[Behavior patterns related to sexual practices and drug use among female adolescents in Vitória, Espírito Santo, Brazil, 2002]

Preliminary Results of a Screening Programme for Chlamydia in an Asymptomatic Young Population in Spain

Introduction:Chlamydia trachomatis (CT) infection has increased in recent years, reaching 127 million cases in 2016. Possible complications, especially among women, require intervention for early detection of the infection. The objective of our study was to determine the prevalence of CT infection in a young, sexually active, asymptomatic population. Methods: A cross-sectional study was conducted between December 2017 and 31 December 2018 among young patients aged 18-25 years attending the emergency room for any reason. The presence of CT and other STIs in urine was determined by the Allplex Nucleic Acid Amplification Test (NAAT) with a urine sample. All patients testing positive were followed by the STD unit and tests on all sexual partners/contacts were offered. Moreover, we obtained data about sexual habits and risk factors via a self-reporting questionnaire. Results: One thousand three hundred eight patients were eligible for inclusion of whom 298 consented to participate. Of these, 22/298 (7.4%) were diagnosed with CT. Young people with two or more sexual partners in the last month and those suffering from infection by ureaplasma were at greater risk of infection by CT. Up to 50% of participants do not use barrier methods. Conclusion: The prevalence of infection by CT in the asymptomatic young population is higher than expected according to the recent literature in Spain. The scarce use of barrier methods among this population may be one of the causes of this increase and one of the targets to work on in order to reduce the prevalence of the infection.

Factors associated with sexually transmitted infections: a population based survey in the city of São Paulo, Brazil

We determined the prevalence of sexually transmitted infections (STIs), the factors associated with infection and types of counseling received by men and women from health professionals in the City of São Paulo. The investigation consisted of a cross-sectional study conducted with men and women aged between 15 and 64 years living in the City of São Paulo. Of 4,057 individuals who had engaged in sexual activity, 6.3% reported previous history of a STI: 4.3% of women and 8.2% of men. The factors associated with STI were being aged over 34 years and not using a condom during first sexual intercourse, among men, and being aged over 25 years among women. Protective factors included not having had sexual intercourse with someone from the same sex, among men, and having initiated sexual activity after the age of 15 years and not having a casual sex partner over the last 12 months, among women. Counseling about the importance of HIV and syphilis testing was received by 72.1% and 64.7% of women, respectively, while fewer than half of the men received this type of counseling (40.2% and 38.6 %, respectively). The prevalence of previous history of a STI was high among the population of the City of São Paulo. The findings of this study informed the development, implementation, and evaluation of STI policies, including those directed at HIV, leading to a reduction in the barriers that hinder access to and use of condoms and the creation of STI prevention app.

Alcohol misuse among women in Brazil: recent trends and associations with unprotected sex, early pregnancy, and abortion

Objective:

This study compared the rates of binge drinking (BD) and alcohol use disorder (AUD) reported for 2006 with those reported for 2012, exploring their associations with unprotected sex, early pregnancy, and abortion in a representative sample of women in Brazilian households.

Methods:

This was a descriptive analysis of data from a cross-sectional study involving randomized multistage cluster sampling of the population ≥ 14 years of age. Weighted prevalence rates and odds ratios were estimated, and serial mediation analysis was performed.

Results:

A total of 4,256 women were analyzed. The BD prevalence was 35.1% and 47.1% in 2006 and 2012, respectively, a significant increase, especially among women 40-59 years of age. There was no significant difference in AUD prevalence. BD (without AUD) was found to increase the odds of unprotected sex and abortion. The path analysis showed that early pregnancy was a mediator of the relationship between alcohol consumption and abortion.

Conclusion:

Among women in Brazil, the harmful use of alcohol is increasing, which has an impact on female reproductive health and exposure to risks. There is a need for specific prevention initiatives focusing on alcohol-related behaviors in women.

Associação de conhecimento sobre DST e grau de escolaridade entre conscritos em alistamento ao Exército Brasileiro. Brasil, 2007

Foi descrito o conhecimento dos alistados no Exercito Brasileiro, em relação às DST segundo escolaridade. Foi utilizado questionário autoaplicável com características demográficas, modos transmissão, comportamento sexual e preferência de acesso a informações sobre DST em amostra com representatividade nacional, 2007. As variáveis associadas a menor escolaridade foram: ter 19-20 anos [OR = 1,2(IC95%:1,18-1,32)], relatar que a transmissão de DST pode ser por: ingestão de alimento contaminado [OR = 2,2(IC95%:1,96-2,55)], tomar banho em rios/praias [OR = 1,5(IC95%:1,27-1,88)], picada de mosquitos [OR = 1,5(IC95%:1,38-1,65)], início de atividade sexual antes de 14 anos de idade [OR = 1,4(IC95%: 1,33-1,55)]. As variáveis com associação inversa à baixa escolaridade foram: auto declarado branco [OR = 0,9(IC95%: 0,82-0,91)]; afirmar que a transmissão das DST pode ser por: compartilhar seringas/agulhas [OR = 0,7(IC95%: 0,62-0,78)]; transmissão materna, no parto e amamentação [OR = 0,6(IC95%: 0,58-0,69)]; usar preservativo no último coito [OR = 0,8(IC95%: 0,71-0,85)]; ser HSH [OR = 0,7 (IC95%: 0,60-0,92); e reconhecer o não uso do preservativo como aumento do risco de transmissão [OR = 0,4(IC 95%: 0,37-0,51)]. Dada a baixa escolaridade associada ao menor conhecimento, aponta para necessidade de ações educativas destinadas a essa população, que se encontra em situação mais vulnerável.

[Perception of risk of school adolescents in relation to alcohol consumption and sexual behavior]

Alcohol use has been a major precipitating cause of situations of vulnerability in adolescence. The study aims to analyze the risk perception about the relationship of adolescent alcohol use and sexual behavior. The subjects were ten adolescents between 14 and 19, students from a public school in Fortaleza, Ceará, Brazil. Exploratory and descriptive qualitative approach based on the technique of focus group and systematized by means of five workshops. Teenagers recognize the risk between alcohol consumption and sexual behavior and emphasize that drinking facilitates the relations between sexual peers and indicate the influence of media in this process. The perception of adolescents and their relation to alcohol abuse and its consequences is particularly relevant to the implementation of public policies for preventing and fighting alcohol consumption at this stage of growth and development.

Young women and their reproductive health needs in a family practice setting: factors influencing care seeking in Vitoria, Brazil

BACKGROUND

Young women often have diverse options for addressing their reproductive health and other health needs in urban settings. In Brazil, they may access care through the government-run Family Health Program (FHP). Understanding factors associated with service utilization can enhance access to and delivery of appropriate services.

OBJECTIVES

To describe demographic, behavioural and clinical characteristics of young women accessing services through FHP in Vitória, Brazil.

METHODS

From March to December 2006, women aged 18-29 years were recruited into a population-based, household survey. Responses were analysed to assess previous 6 months utilization of FHP services in this population and characteristics associated with accessing care through this public family practice model.

RESULTS

Of 1200 eligible women identified, 1029 enrolled (85.7%). Median age was 23 (interquartile range 20-26) years, 42.7% were married or cohabitating with a male partner. A majority (72%) accessed FHP services in the preceding 6 months, principally for routine and gynaecological visits. Factors independently associated with seeking FHP included: ever tested for human immunodeficiency virus, using anal sex as contraceptive method and reporting a current vaginal discharge. Prior commercial sex work, previous diagnosis with an sexually transmitted infection or using oral sex as a contraceptive method were associated with less use of FHP services.

CONCLUSIONS

A public option for delivery of FHP has attracted wide utilization across a cross-section of young women in Vitoria, Brazil. Greater sensitization to specific practices and needs of this population, especially around reproductive health, could further enhance the services provided by family practitioners.

Avaliação da informação sobre drogas e sua relação com o consumo de substâncias entre escolares

OBJETIVO: Conhecer a percepção dos adolescentes sobre os programas de prevenção ao uso de drogas, e com quem eles aprendem e conversam sobre as drogas. Relacionar o consumo de drogas com essas informações. MÉTODO: Foi realizado um estudo transversal com questionário anônimo autoaplicado em uma amostra proporcional de 1041 alunos do ensino médio no município de São José do Rio Preto, São Paulo, Brasil. RESULTADOS: 89,2% dos alunos receberam orientação sobre drogas na escola. Os meios selecionados para a realização de programas de prevenção contra o uso de drogas foram: palestras 83,1%, televisão 72%, jornal 33,7%, cursos 29,3%, cartazes 27,8% e rádio 25,8%. Os meios que permitem diálogo e questionamento foram mais bem avaliados, enquanto os apenas informativos foram criticados. Os alunos conversariam sobre drogas principalmente com os próprios pais (56,6%) e os amigos (50,5%), seguidos de profissionais especializados e professores (30,4% e 22,7%, respectivamente). Eles relataram ter aprendido sobre drogas com os pais (66,5%), seguidos dos professores (60%). As revistas e jornais foram selecionados por 51% dos escolares, e os amigos por 41,4%. Foram relacionados a menor taxa de consumo de drogas lícitas e ilícitas no último mês, o relato de ter recebido orientação sobre drogas na escola, e ter aprendido sobre drogas com pais ou professores. CONCLUSÃO: Os adolescentes consideram os pais e professores suas fontes de conhecimento sobre drogas, porém preferem conversar a respeito com os pais e amigos. A escola é um local oportuno para abordar o assunto, utilizando para isso estratégias que permitam a reflexão.

Child sexual abuse in southern Brazil and associated factors: a population-based study

Background

The prevalence of child sexual abuse (CSA) in the population has been poorly described in developing countries. Population data on child sexual abuse in Brazil is very limited. This paper aims to estimate lifetime prevalence of child sexual abuse and associated factors in a representative sample of the population aged 14 and over in a city of southern Brazil.

Methods

A two-stage sampling strategy was used and individuals were invited to respond to a confidential questionnaire in their households. CSA was defined as non-consensual oral-genital, genital-genital, genital-rectal, hand-genital, hand-rectal, or hand-breast contact/intercourse between ages 0 and 18. Associations between socio-demographic variables and CSA, before and after age 12, were estimated through multinomial regression.

Results

Complete data were available for 1936 respondents from 1040 households. Prevalence of CSA among girls (5.6% 95%CI [4.8;7.5]) was higher than among boys (1.6% 95%CI [0.9;2.6]). Boys experienced CSA at younger ages than girls and 60% of all reported CSA happened before age 12. Physical abuse was frequently associated with CSA at younger (OR 5.6 95%CI [2.5;12.3]) and older (OR 9.4 95%CI [4.5;18.7]) ages. CSA after age 12 was associated with an increased number of sexual partners in the last 2 months.

Conclusion

Results suggest that CSA takes place at young ages and is associated with physical violence, making it more likely to have serious health and developmental consequences. Except for gender, no other socio-demographic characteristic identified high-risk sub-populations.