization of adolescent sexual practices

OBJECTIVE

to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits.

METHOD

a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test.

RESULTS

21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05).

CONCLUSION

a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families.

(1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.

Characterization of adolescent sexual practices

OBJECTIVE

to characterize adolescents' sexual practices and their association with sociodemographic variables, sources of information and behavioral habits.

METHOD

a descriptive, observational, cross-sectional study conducted with 85 adolescents from public elementary and high schools in a city in the state of São Paulo. Data were collected through a structured, self-administered and anonymous questionnaire. Statistical analysis was performed using the χ2 test and Fisher's test.

RESULTS

21.2% had started their sexual life through oral sex, with a predominance of females (94.4%), self-reported brown color (55.0%). The practice of vaginal sex was reported in 31.8%, with a mean age of initiation at 14.5 years. The female sex was predominant (77.0%), with a self-reported brown color (40.0%). The practice of anal sex was detected in 7.1%, with a mean age of 14.4 years, prevalent in females (83.3%), with a self-reported black color (50.0%). There was an association of alcohol, drugs and tobacco use with sexual practices (p<0.05).

CONCLUSION

a diversity of sexual practices associated with substance use was detected, emphasizing the importance of the nurse's role in planning and carrying out health education interventions with adolescents and families.

(1) Analysis of the sequence and time of initiation of sexual practices, demonstrating the diversity of sexual activities performed by adolescents. (2) Family context and low openness to dialogue and its correlation with the initiation of adolescent sexual practices. (3) Behavioral habits: association of alcohol, tobacco and drug consumption by adolescents with sexual activities.

Adolescent pregnancies and adherence to puerperal consultation

Abstract Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais. Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher’s exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance. Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women. Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance.

Gestações na adolescência e adesão à consulta puerperal

Resumo Objetivo: identificar o perfil das gestações e prevalência de adesão à consulta puerperal entre puérperas adolescentes comparadas a não adolescentes, assistidas em um ambulatório de hospital de ensino do interior de Minas Gerais. Método: estudo transversal aninhado a uma coorte de puérperas; amostra não probabilística, por conveniência; gestação na adolescência - variável dependente; sociodemográficas, clínicas e obstétricas - variáveis independentes. Utilizado instrumento próprio, testado mediante piloto. Calculadas razões de prevalência e intervalos de confiança; aplicados testes qui-quadrado e exato de Fisher, considerando nível de significância de 5%, e regressão de Poisson com variância robusta. Resultados: entrevistadas 121 puérperas, 18,2% (22) adolescentes, verificou-se entre elas baixa escolaridade (p<0,001); menor número de gestações cursando com patologias (p = 0,016); predomínio de primíparas (p<0,001) e maiores índices de parto normal (p = 0,032). A prevalência de adesão à consulta puerperal foi de 34,7% e de 31,8% para adolescentes. Não houve diferenças em relação à adesão e idade das puérperas. Conclusão: adolescentes não apresentaram desfechos obstétricos e neonatais negativos, embora tenha sido observada menor escolaridade. Identificou-se associação entre idade precoce e ausência de doenças na gestação e maiores índices de partos vaginais normais. A adesão ao retorno puerperal apresentou-se pouco inferior, porém sem significância estatística.