Néia Schor

Sexual debut in adolescence and gender relations: a cross-sectional study in São Paulo, Brazil, 2002

This cross-sectional study aimed to assess gender differences in adolescents in relation to onset of sexual activity. A total of 406 15-19-year-old adolescents from a family health unit in the city of São Paulo, Brazil, were interviewed from May to December 2002. Nearly half had already had their first sexual intercourse, at a mean age of 15, independently of gender. Sexual debut was usually unplanned (72.7%) and inside the home (86.1%). An equal proportion (61.0%) of males and females used some contraceptive method in their first sexual intercourse; however, more males had used a contraceptive method in their most recent intercourse. Having initiated their sexual activity in stable, affective relationships, females proved to be more vulnerable to STD/AIDS, since they switched from condoms to the pill in their subsequent sexual activity. Male adolescents continued to use mostly condoms, probably because they were involved mainly in non-stable relationships.

Conversando sobre sexo: a rede sociofamiliar como base de promoção da saúde sexual e reprodutiva de adolescentes

This study aimed to assess whom adolescents shared information and dialogues about sexuality with. Therefore, 383 fifteen to nineteen year-old adolescents enrolled in a family health unit in the city of Sao Paulo (Brazil) were interviewed in 2002. Adolescents most frequently seemed to talk about sex with peers, although they lost priority according to the complexity of the theme. Thus, teachers and health professionals were mainly indicated as a reference when talking about std/aids. For 20% of the adolescents, parents were the main persons to get information from, no matter the subject. The results indicated that this entire social and family network should be incorporated as partners in sexual and reproductive health promotion among adolescents.This study aimed to assess whom adolescents shared information and dialogues about sexuality with. Therefore, 383 fifteen to nineteen year-old adolescents enrolled in a family health unit in the city of São Paulo (Brazil) were interviewed in 2002. Adolescents most frequently seemed to talk about sex with peers, although they lost priority according to the complexity of the theme. Thus, teachers and health professionals were mainly indicated as a reference when talking about std/aids. For 20% of the adolescents, parents were the main persons to get information from, no matter the subject. The results indicated that this entire social and family network should be incorporated as partners in sexual and reproductive health promotion among adolescents.

Vivências da maternidade na adolescência precoce

OBJECTIVE Although still scarcely studied in Brazil, motherhood in early adolescence among girls aged 10 to 14 years is mostly unwanted and it is an important public health issue. Most investigations are based on biomedical paradigms and few take into consideration the adolescents point of view. This study aimed to explore the different patterns of experiencing early motherhood from the adolescents own point of view. METHODS William Stephensons Q methodology was applied. The study population was selected from 2 public mother and child health units in Rio de Janeiro, Brazil, and comprised 20 adolescents who became pregnant at the age of 10 to 14 years and were followed up for a period of 6 to 24 months after giving birth. Q-sorts underwent factor analysis and then the factors were interpreted. RESULTS Four qualitatively and statistically (p<0.01) perception patterns were found. Two factors were well defined: Factor I - Satisfied with motherhood/ Dependent on the childs affection: motherhood is a positive and rich experience; and Factor II - Depressed/ Stressed out: motherhood is a negative and stressful experience. Other two potential factors need confirmation in further studies with a larger sample size. CONCLUSIONS It was observed that motherhoods experience is distinct and heterogeneous. For some adolescents, motherhood could be a rewarding experience

Factors associated with sexual debut among adolescents enrolled in a family health unit in East Side São Paulo, Brazil

Com o objetivo de analisar os aspectos individuais e familiares associados ao inicio da vida sexual, foram entrevistados, entre junho e dezembro de 2002, 383 adolescentes solteiros entre 15 e 19 anos de idade, residentes na area de abrangencia de uma unidade de saude da familia da zona leste do Municipio de Sao Paulo, Brasil. Os dados foram analisados por meio de regressao logistica multipla separadamente para homens e mulheres. Os resultados mostraram que o namoro e a idade foram associados ao inicio da vida sexual dos adolescentes. No entanto, somente entre os homens, observou-se como fatores associados variaveis relacionadas aos pais e maes e, apenas entre as mulheres, variaveis relacionadas a propriedade do domicilio e aos irmaos. Dessa forma, o namoro e as questoes familiares, tais como os valores parentais no tocante as praticas sexuais de adolescentes e a presenca de irmao(a) que ja passou por gravidez antes de uma uniao, sao aspectos que necessitam ser incorporados na formulacao de politicas de saude reprodutiva e sexual voltadas aos adolescentes, pois mostraram ser determinantes na iniciacao sexual dos jovens entrevistados.

Women and contraception: knowledge and use of contraceptive methods

This article analyzes knowledge and use of contraceptive methods in women ages 10 to 49 years residing in the southern region of the city of São Paulo in 1992. A total of 1,157 childbearing-age women were studied, focusing on variables that might define them as to: knowledge in the use of contraceptive methods and reasons for choosing a given method. We observed that 86% of the women referred knowledge of some contraceptive method, while the most common was the pill (95.3%), followed by condoms (92.6%). Meanwhile, 14% of the interviewees denied knowledge of any contraceptive method. Of the sexually active women (66.4%), 34.9% reported never having used contraceptive methods. Of those who had, 35.3% used the pill, while 42.9% had resorted to sterilization. Only 5.2% used condoms. Despite the high level of knowledge concerning contraceptive methods, especially oral contraceptives and condoms, we observed limited use of same as compared to the high sterilization rate around the age of 27, thus leaving contraception limited to the pill and female sterilization.

Participação masculina na contracepção pela ótica feminina

OBJETIVO: Identificar as percepcoes das mulheres sobre a participacao masculina na contracepcao. METODOS: Foram realizadas entrevistas domiciliares na Regiao Sul do Municipio de Sao Paulo. A amostra contou com 254 usuarias de metodos reversiveis que referiram, durante a entrevista, ter parceiro sexual. Trabalhou-se com analise estatistica dos dados e tecnica de analise de conteudo. RESULTADOS: Em 78,8% dos casos, o metodo contraceptivo usado era de uso feminino, prescindindo da participacao masculina para sua eficacia (pilula, injetaveis, DIU, diafragma). Apesar da alta concentracao de metodos femininos, 82,7% responderam que o companheiro participava do processo da contracepcao, evidenciando uma desvinculacao entre metodo usado e percepcao da participacao masculina. As principais categorias referentes a representacao feminina sobre a participacao do parceiro na contracepcao foram o apoio a mulher usuaria de metodo feminino e o uso eventual de metodo masculino, quando a mulher necessitava suspender temporariamente o uso de seu metodo contraceptivo. CONCLUSOES: As mulheres interpretaram a participacao masculina na contracepcao como uma atividade de apoio ao uso de metodos femininos de alta eficacia. O apoio do parceiro pode revelar-se pela aquisicao da pilula, pela acao de lembrar a mulher de toma-la ou pela opiniao sobre o numero de filhos desejado. A mulher assume a contracepcao como atividade de sua responsabilidade, e o papel desempenhado pelo parceiro e vivenciado como uma funcao acessoria.

Gravidez na adolescência: estudo comparativo

Estudou-se uma populacao de 349 mulheres que deram a luz no periodo de 01/05/86 a 31/07/86, num Servico de Obstetricia da Grande Sao Paulo. Os resultados revelam que o grupo de gestantes adolescentes (22,2%) teve uma assistencia pre-natal deficiente, ja que a grande maioria (70,6%) teve a primeira consulta no segundo trimestre, tendo em media duas consultas. Durante a gestacao, este grupo apresentou menor incidencia de patologias com tratamento ambulatorial (39,3%) e hospitalar (7,9%), em comparacao com as gestantes adultas (44,4% e 14,7%, respectivamente). Em relacao ao tipo de parto, as adolescentes apresentaram maior proporcao de partos operatorios, sendo 25,7% por forceps e 22,9% cesarea, contra 14,7% e 19,7% nas gestantes adultas, respectivamente. Verificou-se nas gestantes adolescentes maior proporcao de intercorrencias intraparto (12,9% contra 8,2% nas gestantes adultas), predominando neste periodo a hemorragia e a toxemia. Quanto as intercorrencias no puerperio, estas se verificaram em 15,7% das gestantes adolescentes e era 11,8% das adultas, sendo a anemia pos-parto, a toxemia e a infeccao puerperal as patologias mais comuns.

Investigação sobre ocorrência de aborto em pacientes de hospital de centro urbano do Estado de São Paulo, Brasil

Propoe-se identificar determinadas caracteristicas de natureza biologica, demografica, social e institucional com base nas informacoes registradas nas fichas de prontuario de 2.588 mulheres atendidas com complicacoes de aborto em um hospital de Santo Andre, zona urbana e industrializada da Grande Sao Paulo (Brasil), no periodo de janeiro de 1978 a dezembro de 1982. Os dados revelaram uma duplicacao no numero de mulheres com complicacoes de aborto no periodo estudado, elevando-se gradualmente de 302 em 1978 para 672 em 1982. O numero de partos atendidos no mesmo hospital, nao obstante, cresceu em apenas 14% no mesmo periodo, obtendo-se a media de relacao aborto/parto: 1: 3,6 e 1: 1,8 em 1978 e 1982, respectivamente. A maioria da populacao estudada (60%) possuia ocupacao assalariada nao especializada. A idade (16,4% das mulheres estudadas eram menores de 20 anos) apresentou relacao estatisticamente significativa com o estado marital, cor, ocupacao e resultados gestacionais. Houve correlacao significativa entre idade na menarca, idade na primeira relacao sexual e idade na primeira gravidez, no grupo de mulheres primigestas.Propoe-se identificar determinadas caracteristicas de natureza biologica, demografica, social e institucional com base nas informacoes registradas nas fichas de prontuario de 2.588 mulheres atendidas com complicacoes de aborto em um hospital de Santo Andre, zona urbana e industrializada da Grande Sao Paulo (Brasil), no periodo de janeiro de 1978 a dezembro de 1982. Os dados revelaram uma duplicacao no numero de mulheres com complicacoes de aborto no periodo estudado, elevando-se gradualmente de 302 em 1978 para 672 em 1982. O numero de partos atendidos no mesmo hospital, nao obstante, cresceu em apenas 14% no mesmo periodo, obtendo-se a media de relacao aborto/parto: 1: 3,6 e 1: 1,8 em 1978 e 1982, respectivamente. A maioria da populacao estudada (60%) possuia ocupacao assalariada nao especializada. A idade (16,4% das mulheres estudadas eram menores de 20 anos) apresentou relacao estatisticamente significativa com o estado marital, cor, ocupacao e resultados gestacionais. Houve correlacao significativa entre idade na menarca, idade na primeira relacao sexual e idade na primeira gravidez, no grupo de mulheres primigestas.Certain characteristics--biological, demographical, social and institutional--based on data collected from the recorded case histories of 2,588 women suffering complications after abortion, attended in a hospital of Santo André, an industrial urban area of Greater S. Paulo, State of S. Paulo, Brazil, in the period from January 1978 to December 1982, are identified Data show a two-fold increase in the number of women with complications after abortion over the period studied, rising progressively from 302 in 1978, to 672 in 1982. However, the number of births attended at the same hospital underwent an increase of only 14% in the same period, resulting in an average abortion/birth ratio of 1:3.6 and 1:1.8 in 1978 and 1982, respectively. The majority of the population under study (60%) professed non-skilled occupations. Age presented a statistically significant relationship with martial status, colour, profession and gestational results. A significant relationship was also observed between age at first menstruation, age at first sexual relationship and age at first pregnancy among those women belonging to the primigesta group.

Factors associated with sexual initiation and condom use among adolescents on Santiago Island, Cape Verde, West Africa

The current study focuses on factors associated with sexual initiation and condom use among teenagers on Santiago Island, Cape Verde, according to gender. This was a representative, probabilistic sample of 13-to-17-year-olds (n = 768) attending public secondary schools on Santiago Island in 2007. Associations were tested by test of proportion, Pearsons chi-square, or Fishers exact test and logistic regression. Factors related to sexual initiation among boys were: age over 14 years, Catholic religion, and alcohol consumption. For girls, the factors included: > 9 years of schooling and involvement in an affective-sexual relationship. Unlike other Sub-Saharan countries, this study showed a high prevalence of condom use during initial sexual activity. Adolescents are able to safely begin sexually active life if they have access to information, sex education, and other STD prevention and contraceptive methods. This study provides insights on the development of policies to reduce the vulnerability of the young population to STD/AIDS and the limits and challenges related to the promotion of condom use and sex education, focusing on unequal gender relations.

Motivos de rejeição aos métodos contraceptivos reversíveis em mulheres esterilizadas

OBJECTIVE To identify the representations of contraceptive methods within a group of sterilized women, aiming at understanding the reasons why they refused those methods. METHODS A descriptive qualitative study was carried out on 31 sterilized women, randomly selected from a list of patients attending the Family Planning Program of a university hospital. Data was collected through a semi-structured interview. Interview transcription was analyzed according to the Content Analysis method. RESULTS Refusal to other contraceptive methods was based on representations formed from a mixture of technical information received at health service units, their previous experiences with contraceptive methods and information received in the social environment. Rejection of high efficacy methods (hormonal and IUD) was mostly based on their low innocuousness; refusal to fertility awareness methods (calendar calculation, Billings ovulation method) was due to their low efficacy; and rejection of barrier methods (condom, diaphragm) was due to a culturally patterned sexuality full of interdictions as well as to their low efficacy. CONCLUSIONS The option for female sterilization may be indicative of the refusal to the contraceptive alternatives offered by health services. Reproductive health professionals should increase in their practice the knowledge about personal, socio-economic and cultural factors that affect womens choice of a contraceptive method that could guarantee a better control over their own reproductive life.