Electra González A

Comportamientos sexuales y diferencias de género en adolescentes usuarios de un sistema público de salud universitario

We studied 4,971adolescents of both sexes aged between 12 and 19 years, who consulted in a clinic for adolescentsbetween the years 1990 and 2005. Several variables related to adolescent sexuality were considered.Uni and bivariate analysis were carried out and a model of stratified lineal regression per sex wasfixed to explain the following variables: age at which sexual activity is initiated, number of sexualpartners, time period between start of dating and the start of sexual activity along time.

Madres niñas-adolescentes de 14 años y menos: Un grave problema de salud pública no resuelto en Chile

Background: Teenage fecundity rates are an indicator of epidemiological discrimination in developing countries. Aim: To study fertility rates of girls under 14 years of age in Chile from 1993 to 2003. Material and methods: Information of children born alive from mothers aged 10 to 15 years, was obtained from the Chilean National Institute of Statistics. Age segmented population data was obtained from the Ministry of Health. Trends were analyzed by regions and single ages. The rates in communities of the Metropolitan Region were compared. Results: Between 1993 and 2003, there was an increasing trend in fecundity rates, ratios and crude numbers. These rates duplicate from 14 to 15 years of age. In the Metropolitan Region, the fecundity ratios of communities with lower economical incomes is seven times greater than those with higher incomes. During 2003, the fecundity rates in Chile were 100 and 10 higher than those of Holland and Sweden in 1981. Conclusions: In developing countries with very low infant mortality rates such as Chile, the high fecundity rates of young girls is an indicator of a deficient human and social development. Sexual Education and Health Services for adolescents are essential to prevent this public health problem

PERCEPCIONES Y EXPERIENCIAS DEL INICIO SEXUAL DESDE UNA PERSPECTIVA DE GÉNERO, EN ADOLESCENTES CONSULTANTES EN UN CENTRO UNIVERSITARIO DE SALUD SEXUAL Y REPRODUCTIVA

Antecedentes: El contexto en que se inicia la actividad sexual en adolescentes tiene importantes signifca-dos para las personas e implicancias en salud publica. Objetivo: Conocer con un enfoque exploratorio, los factores que infuyen en el inicio de la actividad sexual en adolescentes y explorar el contexto en el cual ocurre. Metodo: Muestra de adolescentes, hombres y mujeres, sexualmente activos entre 14 y 19 anos, re-clutados en el CEMERA, durante 2007. Se realizaron 117 entrevistas semiestructuradas. Se utilizo el analisis tematico de los datos. Los signifcados e interpretaciones fueron constantemente verifcados a traves de sucesivos analisis. Resultados: El grado de control personal que tuvieron sobre los factores que condujeron a su primera experiencia sexual, determino como ellos/as se sintieron con esta experiencia. Aquellos/as que dijeron que habia sido una buena experiencia, demoraron el inicio sexual hasta que se sintieron comodos/as con el momento y con quien debutaron sexualmente. Sin embargo, sentimientos de culpa marcaron el evento, porque ellos/as habian transgredido las normas sociales. En contraste, la coercion de sus parejas y los efectos del alcohol, fueron razones que llevaron a una experiencia sexual prematura y no deseada. Conclusiones: El rol de la interaccion con sus pares, el abuso de alcohol y la presion de la pareja, en el caso de las ninas, infuyen en la actividad sexual prematura y no deseada. Las intervenciones educacionales debieran considerar estos aspectos para que tengan relevancia personal y el impacto pueda ser mayor en la postergacion del inicio de la actividad sexual o que esta sea protegida.

Propiedades psicométricas del cuestionario de calidad de vida relacionada con la salud KIDSCREEN-27 en adolescentes chilenos

The reliability, calculated through Cronbach’s alpha, for the entire instru-ment (five dimensions) was 0.89. For physical well-being, psychological well-being, autonomy and relationship with parents and peer social support dimensions, scores were higher than 0.75 while for school environment, the score was 0.69. The confirmatory factor analysis showed that the indices obtained to assess the goodness of fit in this study were a

Factores familiares asociados al inicio sexual temprano en adolescentes consultantes en un centro de salud sexual y reproductiva en Santiago de Chile

Background: Nowadays, adolescent population begins sexual activity earlier, a behavior with negativepsychological ana social consequences. Aim: To determine the association between family factors and early sexual activity in adolescents oflow and middle socioeconomic level. Material and Methods: A sample of 3,210 adolescents, who confidentially requested care in a sexual and reproductive health university center, between 2000 and 2007, was analyzed. Adolescents who started sexual activity before 15years ofage, and those who started sexual activity after 15years ofage, were compared. Data was collectedfrom structured interviews conducted at the adolescente firstvisit. Logistic regression was used to identify family factors associated with early sexual initiatingin both, men and women. Results: Family factors associated with early sexual activity startwere not being raised by both parents, apoor parent-child relationship, a poor family communication, mothers with a history of adolescent motherhood, mothers employed outside the home and family dysfunction. Among women, the variables associated with a higher risk of early sexual debut were not married parents and history of adolescent fatherhood record among parents. Among men, these variables were permissions without restriction during the week and punishment when family rules were broken. Conclusions: Family factors must be considered in the design ofstrategies to prevent early sexual activity.BACKGROUND Nowadays, adolescent population begins sexual activity earlier, a behavior with negative psychological ana social consequences. AIM To determine the association between family factors and early sexual activity in adolescents of low and middle socioeconomic level. MATERIAL AND METHODS A sample of 3,210 adolescents, who confidentially requested care in a sexual and reproductive health university center, between 2000 and 2007, was analyzed. Adolescents who started sexual activity before 15 years of age, and those who started sexual activity after 15 years of age, were compared. Data was collected from structured interviews conducted at the adolescente first visit. Logistic regression was used to identify family factors associated with early sexual initiating in both, men and women. RESULTS Family factors associated with early sexual activity start were not being raised by both parents, a poor parent-child relationship, a poor family communication, mothers with a history of adolescent motherhood, mothers employed outside the home and family dysfunction. Among women, the variables associated with a higher risk of early sexual debut were not married parents and history of adolescent fatherhood record among parents. Among men, these variables were permissions without restriction during the week and punishment when family rules were broken. CONCLUSIONS Family factors must be considered in the design of strategies to prevent early sexual activity.

Factores asociados al inicio sexual en adolescentes de ambos sexos de nivel socioeconómico medio-bajo de la Región Metropolitana

Antecedentes: Escasa evidencia esta disponible en Chile acerca del inicio de la actividad sexual adolescente. Objetivo: Examinar cuales variables identificadas previamente estan asociadas al inicio de la actividad sexual en una poblacion adolescente de nivel socioeconomico medio-bajo de la Region Metropolitana. Metodo: Los datos corresponden a adolescentes consultantes en CEMERA. Se compararon con adolescentes que habian iniciado actividad sexual y aquellos que no. La informacion fue recolectada en la primera consulta a 5.854 adolescentes de ambos sexos entre 12 y 19 anos. Se uso regresion logistica para identificar los factores asociados al inicio sexual. Resultados: 92,6% mujeres y 7,4% hombres. El 84,2% habia iniciado actividad sexual y no el 15,8%. Las variables asociadas al inicio sexual fueron: ser hombre; mayor edad; mayor escolaridad; aspiraciones academicas basicas; desempeno escolar bajo; repitencia escolar; no afiliacion religiosa; no asistencia a servicios religiosos; tener un trabajo; tener pareja mayor; tener una pareja que trabaje; conversar temas de sexualidad solo con la pareja; mas parejas romanticas; no participacion social; historia de abuso sexual; mayor numero de hijos; mala relacion padre-hijo; mala comunicacion familiar; supervision parental limitada; historia de paternidad y/o maternidad adolescente en los padres; padres con baja educacion; menor supervision parental. Conclusion: Se necesitan programas que motiven a retardar el inicio sexual. Los programas de educacion sexual deberian animar a la conversacion de los temas de sexualidad con los padres y capacitar a los educandos a demorar el inicio sexual y/o obtener anticonceptivos, en forma expedita, amigable y confidencial.

Características y consecuencias de las agresiones sexuales en adolescentes consultantes en un centro de salud sexual y reproductiva

Antecedentes: La agresion sexual es un evento traumatico y doloroso que afecta de manera transversal, a las victimas de ambos sexos, de todos los niveles socioeconomicos con graves consecuencias para la salud fisica, psicologica y social para quienes la sufren. Objetivo: Determinar las caracteristicas de las agresiones sexuales y sus consecuencias en adolescentes consultantes en un centro de atencion en Salud Sexual y Reproductiva. Metodo: Estudio analitico de corte transversal de 573 adolescentes atendidas en un centro de medicina reproductiva (CEMERA) en el periodo 2003-2010 y que reportaron antecedente de abuso sexual. Se estudiaron tanto las caracteristicas como las consecuencias del abuso, datos que se obtuvieron desde las fichas clinicas. Resultados: En el 86,5 % de los casos se reporto abuso sexual y en un 13,5% violacion. El 48,5% de los agresores son familiares. La edad mas vulnerable fue entre 5-9 anos con un 41,2%. En el 39,2% el abuso sexual fue reiterado. En un 43,4% el lugar fue el propio hogar de la victima. Un 70% revelo y de estos el 45,9% lo hizo en forma tardia. Solo en un 19% se hizo la denuncia legal. De las adolescentes que iniciaron actividad sexual voluntaria (83,3%), un 35,4% tenia menos de 15 anos. Un 11,8% reporto 3 y mas parejas sexuales. Conclusion: El antecedente de abuso sexual debe ser considerado en la atencion de adolescentes que consultan por salud sexual y reproductiva. El equipo de salud debe estar preparado para atender sus multiples necesidades.

PRINCIPALES CONSIDERACIONES BIOÉTICAS EN LA ATENCIÓN EN SALUD SEXUAL Y REPRODUCTIVA EN ADOLESCENTES

SUMMARY Background: Health care of adolescents in particular, on issues of Sexual and Reproductive Health, represents a special challenge for health teams and institutions, mainly in the field of bioethics. Aims: To analyze the major bioethical issues that may arise in clinical practice. Method: We analyze four basic bioethical principles, addressing other important aspects such as the professional relationship-patient, assessing the capacity/competence in decision making and confidentiality in care. Conclusions: The duty of institutions and health teams responsible for the care on the health of adolescents, is to maintain a proper balance between these principles, respecting the right of autonomy and confidentiality in the attention, framed within reasonable limits and that in no case will help to limit access to quality care. It is essential that there is a training and updating of professionals in the field of bioethics, in order to contribute to carefully analyze and resolve conflicts that arise, considering that health care should be framed with respect to rights and dignity of individuals.

Características de la maternidad adolescente de madres a hijas

SUMMARY Background: The research on adolescent pregnancy has been focused on medical difficulties, psychological and consequences on adolescent life, besides, it is also necessary to call the attention to the role family, especially, mother during her daughter’s pregnancy. Objective: Characteristics of pregnant adolescent’s mothers and happening of adolescent pregnancy in these women’s life. Methods: The study was carried out on 225 women and their pregnant adolescent daughters. A uni and bivariate analyses were carried out. Results: Mothers who had adolescent maternity background were younger, had low schooling, a great number of children, under ideal age they would have preferred to become mothers. They usually did housework and they were single at the first pregnancy in larger proportion than mothers who had not this previous background; 58.4 % of mothers were single at the moment of pregnancy and daughters 100%; 27.1% of mothers were single when they gave birth and 90.2% of daughters. The age average at the beginning of mothers maternity was 19.7% years old and daughters 16.2 years old. The schooling average of mothers was 7.7 years, 9.1 years for daughters. 26.2% of adolescent mother’s daughters did housework versus 8.5% adult mother’s daughters. 43% of adolescent mother’s daughters did not aspire to have higher education compared to 26.4% no adolescent mother’s daughters.

Diferencias de género en la calidad de vida relacionada con la salud en adolescentes escolarizados chilenos

Background: Health-related quality of life (HRQOL) refers to individuals´ perception of their subjective well-being, considering various aspects of their life and the impact on their health. Aim: To analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence. Material and methods: Analytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed. Results: In total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the “Peers and Social Support” and “School Environment” dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed. Conclusions: This study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.