Adriana de Oliveira Rodrigues

A epidemia de AIDS em adolescentes de 13 a 19 anos, no município do Rio de Janeiro: descrição espaço-temporal

INTRODUCTION The purpose of this study was to analyze the dynamics of the AIDS epidemic affecting adolescents in Rio de Janeiro to establish healthy prevention strategies. The incidence of AIDS in Brazil is declining among men who have sex with men (MSM) except in individuals between 13 and 19 years of age, and the feminization phenomenon is more pronounced among adolescents. METHODS We evaluated data from Sistema de Informações de Agravos de Notificação (SINAN) regarding cases of AIDS in patients aged between 13 and 19 years through November 2009. RESULTS This study includes 656 cases. The incidence of AIDS increased until 1998, and, since 1996, more cases have been diagnosed in girls than in boys. The homo/bisexual exposure category predominantly consisted of boys (50.8%), and the heterosexual category predominantly consisted of girls (88.9%). The geographic distribution of the cases by year of diagnosis revealed that the increase was proportionally larger in the poorest area and that there was a large decrease in the wealthiest area. A decreasing linear tendency was observed in the relationship between the year of diagnosis and the human development index (HDI). CONCLUSIONS This study demonstrates the need for greater investment in sexual health and reproductive services in the poorest areas of the city and in the promotion of healthy sexual practices directed to MSM and female adolescents.

The perceptions of medical researchers on qualitative methodologies

Abstract We aimed to verify doctor’s perception of the qualitative research method, via a qualitative study of interviews with questions on the aca-demic profile of doctors and on the methodol -ogy. We interviewed 42 professionals, of which 18 had experience with the qualitative method and 24 with the quantitative method. The re-sults showed that knowledge on the qualitative method was virtually nil among “quantitative researchers”, who did not value qualitative re-search, although some of those realized that it would be important to be more accepting in clinical practice. Others only considered the method as subsidiary to quantitative. The ma-jority considered qualitative methods as lacking academic structure, taking too long to conduct empirical studies, and being difficult to publish. All of them criticized the misuse of the method, and the “quantitatives” pointed out the prob-lem of being unable to reproduce. We concluded that widening the use of the qualitative method by doctors requires investment from the begin-ning of the academic career and participation in qualitative research projects.Physicians; Research Personnel; Qualitative Research

Percepção de pesquisadores médicos sobre metodologias qualitativas

Abstract We aimed to verify doctor’s perception of the qualitative research method, via a qualitative study of interviews with questions on the aca-demic profile of doctors and on the methodol -ogy. We interviewed 42 professionals, of which 18 had experience with the qualitative method and 24 with the quantitative method. The re-sults showed that knowledge on the qualitative method was virtually nil among “quantitative researchers”, who did not value qualitative re-search, although some of those realized that it would be important to be more accepting in clinical practice. Others only considered the method as subsidiary to quantitative. The ma-jority considered qualitative methods as lacking academic structure, taking too long to conduct empirical studies, and being difficult to publish. All of them criticized the misuse of the method, and the “quantitatives” pointed out the prob-lem of being unable to reproduce. We concluded that widening the use of the qualitative method by doctors requires investment from the begin-ning of the academic career and participation in qualitative research projects.Physicians; Research Personnel; Qualitative Research

Saúde sexual e reprodutiva para a população adolescente, Rio de Janeiro, Brasil

We aimed to analyze the geographic distribution, the structure of healthcare services and the human resources of all units of the Sistema Único de Saúde (SUS - the Unified Health System) that provide sexual and reproductive health (SRH) services to the adolescent population in the second largest city in Brazil. We conducted a cross-sectional study with geographical mapping and data collection through a questionnaire applied in person with coordinators of the units or their representatives in 147 outpatient clinics in Rio de Janeiro that have SSR services. We found that in over 90% of the units, adolescents are treated together with the adult population, without particular shifts or rooms for this age group. In more than 10% of services, treatment is only provided with the presence of the guardian. In cases of sexual violence, this proportion is 34%. Specific educational activities for this age group are only carried out in 12.9% of units and less than one third of doctors had received some kind of training to deal with adolescent health. In conclusion, despite the wide geographic distribution of health facilities, the structure of care and the human resources do not meet the specific needs of adolescents.

Infecção pelo HIV em adolescentes do sexo masculino: um estudo qualitativo

The gradual reduction in the incidence of AIDS among men who have sex with men has not occurred in the youngest age group; on the contrary, it is growing. This paper examines the vulnerabilities of adolescent males at risk of HIV infection. This is a qualitative study conducted through interviews with HIV positive young men undergoing treatment, whose diagnosis was made during adolescence. The interviews were recorded and transcribed in full. They were analyzed by intensive reading, classified by issues, and interpreted from a hermeneutic-dialectic perspective in dialogue with the literature. We interviewed 16 young men whose diagnosis occurred between the ages of 11 and 19 and for all of them the method of HIV transmission was sexual; 12 of the men were homosexual and 4 were heterosexual. It was evident that vulnerable situations included disbelief in the possibility of contamination, subjection to sex, homophobia and commercial sexual exploitation. This study demonstrates the importance of the formulation of public policies on sexual and reproductive health, which include adolescents and young men. These policies should embody the perspective of masculinity in all its widest aspects, as well as actions in favor of sexual diversity.`The gradual reduction in the incidence of AIDS among men who have sex with men has not occurred in the youngest age group; on the contrary, it is growing. This paper examines the vulnerabilities of adolescent males at risk of HIV infection. This is a qualitative study conducted through interviews with HIV positive young men undergoing treatment, whose diagnosis was made during adolescence. The interviews were recorded and transcribed in full. They were analyzed by intensive reading, classified by issues, and interpreted from a hermeneutic-dialectic perspective in dialogue with the literature. We interviewed 16 young men whose diagnosis occurred between the ages of 11 and 19 and for all of them the method of HIV transmission was sexual; 12 of the men were homosexual and 4 were heterosexual. It was evident that vulnerable situations included disbelief in the possibility of contamination, subjection to sex, homophobia and commercial sexual exploitation. This study demonstrates the importance of the formulation of public policies on sexual and reproductive health, which include adolescents and young men. These policies should embody the perspective of masculinity in all its widest aspects, as well as actions in favor of sexual diversity.

Percepção de pacientes com AIDS diagnosticada na adolescência sobre o aconselhamento pré e pós-teste HIV realizado

Pre- and post-HIV test counseling has singular importance in adolescence, since it is a phase of great changes, and AIDS is an incurable chronic disease. In order to comprehend the perception of young people with AIDS diagnosed in adolescence regarding the counseling received upon testing, we conducted 39 in-depth interviews, with 23 in female patients and 16 male patients, and then analyzed the data with extensive reading, categorization and interpretation on a comprehensive basis. The results revealed that less than one third received pre-test counseling (30.8%), which often was limited to the explanation of the reason of the test, and 51.2% were counseled post-test. We found that most patients were unaccompanied when receiving the communication of their seropositivity, some of which were later informed by the adolescents guardian. Some patients felt secure after counseling, realizing that the disease is something that would not change their lives, if they properly followed the guidelines. On the other hand, the feelings of desperation and suicide expressed by some of the patients may have been influenced by the lack of adequate counseling. We have concluded that, for the improved management of the epidemic, there is a need to enhance the communications of health professionals, especially those that are in primary care, pre-natal services, gynecology and family health strategy.Pre- and post-HIV test counseling has singular importance in adolescence, since it is a phase of great changes, and AIDS is an incurable chronic disease. In order to comprehend the perception of young people with AIDS diagnosed in adolescence regarding the counseling received upon testing, we conducted 39 in-depth interviews, with 23 in female patients and 16 male patients, and then analyzed the data with extensive reading, categorization and interpretation on a comprehensive basis. The results revealed that less than one third received pre-test counseling (30.8%), which often was limited to the explanation of the reason of the test, and 51.2% were counseled post-test. We found that most patients were unaccompanied when receiving the communication of their seropositivity, some of which were later informed by the adolescents guardian. Some patients felt secure after counseling, realizing that the disease is something that would not change their lives, if they properly followed the guidelines. On the other hand, the feelings of desperation and suicide expressed by some of the patients may have been influenced by the lack of adequate counseling. We have concluded that, for the improved management of the epidemic, there is a need to enhance the communications of health professionals, especially those that are in primary care, pre-natal services, gynecology and family health strategy.

Experiências homossexuais de adolescentes: considerações para o atendimento em saúde

Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.

Homosexual experiences of adolescents: considerations for healthcare

Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.

Experiencias homosexuales de adolescentes: consideraciones para la atención en salud.

Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.Objetivamos conhecer significados das praticas homoafetivas de adolescentes, tendo em vista contextos de vulnerabilidade que envolvem o exercicio da sexualidade numa sociedade homofobica. Realizamos entrevistas com nove rapazes e quatro mocas que procuraram atendimento em saude e relataram experiencia homossexual. Para alguns rapazes, a experiencia homossexual ocorreu de forma circunstancial, por curiosidade e experimentacao; para outros, esteve associada a prostituicao, e, para a maioria, relacionou-se a identidade homossexual autodeclarada. Nas mocas, dois significados sobressairam: a atividade homossexual associada ao amor e como possivel reacao a violencia sexual sofrida antes do inicio da experiencia homossexual. Todos os entrevistados revelaram nunca terem sido perguntados ou orientados acerca de homossexualidade nos servicos de saude. O estudo evidencia a necessidade de uma politica de atencao integral a saude deste publico, cuja sexualidade e diversa do padrao hegemonico da sociedade.

Percepción de los investigadores médicos en metodologías cualitativas

Abstract We aimed to verify doctor’s perception of the qualitative research method, via a qualitative study of interviews with questions on the aca-demic profile of doctors and on the methodol -ogy. We interviewed 42 professionals, of which 18 had experience with the qualitative method and 24 with the quantitative method. The re-sults showed that knowledge on the qualitative method was virtually nil among “quantitative researchers”, who did not value qualitative re-search, although some of those realized that it would be important to be more accepting in clinical practice. Others only considered the method as subsidiary to quantitative. The ma-jority considered qualitative methods as lacking academic structure, taking too long to conduct empirical studies, and being difficult to publish. All of them criticized the misuse of the method, and the “quantitatives” pointed out the prob-lem of being unable to reproduce. We concluded that widening the use of the qualitative method by doctors requires investment from the begin-ning of the academic career and participation in qualitative research projects.Physicians; Research Personnel; Qualitative Research