Conocimiento sobre la no adherencia de métodos anticonceptivos ¿Podría disminuir la mortalidad materna?

Introducción : En el Perú, el 78,1% de mujeres, entre 15 a 49 años, utilizan un método anticonceptivo, lo cual se ve mermado por diversos factores asociados a su no adherencia; ello ha generado embarazos no deseados y contagio de enfermedades de transmisión sexual. Objetivo : Determinar los factores asociados a la no adherencia de métodos anticonceptivos en mujeres en edad fértil en el Perú, según la ENDES 2021. Métodos : Estudio de tipo observacional, analítico y transversal. La información utilizada se encuentra en la base de datos pública de la ENDES 2021. La población está constituida por peruanas de 15 a 49 años. El análisis estadístico se realizó con el programa estadístico SPSS versión 26.0. Las variables cualitativas fueron representadas en una tabla univariada con frecuencias y coeficientes de variación. El valor de significancia estadística aprobado fue de confianza al 95%. Resultados : El 43,7% de mujeres no tuvieron adherencia al método anticonceptivo. Hubo asociación significativa para las variables: área de residencia rural (RPa 1,05, IC 1 - 1,1) , estado civil separada (RPa 1,1, IC 1 - 1,1) , estado civil viuda (RPa 1,3, IC 1,1 - 1,5), estado civil conviviente (RPa 1,1, IC 1,1 - 1,2), índice de riqueza pobre(RPa 1,03, IC 0,9 - 1,0). Conclusiones : Los factores asociados a la no adherencia de métodos anticonceptivos en mujeres de edad fértil en el Perú, los cuales se asocian de manera significativa son: el área de residencia rural, el estado civil separada, viuda y conviviente y poseer un índice de riqueza pobre.

Introduction: In Peru, 78.1% of women between the ages of 15 and 49 use a contraceptive method, which is diminished by various factors associated with non-adherence to the contraceptive method, thus producing unwanted pregnancies and the spread of sexually transmitted diseases. Objective: To determine the factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru according to ENDES 2021. Methods: Observational, analytical and cross-sectional study. The information used is found in the ENDES 2021 public database. The population of this research is made up of peruvian women between the ages of 15 and 49. Statistical analysis was performed with the statistical program SPSS version 26.0. The qualitative variables were represented in a univariate table with frequencies and coefficients of variation. The approved statistical significance value was p <0.05 with 95% confidence intervals. Results: 43.7% of women did not adhere to the contraceptive method. There was a significant association for the variables: area of rural residence (RPa 1.05 IC 1 - 1.1), separated marital status (RPa 1.1, IC 1 - 1.1), widow marital status (RPa 1.3, IC 1.1 - 1.5), cohabiting marital status (RPa 1.1, IC 1.1 - 1.2) , poor wealth index (RPa 1.03, IC 0.9 - 1.0) Conclusions: The factors associated with non-adherence to contraceptive methods in women of childbearing age in Peru, which are significantly associated are: rural area of residence, separate marital status, widow and cohabitant and have a poor wealth index.

Conhecimento sobre métodos contraceptivos de adolescentes atendidas em Ambulatório de Ginecologia / Knowledge about contraceptive methods of adolescents seen in the Gynecology Outpatient Clinic

Objetivo: Investigar o conhecimento das adolescentes atendidas no Ambulatório de Ginecologia sobre os métodos contraceptivos. Métodos: Foi realizado um estudo quantitativo de corte transversal com adolescentes do sexo feminino, acompanhadas no Serviço de Ginecologia. A seleção foi por ordem de chegada mediante agendamento prévio. Após consulta médica, foi aplicado um questionário anônimo e estruturado sobre: características sociodemográficas; antecedentes ginecológicos; conhecimento do uso correto e indicação dos métodos contraceptivos. As variáveis foram analisadas pela estatística descritiva com medidas de tendência central e variabilidade. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: A população estudada foi composta por adolescentes com média de idade de 15,80 anos (+/- 1,3), 48,0% de etnia/cor parda, 84,0% frequentavam a escola pública e 56,0% cursavam o ensino médio. A maioria possuía conhecimento insuficiente/ausência de conhecimento e 80,0% tinham informações sobre contracepção que não envolveu a participação de um profissional de saúde, apesar de eles indicarem o uso dos métodos para a maioria dessas jovens (75,0%). A combinação do preservativo masculino e anticoncepcional oral foi referida em 25,0% das adolescentes. Conclusão: A maioria das adolescentes possuía conhecimento insuficiente/ausente sobre métodos contraceptivos, o que parece contribuir para o uso inconsistente deles. A maior prevalência do uso do preservativo masculino e do anticoncepcional oral associada à baixa participação dos profissionais de saúde como fonte de informação para o uso correto dos métodos ratifica a necessidade de políticas públicas sobre educação sexual para que as adolescentes exerçam sua sexualidade com responsabilidade e segurança.(AU)

Objective: Evaluate the knowledge of adolescents seen in the Gynecology Outpatient Clinic for Children and Youth. Methods: A quantitative transverse study was carried out with thems, regularly seen at the Gynecology Outpatient Clinic for Children and Youth. We selected participants by arrival order. After having their appointment done, we applied an anonymous and structured questionnaire containing questions regarding sociodemographics characteristics, past gynaecological history and knowledge, correct use and indications of contraceptives methods. Those variables were analysed using descriptive statistics such as central tendency and variability. The research was approved by the Ethics in Research Committee. Results: The population studied was composed of adolescents with an average age of 15.8 years (+/- 1.3), 48.0% of ethnicity/brown colour, 84.0% attended public school and 56.0% were in high school. Most of them had insufficient knowledge/lack of knowledge and 80.0% had information about contraception that did not involve the participation of a health professional, however health professionals had suggested a method of contraception for most of these young women (75.0%). The combination of male condoms and oral contraceptives were reported by 25.0% of adolescents. Conclusion: That most of the adolescents had insufficient/absent knowledge about contraceptive methods which seems to contribute to their inconsistent use. The high prevalence of the use of male condoms and oral contraceptives found in this study and low participation of health professionals as a source of information for the correct use of methods ratify the need for public policies on sex education for adolescents enjoy their sexuality responsibly and safely.(AU)

Anticoncepción y cáncer de mama: te advierto que no quedes embarazada, pero, ¿qué hago al respecto? / Contraception and breast cancer: I warn you against getting pregnant, but what do I do about it?

La creciente incidencia de cáncer de mama (CM) en mujeres jóvenes nos obliga a repensar la forma en como asesoramos sobre el método anticonceptivo (MAC) en estas mujeres, cuya fertilidad puede ser variablemente afectada por los tratamientos. Se les aconseja, post tratamiento, evitar la gestación temporalmente, sin embargo se observa un patrón de uso insuficiente de MAC con elección de métodos anticonceptivos poco efectivos. El objetivo de la presente revisión es indagar en al necesidad anticonceptiva de mujeres jóvenes con cáncer de mama evaluando la evidencia científica sobre qué métodos anticonceptivos pueden o no utilizar, analizando especialmente el rol del sistema intrauterino liberado de levonorgestrel y la salpingectomía de la oportunidad como cirugía anticonceptiva con potencial reducción de riesgo de cáncer de ovario en pacientes con riesgos genético. Además se pretende brindar estrategias para evitar embarazos no planificados en este grupo de pacientes.

The increasing incidence of breast cancer (BC) in young women forces us to rethink the way in which we counsel on the contraceptive method (CM) in these women, whose fertility can be variably affected by the treatments. They are advised, post treatment, to avoid pregnancy temporarily, however a pattern of insufficient contraception use is observed with the choice on ineffective contraceptive need of young women with breast cancer, evaluating the scientific evidencially analyzing the role of the levonorgestrel-releasin intrautrien system and oppotunistic salpingectomy as a contaceptive surgery with potential ovarian cancer risk reduction in patients with genetic risk. Is is also intended to provide strategies to avoid unplanned pregnancies in this group of patients.

A cross sectional study on knowledge, attitude and practice of family planning method usage among urban women of Dr. B. R. Ambedkar Medical College field practice area

Background: India is currently facing “population explosion” which is directly perpetuating development of country. Family planning is the only safest and cost-effective strategies to have impact on health of women.Methods: Community based cross sectional study, conducted by face to face interview with women included for study after systematic random sampling. The collected information was analysed using appropriate statistical tools.Results: Total of 88.7% of women were aware that family planning is for limitation of births but, 292 (70.2%) women had ever used contraceptive, and 30 (24.2%) of them have faced minor complications, which has either self-resolved or on medication. The most common reason for not using contraceptive was being uncomfortable (76.6%) to use them.Conclusions: Women had good knowledge regarding contraceptives, but most of the women followed methods suggested by their elders. Advertisement regarding newer methods has to be strengthened.

Determination of prevalence, knowledge, attitude and practices of contraceptive use in an urban population in South India: a community based study

Background: Family planning influences mothers and infant’s health, population growth and regional and national development. Studying the knowledge, attitude and practice of contraceptive methods of a region aids in overcoming the barriers in the utilization of the services providing them.Methods: A community based cross sectional study was done among 350 married women of an urban population by systematic random sampling using a structured questionnaire.Results: From a total of 350 women enrolled, majority were of the Hindu religion (84.9%) and from the lower socio-economic status (68%). The prevalence of use of contraceptive methods was 75.4% and it was predominantly female sterilization. It was significantly higher (p<0.001) in women aged above 32 years, married for more than 10 years, having more than two children and last child birth of more than seven years. Only 142 (40.6%) of the participants had adequate knowledge of contraceptive methods. However, 299 (85.4%) had a positive attitude to contraception and 296 (84.6%) had good practice of family planning (FP) methods.Conclusions: The knowledge and use of contraceptive methods especially temporary methods needs to be improved in our community. The utilization of media can be improved in addressing this shortfall. Health care providers being the bulk source of information on contraceptive methods must be pro-active in every interaction with women and men of reproductive age group by providing information on the various methods.

Knowledge, attitude and practices of contraception among urban women in Mangaluru, Karnataka

Background: India with 50% percent of its population in reproductive age group is the second most populous country in the world with an estimated population of 1.37 billion and if measures are not taken; it is likely to rise to 1.68 billion by the year 2050.The answer lies in promoting small family norms by modern contraceptive methods with the proposed goal of 75% coverage by 2030. In the backdrop of above present research was conceived to study, the knowledge, attitude and practices of contraception among urban women in Mangaluru, Karnataka. Methods: Present study is a cross sectional study. A total of 110 urban women were evaluated with the help of a pre-designed and pre-tested questionnaire for the knowledge, attitude and practices on various prevalent contraceptive methods. Results: Though all the participants were found to be aware of available contraceptives, only 57.3% of them had used one or the other method in their life time. The attitude of large majority (82.7%) of study subjects was found to be positive. The most commonly used contraceptive was condom 73.9%, followed by oral pills (39.2%) and Copper -T (23.9%). Desire for male child (30.1%), lack of awareness (15.1%) and fear of side effects (11.3%) were cited as the main barriers to the use of contraceptives. Conclusions: The study brings out the need for health educational strategies to create awareness in the community on family planning and contraceptive methods.

Caracterización de la conducta sexual y reproductiva en adolescentes femeninas de 12 a 15 años / Characterization of the sexual and reproductive behavior in female teenagers aged 12-15 years

RESUMEN Introducción: la sexualidad constituye una dimensión integral de las personas y está presente desde el momento de la concepción hasta la muerte. Objetivo: caracterizar la conducta sexual y reproductiva en adolescentes femeninas. Materiales y métodos: se realizó un estudio descriptivo transversal en 53 estudiantes femeninas, de 12 a 15 años de edad, en la secundaria básica "Paquito Rosales Benítez", Manzanillo, Granma, en el año 2017. Resultados: la edad media fue 1,15 años, el 67,93 % de las adolescentes mantenían relaciones sexuales con una edad media de la sexarquia de 13,53 años. La "atracción física" fue el principal motivo para el inicio de las relaciones sexuales. El 36,11 % de las adolescentes no utilizaban algún método anticonceptivo y las tabletas anticonceptivas fueron las más utilizadas. El 22,22 % de las féminas habían tenido, al menos, un embarazo. Conclusiones: las adolescentes de la secundaria básica "Paquito Rosales" mantiene una conducta sexual adecuada.

ABSTRACT Introduction: sexuality is an integral dimension of the persons that is present from the moment of conception until death. Objective: to characterize sexual and reproductive behavior in female teenagers. Materials and methods: a descriptive, cross-sectional study was carried out in 53 female students, aged 12 to 15 years, who study at "Paquito Rosales" Junior High School, Manzanillo, Granma, in 1917. Results: the average age was 1,15 years. 67.93 % of the female teenagers had sexual relationships for a first time at an average age of 13.53 %. Physical attraction was the main motive for the beginning of sexual relationships. 36.11 % of teenagers did not use any contraceptive method being birth-control pills the most used one. 22.22 % of the teenagers had had, at least, one pregnancy. Conclusions: female teenagers of "Paquito Rosales" Junior High School have an appropriate sexual behavior.

Métodos contraceptivos reversíveis de longa duração no Sistema Único de Saúde: o debate sobre a (in)disciplina da mulher / Long-acting reversible contraception methods in the Brazilian Unified National Health System: the debate on women's (in)discipline

Resumo Recentemente a Federação Brasileira das Associações de Ginecologia e Obstetrícia submeteu ao Ministério da Saúde uma solicitação para oferta no Sistema Único de Saúde de métodos contraceptivos reversíveis de longa duração (LARC), para jovens mulheres de 15 a 19 anos. Os dois dispositivos a serem incluídos seriam o implante subdérmico liberador de etonogestrel, com duração de três anos, e o sistema intrauterino liberador de levonorgestrel, com duração de cinco anos. O Ministério da Saúde abriu então consulta pública para avaliar tal introdução, terminando por decidir contrariamente à inclusão destes métodos na rede pública de saúde. O artigo discute as estratégias discursivas utilizadas para fundamentar e justificar a aceitação e aplicabilidade destes métodos em "populações especiais". O debate sobre o planejamento reprodutivo precisa compreender melhor as descontinuidades contraceptivas no uso de métodos, a centralidade da contracepção de emergência e o quanto as hierarquias de gênero dificultam uma prática contraceptiva segura. Ao contrário, a ênfase na (in)disciplina da mulher no tocante aos cuidados com a utilização de métodos contraceptivos de uso regular termina por reforçar sua condição de menoridade social.

Abstract Recently, the Brazilian Federation of Gynecology and Obstetrics Associations submitted a request to the Brazilian Ministry of Health for an introduction of long-acting reversible contraception (LARC) methods for young women aged 15 to 19 years in the Brazilian Unified National Health System. The two devices to be included were the etonogestrel-releasing subdermal implant (ENG implant), with a duration of three years, and the levonorgestrel-releasing intrauterine system (LNG-IUS), lasting five years. The Ministry of Health then launched a public inquiry to evaluate this introduction, deciding against the inclusion of these methods in the public health services. The article discusses the discursive strategies used to justify the acceptance and applicability of these methods in "special populations." The debate on family planning needs to understand fully the discontinuity of contraception in the use of such methods, the central concept of emergency contraception, and how gender hierarchies prejudice safe contraceptive practice. On the contrary, the emphasis on the (in)discipline of women regarding care with regular-use contraceptive methods effectively reinforces their condition of social minority.

Socio-demographic determinants and modern family planning usage pattern-an analysis of National Family Health Survey-IV data

Background: India, which accounts for world's 17.5 percent population, is the second most populous country in the world next only to China (19.4%). The major objective of the NFHS surveys has been to strengthen India’s demographic and health database, to anticipate and meet the country’s needs for data on emerging health and family welfare issues. The objectives of the study were to study the different background characteristics of women adopting different family planning methods and to analyze the associated socio-demographic factors..Methods: Secondary data analysis of NFHS 4 datasets obtained from DHS program portal. Appropriate statistical testing of associated socio-demographic variables done and interpreted accordingly.Results: Out of total 63696 couples, 99.2% women and 98.6% men knew modern method of contraception, 48.6% were currently using modern method of contraception and 7.4% traditional method. The majority (34%) women adopted female sterilization as current method of contraception. There is interstate variation in the contraceptive prevalence rate highest (80.60%) in Chandigarh compared to least (26.64%) in Goa. There is significant association observed between place of residence, religion, wealth index, women education, education of husband towards current contraceptive use.Conclusions: About 45% of population increase is contributed by births above two children per family. The adoption of appropriate method of contraception by couples made available through quality family planning services and empowering women by proper behavior change communication will help improve the present contraceptive prevalence rate especially among the vulnerable groups.

Relación entre el conocimiento y la intención de uso del anticonceptivo oral masculino (DMAU) en estudiantes varones en edad fértil de una universidad del sur de Chile / Relationship between the knowledge and the intention of use of the male oral contraception (DMAU) in students male in the fertile age of a university of the south of Chile

A lo largo de la historia las mujeres han sido las responsables de la reproducción biológica, han cargado mayormente con la responsabilidad de la anticoncepción (1); surge la necesidad de incorporar a hombres en salud reproductiva con métodos modernos, efectivos y reversibles, como la Píldora Anticonceptiva Oral Masculina, que se encuentra en fase II de investigación, y así participar activamente en la planificación familiar. OBJETIVO: Establecer la relación entre el conocimiento e intención de uso de la Píldora Anticonceptiva Oral Masculina, en varones en edad fértil de una Universidad del Sur de Chile, durante segundo semestre del 2018. MATERIAL Y MÉTODO: Investigación Cuantitativa, correlacional, no experimental y transversal, en 301 estudiantes regulares, se autoadministra instrumento: "Encuesta Anticonceptivos Orales en Varones en Edad Fértil", validado por medio de comité de expertos, con Coeficiente de Alpha de Cronbach de 0,81. RESULTADOS: Respecto al nivel de conocimiento acerca de la Píldora, sólo un 16% tuvo un puntaje mayor o igual a 17 puntos considerándose como alto conocimiento. Respecto de intención de uso, un 58% de los estudiantes varones tiene una alta intención de uso, además de que el 42% estaría dispuesto a utilizar este método anticonceptivo de forma diaria. CONCLUSIÓN: No existe una relación entre el nivel de conocimiento y la intención de uso de la píldora, pues independiente del nivel de conocimiento siempre se mantuvo una alta intención de uso investigación y así participar activamente en la planificación familiar

Throughout history, women have been responsible for biological reproduction, they have been mostly responsible for contraception (1); There is a need to incorporate men into reproductive health with modern, effective and reversible methods, such as the Male Oral Contraceptive Pill, which is in phase II of research, and thus actively participate in family planning. OBJECTIVE: To establish the relationship between the knowledge and intention to use the Male Oral Contraceptive Pill, in men of childbearing age of a University of Southern Chile, during the second half of 2018. MATERIAL AND METHOD: Quantitative, correlational, non-experimental research and Transversal, in 301 regular students, self-administered instrument: "Survey of Oral Contraceptives in Men of Fertile Age", validated through an expert committee, with Cronbach's Alpha Coefficient of 0.81. RESULTS: Regarding the level of knowledge about the Pill, only 16% had a score greater than or equal to 17 points, considered ashigh knowledge. Regarding intention to use, 58% of male students have a high intention to use, in addition to 42% would be willing to use this method of contraception on a daily basis. CONCLUSION: There is no relationship between the level of knowledge and the intention to use the pill, because independent of the level of knowledge, a high intention to use research was always maintained and thus actively participate in family planning.

Evaluación de las conductas sexuales de riesgo y hábitos anticonceptivos en una muestra de población mexicana / Evaluation of sexual risk behaviors and contraceptive habits in a sample of the Mexican population

Resumen OBJETIVO: Evaluar, a través de una encuesta, la situación actual de las conductas sexuales de riesgo en una muestra de población mexicana de entre 15-60 años, e identificar los métodos de planificación familiar más utilizados y el promedio de inicio de la vida sexual. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, con muestreo no probabilístico tipo "bola de nieve". Se aplicó una encuesta validada internacionalmente de conductas sexuales de riesgo, entre julio y octubre de 2017, en una muestra mexicana de 15-60 años de edad. Se excluyeron las encuestas incompletas y con discordancias, y personas de otras nacionalidades. Entre las variables estudiadas se incluyeron: sexo, edad y estado socioeconómico. Se calculó un tamaño de muestra de 385, con un intervalo de confianza de 95% (IC95%). Los datos se reunieron en el programa de Excel 2016, donde se analizaron e interpretaron. RESULTADOS: Se encuestaron 689 sujetos, pero se excluyeron 38; de esta forma se registraron 650 casos. El 87.4% de los casos inició su vida sexual entre los 16 y 25 años; un tercio la calificó satisfactoria. El 50% de los encuestados de entre 13 y 15 años utilizó preservativo. El 61% refirió la comunicación de temas sexuales con sus padres poco satisfactoria o inexistente; 6.6% no utiliza o es usuario de algún método de planificación y 40.3% recurre a uno poco efectivo. CONCLUSIÓN: Es importante conocer las prácticas sexuales de la población mexicana, para identificar las áreas de oportunidad, promover la prevención de prácticas sexuales de riesgo y aumentar la difusión de la información.

Abstract OBJECTIVE: Evaluate, through an internationally validated survey, the risky sexual behavior in a Mexican sample between 15-60 years, the average of initiation of sexual activity and the most used contraceptive methods. MATERIALS AND METHODS: Descriptive, cross-sectional study, with non-probabilistic sampling type snowball. We apply an internationally validated survey of Risky Sexual Behavior between July and October 2017 through social networks to Mexican population between 15 and 60 years. Incomplete surveys were excluded, with disagreements in responses and people of other nationalities. The variables studied included sex, age and socioeconomic status. A sample size of 385 was calculated with a confidence level of 95%. The data was gathered in an Excel sheet 2016 where they were analyzed and interpreted. RESULTS: A total of 689 subjects were surveyed, 38 were excluded; In this way, a total of 650 cases were registered. 87.4% started sexual life between 16 and 25 years old, being satisfactory in a third of the cases. 50% of people between 13 and 15 years used condoms and 56% between 16 and 18 years. 61% reported the communication of sexual issues with their parents unsatisfactory or non-existent. 6.6% of people do not have a planning method while 40.3% have a little cash. CONCLUSION: It is important to know the sexual practices in the Mexican population to detect areas of opportunity, make changes in the prevention of risky sexual actions and in the distribution of information.

Experiences of localization and removal of non-palpable subdermal contraceptive implants with ultrasound

OBJECTIVE: The aim of this study was to present experiences in localization and removal of non-palpable subdermal contraceptive implants with ultrasonography. METHODS: Medical records from January 1, 2016, to April 30, 2018, were retrospectively reviewed for 21 patients who were referred to a single institution and had an impalpable implant despite following the removal instruction. In all the cases, more than one attempt was made to remove the implant before referral. The rod was detected using radiography and ultrasonography. In all the cases, localization of the single implant was achieved with ultrasonography. The distal depth of the rod was measured, and skin marking was made following the echogenicity. The implants were subsequently removed under anesthesia. RESULTS: In 18 cases, the rods were localized using ultrasonography and successfully removed under local anesthesia. In the other three cases, removal with local anesthesia failed. Although the rod was detected successful with ultrasonography, the implants were removed under general anesthesia in the operating room. The depth from skin to rod, measured with ultrasonography, was >12.0 mm in all the cases and located deep in the muscular layer in the failure cases. The depth of the implants positively correlated with the time spent for removal (r=0.525; P=0.015). CONCLUSION: High frequency ultrasonography is a highly accurate tool for localization and measurement of the skin-to-rod depth. It is also useful for removing non-palpable implants. If the depth of the implant is >12.0 mm, removal of the implant in the operating room under general anesthesia is recommended.

Avaliação do conhecimento de alunos de uma escola pública de Pouso Alegre/Minas Gerais sobre gravidez e infecções sexualmente transmissíveis / Evaluation of students' knowledge of a public school in Pouso Alegre / Minas Gerais on pregnancy and sexually transmitted infections

A sexualidade se estabelece por um conjunto de possibilidades que necessitam de serem exploradas, haja vista que a adolescência que corresponde ao período de 10 a 19 anos, é marcada pela transição da infância para a fase adulta e por uma série de transformações, tanto anatômicas, fisiológicas, psicológicas como também sociais. Nesse contexto associa-se a este ciclo da vida a necessidade de compreender e refletir o conhecimento que os adolescentes possuem tanto sobre as infecções sexualmente transmissíveis quanto a gravidez na adolescência, já que, é nesse momento da vida que os mesmos têm um maior risco tanto quanto as infecções advindas do sexo inseguro como também a uma gravidez não planejada, sendo essencial nessa conjuntura que estes temas sejam interiorizados de forma cotidiana, atual e preventiva tanto na escola quanto na família. Parte-se do pressuposto das perspectivas de ação das práticas de educação em saúde, além dos conteúdos se são, explícita e implicitamente, veiculados acerca do tema sexualidade e seus desdobramentos, além do acometimento psicossocial de uma gravidez precoce. Nessa perspectiva, este trabalho objetiva avaliar o conhecimento dos adolescentes de uma escola pública sobre as práticas, percepções necessidades de diálogo sobre as IST e de uma gravidez durante o período da adolescência. A metodologia consistiu em um estudo transversal, de natureza quantitativa, sendo escolhida de forma intencional uma escola pública da cidade de Pouso Alegre-MG; o número de participantes desta pesquisa foi de 499, de ambos os sexos do 8º ano do ensino fundamental II ao ensino médio. Esse processo somente se deu a partir da aprovação do Comitê de Ética da EERP, e da assinatura do Termo de Consentimento Livre e Esclarecido e do Termo de Assentimento Livre e Esclarecido; o instrumento utilizado para a coleta de dados foi um questionário semiestruturado. Quanto aos resultados, o estudo mostrou que os adolescentes participantes pertenciam ao grupo de idade entre 12 - 17 anos (99,8%), sendo que adolescentes com 12 anos representam a menor parte (9,6%) e os de 17 a maior (37,7%). O sexo feminino representou 58,5% da amostra e o sexo masculino 41,5%. A iniciação sexual ocorreu em média aos 13,8 anos com os meninos e 14,4 anos em relação as meninas. Além disso, demonstrou-se que 90,18% dos participantes valorizam e concordam com a ocorrência de oficinas e projetos de sexualidade no interior do ambiente escolar. Dessa forma, é pertinente a necessidade de programas e políticas públicas voltadas a informar, conscientizar e estimular esses indivíduos a se prevenirem e entenderem as modificações dessa fase da vida. Além disso, é pertinente discutir entre os adolescentes as emoções e valores que impedem o uso das informações que os mesmos possuem em suas práticas sexuais. Nota-se também a necessidade de a escola assumir um trabalho cotidiano de abordagem da sexualidade como intrínseca a saúde, como prática sexual saudável e segura através do uso de métodos anticoncepcionais e preventivos contra a IST

Sexuality is established by a set of possibilities that need to be explored, since the adolescence that corresponds to the period from 10 to 19 years is marked by the transition from childhood to adulthood and by a series of transformations, both anatomical, physiological, psychological as well as social. In this context, it is associated with this cycle of life the need to understand and reflect the knowledge that adolescents have as much about sexually transmitted infections as teenage pregnancy, since it is at that moment of life that they have a greater risk both as well as the infections due to unsafe sex, as well as to an unplanned pregnancy, and it is essential at this juncture that these themes are internalized in a daily, current and preventive manner, both at school and in the family. It is based on the assumption of the perspectives of action of health education practices, in addition to the contents if they are explicitly and implicitly conveyed about the theme sexuality and its unfolding, in addition to the psychosocial involvement of an early pregnancy. In this perspective, this study aims to evaluate the knowledge of the adolescents of a public school about the practices, perceptions, needs for dialogue about STIs and a pregnancy during adolescence. The methodology consisted of a transversal study, of quantitative nature, being chosen intentionally a public school in the city of Pouso Alegre-MG; the number of participants in this research was 499, of both sexes from the 8th year of elementary school II to high school. This process only occurred after the approval of the Ethics Committee of the EERP, and the signing of the Term of Free and Informed Consent and the Term of Free and Informed Assent; the instrument used for data collection was a semi-structured questionnaire. Regarding the results, the study showed that the adolescents belonged to the age group between 12 - 17 years (99.8%), with 12 year olds representing the smallest part (9.6%) and those 17 years old (37.7%). The female sex represented 58.5% of the sample and the male sex 41.5%. Sexual initiation occurred on average at 13.8 years for boys and 14.4 years for girls. In addition, 90.18% of the participants have been shown to value and agree with the occurrence of sexuality workshops and projects within the school environment. In this way, the need for public policies and programs to inform, raise awareness and stimulate these individuals to prevent and understand the modifications of this phase of life is pertinent. In addition, it is pertinent to discuss among adolescents the emotions and values that prevent the use of the information they have in their sexual practices. It is also noted the need for the school to take on a daily work of approaching sexuality as intrinsic to health, as a safe and healthy sexual practice through the use of contraceptive and preventive methods against STI

Articulações entre contracepção, sexualidade e relações de gênero / Interconnections between contraception, sexuality, and gender relations

Resumo O artigo propõe uma abordagem socioantropológica para discutir questões ainda candentes em torno da contracepção, sobretudo no contexto brasileiro. A prática contraceptiva compreende uma série de decisões e lógicas complexas entranhadas em múltiplos domínios da vida, requerendo análises acerca de práticas e representações sobre contracepção, maternidade, conjugalidade, família, prazer e sexualidade, sem que se deixe de considerar aspectos materiais cruciais como a oferta contraceptiva (disponibilidade de serviços e métodos). São revisitadas algumas contribuições sociológicas e antropológicas que oferecem chaves de interpretação para o entendimento dos percursos contraceptivos femininos e permitem a discussão acerca dos processos decisórios relativos à contracepção. O artigo problematiza a equação simplista entre gestações imprevistas e falta de informação e/ou acesso adequado aos métodos contraceptivos, ou ainda, como reflexo de uma suposta restrita racionalidade e/ou responsabilidade dos sujeitos em relação à vida contraceptiva - tendências ainda hegemônicas em campos disciplinares como a saúde pública e a demografia. As reflexões propostas ressaltam a necessidade de ponderar as assimetrias de gênero e as mediações biográficas, contextuais e culturais subjacentes nos processos que engendram um evento reprodutivo. Este tipo de análise abre espaço para introdução de discussões sobre sexualidade e sua conexão com as formas como as pessoas lidam com a contracepção e a reprodução. Trata-se de um artigo teórico que procura contribuir para o debate sobre a cultura contraceptiva no Brasil.

Abstract This paper proposes a social-anthropological approach to discuss (still) burning issues around contraception, especially in the Brazilian context. Contraceptive practices embrace a wide range of decisions and complex perspectives intertwined in multiples life domains, requiring analysis about practices and representations on contraception, motherhood, conjugality, family, pleasure and sexuality, not forgetting the consideration of crucial material aspects as the contraceptive supply (availability of services and methods). Some sociological and anthropological contributions are revisited, since they provide interpretation keys to comprehend female contraceptives paths and enable the discussion about the decision-making processes associated to contraception. The article problematizes the simplistic equation which links unexpected pregnancy to the lack of information and/or proper access to contraception methods, or to an alleged and strict rationality and/or individual responsibility towards contraceptive life - this is a still hegemonic pattern in disciplinary fields such as Public Health and Demography. The presented considerations emphasize the urge to ponder biographical, contextual and cultural mediations and gender imbalance underlying a reproductive event. This kind of analysis enables to bring sexuality into discussion, and its relation with the ways people deal with contraception and reproduction. This is a theoretical article that aims to contribute to the debate about contraceptive culture in Brazil.

Por que elas não usam?: um estudo sobre a não adesão das adolescentes aos metodos contraceptivos e suas repercussões / Why they do not use?: a study about the accession of adolescents not contraceptive methods and their implications

A Organização Mundial da Saúde (OMS) define adolescência como uma etapa intermediária do desenvolvimento humano, entre a infância e a fase adulta, que ocorre entre os 10 e 19 anos de idade. Objetivo: Compreender o que leva as adolescentes à gravidez não planejada. Métodos: Trata-se de uma pesquisa qualitativa exploratória do tipo pesquisa de campo. A coleta de informações foi realizada com 13 gestantes adolescentes menores de 19 anos cadastradas em uma Clinica da Familia em Padre Miguel, no Rio de Janeiro no período entre agosto a setembro 2015 .Resultados: As adolescentes entrevistadas são gestantes,se auto declararam pardas, solteiras, tem baixa escolaridade, moram com os pais e vivem com a renda familiar em torno de 1 salário mínimo. Tiveram sua menarca entre 12 e 14 anos, com relação ao início da atividade sexual , 46,15% relataram usar camisinha de vez em quando, 38,46% informaram ter recebido orientação sexual através dos amigos e 31,53% tinham parceiro fixo. Constatou-se conhecimento insuficiente e pouco ou quase nenhuma utilização de método contraceptivo, informam efeitos colaterais , objeção do parceiro no uso da camisinha tanto para prevenir gravidez quanto DST's. Conclusão: Reforça-se a importância de investimentos na Educação sexual dos adolescentes e a equipe de saúde, esteja atenta no desenvolvimento de ações na promoção, reflexão e conscientização dos adolescentes em relação as questões da anticoncepção, gerando mudanças de comportamento e respeitando a capacidade individual em receber e processar as informações para utilizá-las corretamente.

The World Health Organization (WHO) defines adolescence as a transitional stage of human development between childhood and adulthood, which occurs between 10 and 19 years old. Objective: To understand what drives teens to unplanned pregnancy. Methods: This is an exploratory qualitative research of field research type. Data collection was performed with 13 pregnant teenagers under 19 years enrolled in a clinic of the Family in Padre Miguel, in Rio de Janeiro in the period August-September 2015. Resultados: Adolescents are interviewed pregnant women, self declared brown, single, It has low education, living with parents and living with the family income around 1 minimum wage. Had their menarche between 12 and 14 years, with the start of sexual activity, 46.15% reported using a condom every so often, 38.46% reported receiving sexual orientation through friends and 31.53% had a steady partner. It found insufficient knowledge and little or no use of contraception, inform side effects, partner objection on the use of condoms to prevent both pregnancy and STDs. Conclusion: It reinforces the importance of investments in sexual education of adolescents and the health team, be careful in the development of actions to promote, reflection and awareness of adolescents regarding the issues of contraception, generating behavioral change and respecting the individual capacity to receive and process the data to use them properly.

Conocimientos previos acerca de métodos anticonceptivos y su relación con conocimientos adquiridos después de una intervención educativa con simulador / Previous knowledge about contraceptive methods and its relation with knowledge acquired after an educational intervention with simulator

ResumenIntroducción.El objetivo de este trabajo es relacionar conocimientos previos (pre-saberes) acerca de métodos anticonceptivos con los conocimientos adquiridos (saberes), después una intervención educativa con simulador.Método.Es un estudio realizado con 295 adolescentes escolarizados que cursan noveno, décimo y undécimo en una institución educativa pública. Es de tipo descriptivo. El proceso estuvo compuesto por tres fases; en la primera se midió conocimientos o saberes previos acerca de métodos anticonceptivos, mediante un cuestionario auto-informado; en la segunda se definió los contenidos y actividades de intervención para mejorar los conocimientos previos, y en la tercera fase de post-intervención educativa, se reevaluó los saberes adquiridos con el simulador.Resultados.Se detectó que los pre-saberes en métodos anticonceptivos son deficientes independientemente de la edad y la escolaridad, lo cual requiere planeación, desarrollo y evaluación de la estrategia de aprendizaje colectivo y cooperativo mediante talleres. En cuanto a los post-saberes, se obtuvo una calificación de deficientes a regulares, en el caso del condón masculino, mientras que el reconocimiento de métodos modernos como parche, anillo vaginal, dispositivo intrauterino, entre otros, se dio gracias al contacto directo con el simulador.Conclusiones.Se recalca que a pesar de las diferencias de edad y escolaridad, no hubo hallazgos relevantes que demostraran diferencias de conocimiento. En los pre-saberes, se encontró niveles de conocimiento deficientes sobre métodos anticonceptivos. El uso de simuladores como herramienta de aprendizaje demostró eficacia en los talleres; en cuanto a los simuladores posibilitan la ruptura de la barrera cognitiva, dado que el adolescente, en este caso, puede explorar y adquirir conocimiento al interaccionar con el objeto de aprendizaje.

AbstractIntroduction:The objective of this work is to relate previous knowledge about contraceptive methods with the acquired knowledge after an educational intervention with Simulator.Method:It is a study of 295 school adolescents enrolled in ninth, tenth, and eleventh in a public educational institution. It is descriptive. The process consisted of three phases; the first was measured knowledge or previous knowledge about contraceptive methods, using a self-reported questionnaire; the second was defined the contents and activities of intervention for improving the background, and in the third phase of post-intervention educational re-evaluated the knowledge acquired with the simulator.Result.Detected that the pre-knowledge in methods of contraception are poor regardless of age and schooling, which requires planning, development and evaluation of the strategy of collective and cooperative learning through workshops. As for the post-knowledge, was obtained a rating of poor to regular, in the case of the male condom, while the recognition of modern methods such as patch, vaginal ring, IUD, among others, by their physical appearance and location by direct contact with the simulator.Conclusión.Stressing that despite differences of age and education, there were no relevant findings that demonstrated differences in knowledge. In the pre-knowledge, found leveis of knowledge deficient about contraception. The use of simulators as a learning tool demonstrated effectiveness in the workshops; regarding simulators make possible rupture of the cognitive barrier, since the adolescent, in this case, can explore and acquire knowledge to interact with the aim of learning.

Use of traditional contraceptive methods in India & its socio-demographic determinants.

Background & objectives: The high use of traditional contraceptive methods may have health repercussions on both partners. High failure rate, lack of protection from sexually transmitted diseases are some of the examples of these repercussions. The aim of this study was to understand the level, trends, pattern, volume and socio-demographic determinants of using traditional contraceptive methods in the Indian context. Methods: Percentages, per cent distribution, cross-tabulation and multinomial logistic regression analyses were carried out. The data from the three rounds of National Family Health survey (NFHS) were used. The unit level district level household survey (2007-2008) were mainly used to carry out the analysis in this paper. Marriage rates for States and Union Territories (UTs) were projected for the period of 2001-2011 to estimate the volume of traditional contraceptive users. These rates are required to get the number of eligible couples as on 2011 in the respective state/UT. Results: The latest round of the district level household survey (2007-2008) revealed that 6.7 per cent currently married women were using traditional contraceptive methods in India. More than half of the currently married women (56%) have ever used these methods. In terms of socio-demographic determinants, the odds ratios of using these methods were significantly higher for women aged 35 years and above, rural, Hindu, other than Scheduled Castes/Tribes (SCs/STs), secondary and above educated, non-poor, having two plus living children, and at least one surviving son in most of the states as well as at the national level. The northeastern region showed higher odds ratios (5 times) of women using traditional contraceptive methods than the southern region. Interpretation & conclusions: A large number of currently married women have ever used the traditional contraceptive methods in India. On the basis of the findings from this study, the total size of those women who were using traditional methods and those who were having unmet need, and are required to use modern spacing methods of family planning in achieving the reproductive goals, is around 53 million. Women from a set of specific socio-demographic backgrounds are more likely to use these methods. A regional pattern has also emerged in use of tradition contraceptive methods in India.

Información sobre anticoncepción y métodos anticonceptivos en adolecentes del municipio "La Lisa" / Information about contraception and contraceptive methods in adolescents in \"La Lisa\" Municipality

Introducción: el control de la natalidad en la adolescencia y la prevención de las Infecciones de Transmisión Sexual (ITS), han sido una preocupación de nuestro Sistema Nacional de Salud, que ha realizado numerosos esfuerzos en aras de lograrlo.Objetivo: caracterizar la información que tienen sobre anticoncepción y métodos anticonceptivos un grupo de adolescentes.Métodos: se realizó un estudio descriptivo de corte transversal. El universo fue de 87 alumnos matriculados en la escuela y se trabajó con 78 de ellos, a los cuales se les aplicó una encuesta de manera anónima, con preguntas cerradas y validadas por criterios de expertos.Resultados: en ambos sexos se identificaron correctamente los métodos anticonceptivos. Los padres fueron la fuente de información más frecuente y predominaron aquellos que no reconocen la posibilidad de un embarazo con la práctica de algunos juegos sexuales.Conclusiones: el conocimiento por parte de los y las adolescentes de la importancia de la anticoncepción y los métodos anticonceptivos resulta aún insuficiente. Los programas de educación sexual para adolescentes deben reforzar estos aspectos. El protagonismo de loseducadores debe ser mayor pues en estas edades se necesita que los transmisores de la información tengan una adecuada preparación que en ocasiones falta en los padres

Background: birth control in adolescence and the prevention of Sexually Transmitted Infections (STI) have been a great concern for our National Health System, which has made many efforts in the interest of achieving it.Objective: to characterize the information that a group of adolescents have about contraception and contraceptive methods.Methods: a cross-sectional descriptive study was performed. The sample was composed of 87 students enrolled at school. To 78 of them, an anonymous inquiry was applied which included closed questions and was also validated by experts´ criteria.Results: in both sexes, the contraceptive methods were identified correctly. Their parents constituted the most frequent source of information and the group that predominated was the one that does not recognize the possibility of pregnancy after practicing some sexual games.Conclusions: the knowledge by adolescents about the importance of contraception and contraceptive methods is still insufficient. The programs about sexual education for adolescents should reinforce these aspects. The prominent role of educators should be bigger because these ages need that the transmitters of information have the adequate preparation that, in some occasions, their parents lack interest in

Contracepção na contemporaneidade: o distanciamento da moral católica / Contraception today: the detachment from the Catholic morality

O artigo discute a correlação entre moral religiosa, em especial a da Igreja Católica, e métodos contraceptivos. Em um segundo plano, objetiva verificar os elementos atualmente utilizados na construção da atitude frente aos métodos contraceptivos. A partir da revisão da bibliografia, que teve como mote a reportagem intitulada -Preservativo: novo documento do Vaticano em perspectiva-, percebeu-se que a base para utilização de métodos contraceptivos na contemporaneidade está vinculada à adoção de métodos baseados no conhecimento científico, como preservativos, pílulas e planejamento familiar, condenados pela Igreja Católica. Isto leva, invariavelmente, à conclusão de que, frente às necessidades individuais, o homem contemporâneo acaba se distanciando das práticas norteadas com base no dogma sustentado pela Igreja Católica.

Modificación de conocimientos sobre salud reproductiva en adolescentes con riesgo preconcepcional / Knowledge modification to sexually reproductive health in adolescents with pre-conception risk

Se hizo una intervención educativa en 30 adolescentes con riesgo preconcepcional, atendidas en la consulta de planificación familiar y salud reproductiva perteneciente al Policlínico Universitario Josué País García de Santiago de Cuba, desde enero hasta diciembre del 2007, a fin de modificar sus conocimientos sobre salud sexual. En la serie predominó la instrucción inadecuada en cuanto a embarazo en la adolescencia, aborto provocado, métodos anticonceptivos e infecciones sexualmente transmisibles; comportamiento que fue variado satisfactoriamente luego de la estrategia educativa, pues la mayoría de las integrantes incorporaron nuevas nociones sobre el tema o incrementaron las que poseían anteriormente al respecto.

A teaching intervention in 30 adolescents with pre-conception risk attended at the Birth Control and Reproductive Health Department from Josué País García University Polyclinic in Santiago de Cuba was carried out from January, 2007 to December, 2007, in order to modify their sexual health knowledge. Inadequate instruction about teenage pregnancy, artificial abortion, contraceptive methods, and sexually transmitted infections were predominant in the series. This behavioral pattern was successfully modified after the educational strategy, since most of the adolescents acquired new ideas about this issue or improved the ones they had already learned.