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de Araújo PX, Moreira P, de Almeida DC, de Souza AA, do Carmo Franco M. Oral contraceptives in adolescents: a retrospective population-based study on blood pressure and metabolic dysregulation. Eur J Clin Pharmacol 2024:10.1007/s00228-024-03671-z. [PMID: 38554180 DOI: 10.1007/s00228-024-03671-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 03/11/2024] [Indexed: 04/01/2024]
Abstract
PURPOSE This study aimed to explore the relationship between oral contraceptive use and blood pressure values and in a national cohort of women adolescents and to investigate the level of coexistence of the high blood pressure levels, dyslipidemia or insulin resistance. METHODS This is a retrospective cohort study that evaluated data form 14,299 adolescents aged 14 to 17 years. Crude and race-and age-adjusted analyses were performed using Poisson regression to estimate the prevalence ratios. Data clustering analysis was performed using machine learning approaches supported by an unsupervised neural network of self-organizing maps. RESULTS We found that 14.5% (n = 2076) of the women adolescents use oral contraceptives. Moreover, an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance (all P < 0.001) was observed among adolescents who use oral contraceptives as compared to those who do not. Our analysis also showed that 2.3% of adolescents using oral contraceptives had both high blood pressure levels and dyslipidemia, whereas 3.2% had high blood pressure levels combined with insulin resistance (all P < 0.001). The algorithmic investigative approach demonstrated that total cholesterol, LDLc, HDLc, insulin, and HOMA-IR were the most predicted variables to assist classificatory association in the context of oral contraceptive use among women adolescents with high blood pressure. CONCLUSIONS These findings suggest that oral contraceptives were associated with an increased prevalence of high blood pressure, dyslipidemia, and insulin resistance among women adolescents. Although the indication of this therapy is adequate to avoid unintended pregnancies, their use must be based on rigorous individual evaluation and under constant control of the cardiometabolic risk factors.
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Affiliation(s)
| | - Priscila Moreira
- Program of Translational Medicine, School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Alexandra Aparecida de Souza
- Laboratory of Applied Computing-LABCOM3, Federal Institute of Education, Science and Technology of São Paulo, São Paulo, Brazil
| | - Maria do Carmo Franco
- Physiology Department, School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
- LiTiVasC - Laboratory of Translational Research in Vascular and Molecular Physiology, School of Medicine, Federal University of São Paulo. Rua Botucatu, 862 - 5° floor - , São Paulo, SP, 04023-062, Brazil.
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Magno L, Medeiros DSD, Soares F, Grangeiro A, Caires P, Fonseca T, Westin MR, Dourado I. Factors associated to HIV prevalence among adolescent men who have sex with men in Salvador, Bahia State, Brazil: baseline data from the PrEP1519 cohort. CAD SAUDE PUBLICA 2023; 39Suppl 1:e00154021. [PMID: 36995866 DOI: 10.1590/0102-311xen154021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/11/2021] [Indexed: 03/29/2023] Open
Abstract
Adolescent men who have sex with men (AMSM) are at a heightened vulnerability for human immunodeficiency virus (HIV). This study aimed to estimate the prevalence of HIV and associated individual, social, and programmatic factors among AMSM in Salvador, Bahia State, Brazil. This is a cross-sectional study which analyzed baseline data from the PrEP1519 cohort in Salvador. Descriptive, bivariate, and multivariate analyses were conducted using the dimensions of vulnerability to HIV as hierarchical levels of analysis. Logistic regression models were used to estimate the odds ratios (OR) of the association between predictor variables and HIV infection. The prevalence of HIV infection among the 288 AMSM recruited to the project was 5.9% (95%CI: 3.7-9.3). Adjusted analysis showed a statistically significant association between self-identifying as a sex worker (OR = 3.74, 95%CI: 1.03-13.60) and HIV infection. Other associations with borderline statistical significance were the use of application programs to find sexual partners (OR = 3.30, 95%CI: 0.98-11.04), low schooling level (OR = 3.59, 95%CI: 0.96-13.41), failing to be hired or being dismissed from a job because of sexual orientation (OR = 2.88, 95%CI: 0.89-9.28), and not using health services as a usual source of care (OR = 3.14, 95%CI: 0.97-10.17). We found a high HIV prevalence among AMSM in Salvador. Furthermore, our study found that individual, social, and programmatic factors were associated with HIV infection among these AMSM. We recommend intensifying HIV combined-prevention activities for AMSM.
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Batista RL, Inácio M, Brito VN, Sircili MHP, Bag MJ, Gomes NL, Costa EMF, Domenice S, Mendonca BB. Sexuality and fertility desire in a large cohort of individuals with 46, XY differences in sex development. Clinics (Sao Paulo) 2023; 78:100185. [PMID: 36965237 PMCID: PMC10091460 DOI: 10.1016/j.clinsp.2023.100185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/31/2023] [Accepted: 03/02/2023] [Indexed: 03/27/2023] Open
Abstract
OBJECTIVE To analyze aspects of sexual life and fertility desire among 46, XY DSD people, including those who changed their gender. METHODS It is a cross-sectional study including 127 adults (> 16 years of age) with 46, XY DSD (83 females; 44 males) from a Single Brazilian Tertiary-Care Medical Center. RESULTS Sexual fantasies and masturbation were more frequent in 46, XY DSD males, whereas orgasm and sexual life satisfaction were similar in both genders. More 46, XY DSD men than women had a long-term romantic relationship. 46, XY DSD women with prenatal androgen exposure reported more fear of being romantically rejected. External genitalia appearance at birth did not impact the sexuality of 46, XY DSD women after surgical genital treatment had been completed. Overall, the sexual life was similar between 46, XY men assigned as males and those who changed to the male gender. Regarding sexual orientation, most self-reported as heterosexual (91% and 92% of women and men, respectively). The desire for fertility had a similar prevalence in both genders, but more women than men considered infertility a barrier to a long-term romantic relationship. Twelve individuals (7 males) had children; 10 out of 12 have adopted children. CONCLUSION Fertility desire was shared among 46, XY DSD people, regardless of gender. Prenatal androgen exposure reduced the desire for motherhood in 46, XY women. 46, XY DSD people who changed from female to male gender presented similar sexual parameters as those assigned as males. Among females, virilized genitalia at birth did not affect sexuality once the surgical treatment is completed.
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Affiliation(s)
- Rafael Loch Batista
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Marlene Inácio
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vinicius Nahime Brito
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Helena Palma Sircili
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Min Jeong Bag
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Nathália Lisboa Gomes
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elaine Maria Frade Costa
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sorahia Domenice
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Berenice Bilharinho Mendonca
- Developmental Endocrinology Unit, Hormone and Molecular Genetics Laboratory (LIM/42), Endocrinology Division, Internal Medicine Department, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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Oliveira GMMD, Almeida MCCD, Marques-Santos C, Costa MENC, Carvalho RCMD, Freire CMV, Magalhães LBNC, Hajjar LA, Rivera MAM, Castro MLD, Avila WS, Lucena AJGD, Brandão AA, Macedo AVS, Lantieri CJB, Polanczyk CA, Albuquerque CJDM, Born D, Falcheto EB, Bragança ÉOV, Braga FGM, Colombo FMC, Jatene IB, Costa IBSDS, Rivera IR, Scholz JR, Melo Filho JXD, Santos MAD, Izar MCDO, Azevedo MF, Moura MS, Campos MDSB, Souza OFD, Medeiros OOD, Silva SCTFD, Rizk SI, Rodrigues TDCV, Salim TR, Lemke VDMG. Position Statement on Women's Cardiovascular Health - 2022. Arq Bras Cardiol 2022; 119:815-882. [PMID: 36453774 PMCID: PMC10473826 DOI: 10.36660/abc.20220734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Daniel Born
- Escola Paulista de Medicina , São Paulo SP - Brasil
| | | | | | | | | | | | | | - Ivan Romero Rivera
- Hospital Universitário Professor Alberto Antunes / Universidade Federal de Alagoas , Maceió AL - Brasil
| | | | | | | | | | | | | | | | | | | | | | - Stéphanie Itala Rizk
- Instituto do Coração (Incor) do Hospital das Clínicas FMUSP , São Paulo SP - Brasil
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Rodrigues MAH, Carneiro MM. [Contraception in other countries: The example of Brazil]. Med Sci (Paris) 2022; 38:280-287. [PMID: 35333165 DOI: 10.1051/medsci/2022029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In Brazil, women have free access to contraception through the public health system, the Unified Health System (SUS) which offers the following contraceptive methods: Male and female condoms, diaphragm, spermicide, copper intrauterine device (IUD), combined oral and injectable contraceptive hormones, progestin-only contraceptives and injections of medroxyprogesterone acetate (DMPA), emergency pill, female sterilization and vasectomy. However, difficulties in scheduling appointments, women's lack of information about contraceptive methods, and the limited availability of different methods all contribute to high rates of unintended pregnancies. The rate of contraceptive use by Brazilian women aged 18 to 49 is approximately 62%; poorer parts of the country and low levels of education are among the main factors associated with lower rates of contraceptive method use. There are therefore challenges to be taken up to minimize the rates of unwanted pregnancies, which are still too high, such as better distribution, better offer of different contraceptive methods for all regions of the country and better training of professionals involved in women's health care.
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Affiliation(s)
| | - Marcia Mendonça Carneiro
- Department of Gynecology and Obstetrics, Federal University of Minas Gerais, Belo Horizonte, Brésil
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Asante KO, Nketiah-Amponsah E, Andoh-Arthur J, Ampaw S. The interactive effect of gender, residence, and socioeconomic status on early sexual debut among sexually active young adults in Ghana. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01285-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Tozetto HCDM, Tiguman GMB, Nicoletti MA, Aguiar PM. Adverse events related to oral hormonal contraceptive use in undergraduate pharmacy students: a cross-sectional study. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e21335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Barros BDS, Kuschnir MCC, Kuschnir FC, Jordão ÉADOC. ERICA: cardiovascular risks associated with oral contraceptive use among Brazilian adolescents. J Pediatr (Rio J) 2022; 98:53-59. [PMID: 34000229 PMCID: PMC9432124 DOI: 10.1016/j.jped.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To investigate the association between oral contraceptive use and cardiovascular risks, including metabolic syndrome and their components in Brazilian adolescents. METHOD This study used data from the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA), a nationwide, cross-sectional, school-based study with individuals aged 12-17 years. Sociodemographic variables and OC use were assessed by a self-administered questionnaire. International Diabetes Federation criteria were used to define metabolic syndrome. Descriptive statistics were reported as prevalence and their respective confidence interval of 95% of oral contraceptives according to variables. Logistic regression was performed. Crude and adjusted odds ratios were calculated. RESULTS This subsample was composed of 22,682 female adolescents, of which 12.65% reported using oral contraceptives and their use was associated with hypertension and hypertriglyceridemia. These associations remained statistically significant after adjusting for age, school region, race, and tobacco use with an increase of 2.68 (1.66 - 4.32) and 3.45 (2.56 - 4.65) times, respectively. CONCLUSION The present study was the first to examine the association between the use of oral contraceptives and cardiovascular risk factors among the largest number of female Brazilian adolescents. This method was significantly associated with hypertension, hypertriglyceridemia. Teenagers using oral contraceptives should be monitored for side effects, including blood pressure measurements and advised to avoid smoking.
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Affiliation(s)
- Bruna de Siqueira Barros
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciência Médicas, Núcleo de Estudos da Saúde do Adolescente, Programa de Pós-Graduação em Ciências Médicas, Rio de Janeiro, RJ, Brazil.
| | - Maria Cristina Caetano Kuschnir
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciência Médicas, Núcleo de Estudos da Saúde do Adolescente, Programa de Pós-Graduação em Ciências Médicas, Rio de Janeiro, RJ, Brazil
| | - Fábio Chigres Kuschnir
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Programa de Pós-Graduação em Ciências Médicas, Departamento de Pediatria, Rio de Janeiro, RJ, Brazil
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Borges ALV, Duarte LS, Cabral CDS, Lay AAR, Viana OA, Fujimori E. Male condom and dual protection use by adolescent men in Brazil. Rev Saude Publica 2021; 55:109. [PMID: 34910032 PMCID: PMC8621551 DOI: 10.11606/s1518-8787.2021055003298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the use of male condoms and dual protection by Brazilian adolescent men, as well as their associated aspects. METHODS A database from the Study of Cardiovascular Risks in Adolescents (ERICA) was used for this national cross-sectiotabelnal school-based research. The sample included adolescents of both sexes, aged between 12 and 17 years old, selected through cluster sampling in 2014 (n = 75,060). This study analyzed information from adolescent men who reported having had sexual intercourse (n = 12,215). The dependent variables were the use of male condoms and the use of dual protection (simultaneous use of male condoms and oral hormonal contraceptives) in the last sexual intercourse. Data were analyzed using univariate and multiple logistic regression. RESULTS Most adolescents used a male condom in the last sexual intercourse, while the use of double protection was quite low. The use of male condoms, reported by 71% (95%CI 68.7-73.1), was positively associated with age, living with both parents, and having used alcohol in the previous 30 days. The use of double protection, reported by 3.6% (95%CI 2.8-4.5) was positively associated with age and studying in a private school, as well as negatively associated with tobacco use in the previous 30 days. CONCLUSIONS The wide difference shown in the proportion of condom or dual protection use in the last sexual intercourse draws attention to the different logics that govern juvenile sexual relations. The low proportion of dual protection use may be a reflection of men's lack of knowledge about a function that has historically been attributed to women, which is contraception. Thus, one must deconstruct such dichotomy that the sphere of sexuality is of the domain/interest of men, while that of reproduction concerns only women.
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Affiliation(s)
- Ana Luiza Vilela Borges
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
| | - Luciane Simões Duarte
- Secretaria de Estado da Saúde de São PauloCentro de Vigilância EpidemiológicaDivisão de Doenças Crônicas Não TransmissíveisSão PauloSPBrasilSecretaria de Estado da Saúde de São Paulo. Centro de Vigilância Epidemiológica. Divisão de Doenças Crônicas Não Transmissíveis. São Paulo, SP, Brasil
| | - Cristiane da Silva Cabral
- Universidade de São PauloFaculdade de Saúde PúblicaDepartamento Saúde, Ciclos de Vida e SociedadeSão PauloSPBrasilUniversidade de São Paulo. Faculdade de Saúde Pública. Departamento Saúde, Ciclos de Vida e Sociedade. São Paulo, SP, Brasil
| | - Alejandra Andrea Roman Lay
- Universidad de TarapacáFacultad de Ciencias de la SaludAricaChileUniversidad de Tarapacá. Facultad de Ciencias de la Salud. Arica, Chile
| | - Osmara Alves Viana
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
| | - Elizabeth Fujimori
- Universidade de São PauloEscola de EnfermagemDepartamento de Enfermagem em Saúde ColetivaSão PauloSPBrasilUniversidade de São Paulo. Escola de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. São Paulo, SP, Brasil
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Paes SC, Paiva NS, Kawa H, Fonseca SC. [Unsafe abortions in the State of Rio de Janeiro, Brazil: magnitude and time trend from 2008 to 2017]. CAD SAUDE PUBLICA 2021; 37:e00299720. [PMID: 34730695 DOI: 10.1590/0102-311x00299720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 04/01/2021] [Indexed: 11/21/2022] Open
Abstract
Data on unsafe abortions are scarce, and estimates based on hospitalizations have pointed to a decline in recent years. The study aimed to analyze the time trend in unsafe abortions in the State of Rio de Janeiro, Brazil, from 2008 to 2017. We used secondary data on hospitalizations in the Brazilian Unified National Health System (SUS) due to complications of abortion in childbearing-age women (CAW) 15 to 44 years of age. We applied indirect estimation with a correction factor based on national and state data. We calculated the unsafe abortion rate per CAW (UAR-CAW), ratio of unsafe abortions per live births (RUA-LB), according to age bracket. We also calculated new indicators: spontaneous abortion rate (SAR) and unspecified abortion rate (USAR) per CAW; ratio of spontaneous abortions (RSA) and ratio of unspecified abortions (RUSA) per live births, independently of age. Time trend was calculated by Joinpoint regression, calculating the annual percent change (APC) and 95% confidence intervals (95%CI). The women that most induced abortions were 20 to 24 years of age, with UAR of 8 per 1,000. Pregnancies that ended in unsafe abortion were most frequent in the 40-44-year bracket: UAR of 16 to 20 per 100 live births. Adolescents showed a reduction in UAR from 2015 to 2017 (APC = -10; 95%CI: -18.2; -1.1), while there was an increase in women 40-44 years of age from 2008 to 2017 (APC = 2.2; 95%CI 0.5 to 4.0). The other age brackets and the indicator UAR-LB showed stability. SAR (APC = -3.5; 95%CI: -5.9; -1.0), and RSA (APC = -3.8; 95%CI: -6.3; -1.2) decreased, while USAR (APC = 6.6; 95%CI: 1.7; 11.8) and RUSA (APC = 6.4; 95%CI: 1.6; 11.3) increased during the period. The magnitude and time trend of unsafe abortions in the State of Rio de Janeiro differed according to age bracket and ICD-10 code.
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Affiliation(s)
- Stéphanie Chaves Paes
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil
| | - Natália Santana Paiva
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Hélia Kawa
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil
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Borges ALV, Duarte LS, Lay AAR, Fujimori E. Individual and context correlates of the oral pill and condom use among Brazilian female adolescents. BMC WOMENS HEALTH 2021; 21:307. [PMID: 34412604 PMCID: PMC8374415 DOI: 10.1186/s12905-021-01447-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 08/06/2021] [Indexed: 01/21/2023]
Abstract
Background Studies have examined the impact of contextual factors on the use of contraceptives among adolescents and found that many measures of income and social inequality are associated with contraceptive use. However, few have focused on maternal and primary health indicators and its influence on adolescent contraceptive use. This paper assesses whether maternal mortality rates, antenatal care visits, and primary healthcare coverage are associated with pill and condom use among female adolescents in Brazil. Methods We used data from the Study of Cardiovascular Risks in Adolescents (ERICA), a national, school-based cross-sectional study conducted in Brazil. A subsample of all female adolescents who had ever had sexual intercourse and were living in one of the 26 State capitals and the Federal District was selected (n = 7415). Multilevel mixed effects logistic regression models were estimated to examine the effect of contextual variables on pill and condom use. Results Sixty-five percent of female adolescents reported using pill while 21.9% reported using condom during the last sexual intercourse. Adolescents living in municipalities with low maternal mortality and high antenatal care coverage were significantly more likely to use pill during the last sexual intercourse compared to those from municipalities with high maternal mortality and low antenatal care coverage. Primary healthcare coverage (proportion of the population covered by primary healthcare teams) was not significantly associated with either condom or pill use during the last sexual intercourse. Conclusion Our findings suggest that promoting the use of pill among female adolescents may require approaches to strengthen healthcare systems rather than those focused solely on individual attributes. Supplementary Information The online version contains supplementary material available at 10.1186/s12905-021-01447-6.
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Affiliation(s)
- Ana Luiza Vilela Borges
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil. .,School of Nursing, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, 419, São Paulo, SP, 05403-000, Brazil.
| | - Luciane Simões Duarte
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil.,School of Nursing, University of São Paulo, Avenida Doutor Enéas de Carvalho Aguiar, 419, São Paulo, SP, 05403-000, Brazil
| | - Alejandra Andrea Roman Lay
- Faculty of Health Sciences, University of Tarapacá, Avenida 18 de Septiembre, 2222, 1000000, Arica, Chile
| | - Elizabeth Fujimori
- Public Health Nursing Department, School of Nursing, University of São Paulo, São Paulo, Brazil
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Perea LME, Antunes JLF, Peres MA. Oral and oropharyngeal cancer mortality in Brazil, 1983-2017: Age-period-cohort analysis. Oral Dis 2020; 28:97-107. [PMID: 33215764 DOI: 10.1111/odi.13732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 12/24/2022]
Abstract
AIM To estimate the effect of age, period, and birth cohort on mortality from oral and oropharyngeal cancer in Brazil. METHODS Deaths due to oral and oropharyngeal cancer from 1983 to 2017 were analyzed. The effect of age, period, and cohort was calculated using the Poisson regression model. RESULTS Between 1983 and 2017, 142,634 deaths were recorded from oral and oropharyngeal cancer in Brazil, 54% from oropharyngeal cancer. The male sex contributed to 81% of the deaths. The average mortality rate for men was 4.5 deaths per 100,000 inhabitants, and for women, it was 0.9 deaths per 100,000 inhabitants. There was a strong effect of age on mortality rates from oral and oropharyngeal cancer. The risk increases from 40 years of age in men and 55 years of age in women. An overall period effect was observed. The 2000 period showed the greatest risk when compared to the 1985 period in men. In women, the period of highest risk was 2010. The cohorts born between 1958 and 1962 had a higher risk of death. CONCLUSIONS The period effect is mainly attributed to mortality from oropharyngeal cancer. Most significant values regarding the effect on the cohort groups were observed in female mortality from oral cancer.
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Affiliation(s)
| | | | - Marco Aurélio Peres
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore.,Systems Research Programme, Duke-NUS Medical School, Oral Health ACP, Health Services, Singapore
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Pornography Use in Adolescents and Its Clinical Implications. J Clin Med 2020; 9:jcm9113625. [PMID: 33187153 PMCID: PMC7698108 DOI: 10.3390/jcm9113625] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/30/2020] [Accepted: 11/04/2020] [Indexed: 02/05/2023] Open
Abstract
(1) Background: The Differential Susceptibility to Media Effects Model (DSMM) suggests that pornography use effects are conditional and they depend on dispositional, developmental, and social differential susceptibility variables. This framework also highlights that the differential susceptibility variables act as predictors of pornography use and as moderators of the effect of pornography on criterion variables. (2) Methods: By administering a survey to n = 1500 adolescents, we tested whether these assumptions were met. (3) Results: Pornography use was related to being male and older, having a bisexual or undefined sexual orientation, higher substance use, being non-Muslim, and reporting sexual interest and the use of the media to obtain sexual information. Structural Equation Modeling (SEM) showed that higher levels in the criterion variables were directly related to pornography use, older age, substance use, and being women. Some mediational links also emerged. Pornography use mediated between the age and criterion variables. Moreover, substance use mediated the association between age and gender with the criterion variables. (4) Conclusions: Our findings support the clinical applicability of the theoretical DSMM framework. Knowing adolescent pornography consumers’ profiles and the impact of pornography on this population would allow for the designing of more effective prevention and regulation proposals.
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Abstract
In late 2015, the Brazilian Ministry of Health and the Pan American Health Organization classified the increase in congenital malformations associated with the Zika virus (ZIKV) as a public health emergency. The risk of ZIKV-related congenital syndrome poses a threat to reproductive outcomes that could result in declining numbers of live births and potentially fertility. Using monthly microdata on live births from the Brazilian Information System on Live Births (SINASC), this study examines live births and fertility trends amid the ZIKV epidemic in Brazil. Findings suggest a decline in live births that is stratified across educational and geographic lines, beginning approximately nine months after the link between ZIKV and microcephaly was publicly announced. Although declines in total fertility rates were small, fertility trends estimated by age and maternal education suggest important differences in how Zika might have impacted Brazil's fertility structure. Further findings confirm the significant declines in live births in mid-2016 even when characteristics of the municipality are controlled for; these results highlight important nuances in the timing and magnitude of the decline. Combined, our findings illustrate the value of understanding how the risk of a health threat directed at fetuses has led to declines in live births and fertility.
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Affiliation(s)
- Letícia J Marteleto
- Population Research Center and Department of Sociology, University of Texas at Austin, Austin, TX, USA.
| | - Gilvan Guedes
- Demography Department and Center for Development and Regional Planning (Cedeplar), Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Brazil
| | - Raquel Z Coutinho
- Demography Department and Center for Development and Regional Planning (Cedeplar), Universidade Federal de Minas Gerais, Pampulha, Belo Horizonte, Brazil
| | - Abigail Weitzman
- Population Research Center and Department of Sociology, University of Texas at Austin, Austin, TX, USA
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15
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França MTA, Frio GS. Factors associated with family, school and behavioral characteristics on sexual initiation: A gender analysis for Brazilian adolescents. PLoS One 2018; 13:e0208542. [PMID: 30532164 PMCID: PMC6287818 DOI: 10.1371/journal.pone.0208542] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 11/19/2018] [Indexed: 11/18/2022] Open
Abstract
Adolescence is a period of transition between childhood and adulthood. The article aims to study the individual, family and school characteristics of adolescents beginning their sexual lives. The database we used was the 2015 PeNSE (National Adolescent School-based Health Survey) and the methodology was the survival analysis. The results show that boys initiate sexual activity before girls and risky behaviors associated with the use of licit and illicit drugs increase the chance of having early sex. In addition, this work highlights the importance of parental practices in reducing the chances of beginning sexual activity, as well as the presence of school workshops on the risks of pregnancy. It should be noted that intervention strategies need to be differentiated according to gender in order to increase effectiveness.
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Affiliation(s)
- Marco Túlio Aniceto França
- Departament of Economics, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Gustavo Saraiva Frio
- Departament of Economics, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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16
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Monteiro DLM, Brollo LCS, Souza TPD, Santos JRPD, Santos GR, Correa T, Costa JTD, Oliveira MAPD, Trajano AJB. Knowledge on the HPV vaccine among university students. Rev Inst Med Trop Sao Paulo 2018; 60:e46. [PMID: 30231162 PMCID: PMC6169093 DOI: 10.1590/s1678-9946201860046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/24/2018] [Indexed: 11/22/2022] Open
Abstract
The objective is to evaluate knowledge on HPV vaccine and its use among university students. This is a cross-sectional study with 301 participants, of which 202 medical students from UERJ and UNIFESO (101 freshmen = M1 and 101 from the 6th year = M2) and 99 UERJ literature students (50 freshmen = L1 and 49 of the last year = L2). Information was obtained by questionnaires. Input and statistical analysis were carried out with the EPI-INFO 3.5.2 Program. Results showed that, among medical students, 21% of M1 and 16% of M2 used the HPV vaccine (p=0.35), mostly adopted by women (M1=29.7% and M2=21.3%) than men (M1=5.4% and M2=7.5%). Similarly, female students showed more interest in using the vaccine (M1=85.1% and M2=80%) than male (M1=56.2% and M2=20.5%). Among literature students, only women received the vaccine (L1=6.5% and L2=22.2%) and no men were vaccinated (p=0.04). More women expressed interest in receiving the vaccine than men (♀ L1=76%, L2=65% and ♂, L1=47%, L2=40%). Comparison among genders regardless of the course showed that the vaccination rate is higher among women (p<0.001), as is the interest in being vaccinated (p=0.004). We concluded that the majority of male university students know less about the HPV vaccine than the female ones, use less and are less interested in being vaccinated, in all the groups interviewed. Vaccination coverage is low among the university population and is higher among medical students.
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Affiliation(s)
- Denise Leite Maia Monteiro
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Tayná Pinheiro de Souza
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Gildásio Rocha Santos
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tatiane Correa
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Julie Teixeira da Costa
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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17
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Priotto EMTP, Führ AL, Gomes LMX, Barbosa TLDA. [Sexual initiation and contraceptive practices among adolescents in the tri-border area between Brazil, Argentina, and ParaguayIniciación sexual y prácticas anticonceptivas de adolescentes en la triple frontera entre Brasil, Argentina y Paraguay]. Rev Panam Salud Publica 2018; 42:e16. [PMID: 31093045 PMCID: PMC6386139 DOI: 10.26633/rpsp.2018.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine the prevalence of sexual initiation and the contraceptive practices of adolescents in the tri-border area between the cities of Foz do Iguaçu (Brazil), Ciudad del Este (Paraguay), and Puerto Iguazú (Argentina). METHOD A cross-sectional study was conducted with 2 788 adolescents from public schools (age 12 to 18 years). Information was obtained through questionnaires administered in the schools between 2012 and 2013. The prevalence of sexual initiation, contraceptive practices, and sociodemographic variables was analyzed. To verify the association between the studied variables, the chi-square test was used with a significance level of 5%. RESULTS The overall prevalence of sexual initiation among adolescents was 34.6% (Puerto Iguazú: 45.3%; Foz do Iguaçu: 35.2%; Ciudad del Este: 23.3%). The prevalence of sexual initiation was higher in males and in the 15-16 year age range. Sexual initiation was associated with sex, age, schooling, and school shift (morning, afternoon, or evening). Having received information on contraceptives was associated with sex, age, schooling, and contraceptive use in all three cities/countries. Adolescents of both sexes had received information about contraceptives, especially from the family and the school. CONCLUSIONS It is suggested that municipalities/countries seek to structure a tri-national border policy with intersectoral programs and projects in order to promote educational practices regarding sexual and reproductive health for adolescents.
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Affiliation(s)
- Elis Maria T. Palma Priotto
- Universidade Estadual do Oeste do Paraná (UNIOESTE), Centro de Educação, Letras e Saúde (CELS), Campus Foz do Iguaçu (PR), Brasil
| | - Aline Luiza Führ
- Universidade Federal da Integração Latino-Americana (UNILA), Instituto Latino-Americano de Ciências da Saúde e da Natureza (ILACVN), Foz do Iguaçu (PR), Brasil
| | - Ludmila Mourão Xavier Gomes
- Universidade Federal da Integração Latino-Americana (UNILA), Instituto Latino-Americano de Ciências da Saúde e da Natureza (ILACVN), Foz do Iguaçu (PR), Brasil
| | - Thiago Luis de Andrade Barbosa
- Universidade Federal da Integração Latino-Americana (UNILA), Instituto Latino-Americano de Ciências da Saúde e da Natureza (ILACVN), Foz do Iguaçu (PR), Brasil
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18
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Gonçalves H, Gonçalves Soares AL, Bierhals IO, Machado AKF, Fernandes MP, Hirschmann R, da Silva TM, Wehrmeister FC, Menezes AMB. Age of sexual initiation and depression in adolescents: Data from the 1993 Pelotas (Brazil) Birth Cohort. J Affect Disord 2017; 221:259-266. [PMID: 28662457 PMCID: PMC5523946 DOI: 10.1016/j.jad.2017.06.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/05/2017] [Accepted: 06/17/2017] [Indexed: 01/25/2023]
Abstract
BACKGROUND Studies have shown that sexual initiation at earlier ages increases the risk of depressive symptoms in adolescents. However, little is known about its association with major depressive episode (MDE). METHODS The association between age of sexual initiation and MDE at 18 years was assessed in the 1993 Pelotas Birth Cohort using multiple logistic regression. Sexual initiation characteristics (age and type of partner) were assessed at the 15- and 18-years follow-up. The age of sexual initiation was evaluated in categories (11-14, 15-16, 17+ years). The type of partner was categorized into: boyfriend/ girlfriend, casual partner and other. MDE was assessed using the Mini International Neuropsychiatric Interview (MINI). RESULTS From the 4027 adolescents assessed, the prevalence of MDE was higher in females (10.1%) than in males (3.4%), and 66.7% of the males and 58.6% of the females reported sexual initiation up to 16 years (p < 0.001). Female adolescents who had sexual initiation <17 years had higher odds of MDE (15-16 years: OR 2.29; 11-14 years: OR 2.23), however no association was found for males. The type of partner in the first sexual intercourse was not associated to depression. LIMITATIONS Possibility of recall bias on the age of sexual initiation, and low statistical power for some analyses. CONCLUSIONS A positive association between age of sexual initiation and MDE was observed only in females. More investigation is needed to understand the mechanisms through which age of sexual initiation can affect the risk of depression and whether the association persists in adulthood.
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Affiliation(s)
- Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
| | - Ana L Gonçalves Soares
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil; MRC Integrative Epidemiology Unit at the University of Bristol, School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Isabel O Bierhals
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | | | - Mayra P Fernandes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Roberta Hirschmann
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Thais M da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | | | - Ana M B Menezes
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
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19
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Mola R, Pitangui ACR, Barbosa SAM, Almeida LS, Sousa MRMD, Pio WPDL, Araújo RCD. Condom use and alcohol consumption in adolescents and youth. EINSTEIN-SAO PAULO 2017; 14:143-51. [PMID: 27462887 PMCID: PMC4943347 DOI: 10.1590/s1679-45082016ao3677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/08/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To determine the association between not using the male condom and alcohol consumption in adolescents and schoolchildren. METHODS An epidemiological study, with a cross-sectional, descriptive, and correlation design carried out from March to July 2014. The sample consisted of students in public primary and secondary education, aged between 12 and 24 years. The social and demographic survey and the Youth Risk Behavior Survey questionnaire were used. RESULTS The study included 1,275 students, of these; 37.0% reported having had sexual relations. The prevalent age of sexual initiation was 14-16 years 55.7% and 65.6% used condom in the last sexual intercourse. Regarding the lack of condom use at the last intercourse, girls showed an association with drunkenness in the previous 30 days (2.19; 95%CI: 1.06-4.54). CONCLUSION In females, the non-use of condoms was associated with drunkenness in the previous 30 days. OBJETIVO Identificar os fatores associados ao não uso de preservativo masculino e ao consumo de bebida alcoólica em adolescentes e jovens escolares. MÉTODOS Estudo epidemiológico, com delineamento transversal, descritivo e correlacional, desenvolvido de março a julho de 2014. A amostra foi composta por estudantes dos Ensinos Fundamental e Médio da rede pública estadual, com idades entre 12 e 24 anos. Empregaram-se o inquérito sociodemográfico e o questionário Youth Risk Behavior Survey. RESULTADOS Foram incluídos 1.275 estudantes; 37,0% deles relataram terem tido relação sexual. A idade prevalente de iniciação sexual foi de 14 a 16 anos, com 55,7%; 65,6% usaram preservativo na última relação. Com relação ao não uso de preservativo na última relação, as meninas apresentaram associação com bebedeira nos últimos 30 dias (2,19; IC95%: 1,06-4,54). CONCLUSÃO O não uso de preservativos esteve associado com bebedeira nos últimos 30 dias nas meninas.
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Affiliation(s)
- Rachel Mola
- Universidade de Pernambuco, Petrolina, PE, Brazil
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