Barreras de acceso a los servicios primarios de salud sexual y reproductiva en adolescentes, de una comunidad urbano marginal del Perú

Introducción: Las barreras de acceso a los servicios de salud primario conforman estructuras sociales que agravan la situación de salud de los adolescentes, impactando negativamente en el ejercicio pleno de la salud sexual reproductiva, situando a los adolescentes en una población de riesgo social. Objetivo: Determinar las barreras en el acceso a los servicios primarios de Salud Sexual y Reproductiva de atención diferenciada a los adolescentes del Centro de Salud I - 4 Pampa Grande Tumbes 2018. Metodología: Estudio analítico de caso control, se entrevistaron a 288 adolescentes del tercero, cuarto y quinto de secundaria de la institución educativa pública Túpac Amaru del centro poblado Pampa Grande de Tumbes en el año 2019, entre experimento y control con una razón de 1 a 1. Se aplicaron cuestionarios anónimos para evaluar las barreras de accesibilidad a los servicios primarios de salud. Se recogieron variables: características sociodemográficas y culturales que son consideradas, como barreras de acceso a los servicios de salud. Se realizó un análisis descriptivo e inferencial con el programa SPSS® v.23. Resultados: La edad, sexo e ingreso económico están directa y significativamente relacionadas con la accesibilidad a los servicios de salud sexual y reproductiva (p<0.01 IC 95 %); La disposición de recursos económicos para asumir los costos de traslado al centro de salud (OR = 4,23); la utilización del transporte público (OR = 1,58), el conocimiento de los servicios de salud sexual y reproductiva (OR = 1,15) incrementan la probabilidad de acceder a los servicios de salud sexual y reproductiva de los adolescentes. Discusión: Las barreras socioeconómicas a los servicios de salud sexual y reproductiva de los adolescentes son modificables y dependen de la gestión en salud pública.

Introduction: The barriers to access to primary health services make up social structures that aggravate the health situation of adolescents, negatively impacting the full exercise of reproductive sexual health, placing adolescents in a population at social risk. Objective: To determine the barriers in the access to the primary services of Sexual and Reproductive Health of differentiated attention to the adolescents of the Health Center I - 4 Pampa Grande Tumbes 2018. Methods: Analytical case control study, 288 adolescents from the third, fourth and fifth grade of secondary school of the public educational institution Túpac Amaru in the Pampa Grande de Tumbes town center were interviewed in 2019, between experiment and control with a ratio of 1 to 1. Anonymous questionnaires were applied to assess accessibility barriers to primary health services. Variables were collected: sociodemographic and cultural characteristics that are considered as barriers to access to health services. A descriptive and inferential analysis was carried out with the SPSS® v.23 program. Results: Age, sex and economic income are directly and significantly related to accessibility to sexual and reproductive health services (p<0.01 95% CI); The availability of economic resources to assume the costs of transportation to the health center (OR = 4.23); the use of public transport (OR = 1.58), knowledge of sexual and reproductive health services (OR = 1.15) increase the probability of accessing sexual and reproductive health services for adolescents. Discussion: Socioeconomic barriers to sexual and reproductive health services for adolescents are modifiable and depend on public health management.

Cuidado com a saúde sexual e reprodutiva: um olhar a partir da percepção de mulheres que fazem sexo com mulheres / Sexual and Reproductive Health Care: a look from the perspective of women who have sex with women / El cuidado de la salud sexual y reproductiva: una mirada desde la perspectiva de las mujeres que tienen sexo con mujeres

Objetivo: o presente estudo se destina a compreender a percepção das mulheres que fazem sexo com mulheres, referente ao cuidado que recebem nos serviços de saúde, no âmbito de sua saúde sexual e reprodutiva, a fim de verificar se o atendimento ofertado atende a integralidade de seu direito à saúde e, também, evidenciar o papel dos profissionais de saúde na garantia desses direitos. Metodologia: foi realizada revisão de literatura nacional para elaboração do instrumento de coleta de dados e pesquisa qualiquantitativa através de formulário e entrevista individual via internet. Resultados: Foram obtidas 287 respostas, as falas revelaram as seguintes categorias: A- Violência física sofrida em serviços de saúde, B- Negligência e falta de acolhimento em consultas ginecológicas e em serviços de saúde, C- Presunção da heterossexualidade nos serviços de saúde, D- Invisibilidade e violência moral e psicológica. Conclusão: evidenciou-se que mulheres que fazem sexo com mulheres ainda sofrem uma série de discriminações e violências nos serviços de saúde, ao buscarem cuidados integrais, principalmente no que tange aos seus direitos sexuais e reprodutivos.

Objective: this study is intended to understand the perception of women who have sex with women, regarding the care they receive in health services, within the scope of their sexual and reproductive health, in order to verify whether the care offered to them meets the integrality of their right to health and, also, highlight the role of health professionals in guaranteeing these rights. Methodology: A national literature review was carried out for the elaboration of the data collection instrument and qualitative and quantitative research through an individual form and individual interview via the internet. Results: 287 responses were obtained, the statements revealed the following categories: A- Physical violence suffered in health services, B- Negligence and lack of acceptance in gynecological consultations and health services, C- Presumption of heterosexuality in health services, D- Invisibility and, moral and psychological violence. Conclusion: it was evident that women who have sex with women still suffer a series of discrimination and violence in health services, when seeking comprehensive care, especially with regard to their sexual and reproductive rights.

Objetivo: este estudio tiene como finalidad conocer la percepción de las mujeres que tienen sexo con mujeres, respecto a la atención que reciben en los servicios de salud, en el ámbito de su salud sexual y reproductiva, con el fin de verificar si la atención que se les brinda cumple con la integralidad de su derecho a la salud y, además, destacar el papel de los profesionales de la salud en la garantía de estos derechos. Metodología: se realizó una revisión de literatura nacional para la elaboración del instrumento de recolección de datos e investigación cualitativa y cuantitativa a través de formulario individual y entrevista individual vía internet. Resultados: se obtuvieron 287 respuestas, los enunciados revelaron las siguientes categorías: A- Violencia física sufrida en los servicios de salud, B- Negligencia y falta de aceptación en las consultas ginecológicas y servicios de salud, C- Presunción de heterosexualidad en los servicios de salud, D- Invisibilidad y violencia moral y psicológica. Conclusión: se evidenció que las mujeres que tienen sexo con mujeres aún sufren una serie de discriminaciones y violencias en los servicios de salud, al momento de buscar atención integral, especialmente en lo que se refiere a sus derechos sexuales y reproductivos.

Research progress on food-derived antioxidants for alleviating toxicity of endocrine disrupting chemicals / 环境与职业医学

Endocrine disrupting chemicals (EDCs) are a class of chemical substances widely present in daily-life environment, and can enter human body through various pathways, posing a threat to reproductive development and health. Oxidative stress (OS) is one of the most important fundamental mechanisms underlying the reproductive toxicity of EDCs. Numerous studies have found that exposure to EDCs can increase the levels of reactive oxygen species (ROS) in human reproductive system and reduce the activity and quantity of multiple enzymatic antioxidants, leading to oxidative stress and inducing damage to the reproductive system at various levels such as DNA and cells. Many research results have shown that supplementing food-derived non-enzymatic antioxidants can reduce ROS levels and increase the activity of enzymatic antioxidants, thereby reduce OS levels, and further repair EDCs-induced reproductive damage. In addition, many food-derived antioxidants are important elements involved in reproductive physiological activities and have protective effects on reproductive health. This paper summarized the reproductive toxicity of EDCs, including damage to reproductive cells, interference with hormone action, and influence on reproductive-related epigenetic regulation, elaborated the relationship between OS and reproductive toxicity of EDCs, and further summarized the alleviating effects and related mechanisms of food-derived antioxidants such as vitamins, trace elements, and plant polyphenols and pigments against reproductive toxicity of EDCs, aiming to provide a theoretical and scientific basis for prevention and treatment against reproductive toxicity of EDCs.

Staged Treatment with Chinese Herbal Medicine in a Controlled Ovarian Hyperstimulation of In Vitro Fertilization-Embryo Transfer Programme / 中医杂志

It is believed that kidney deficiency is the fundamental pathogenesis while liver constraint and spleen deficiency， and disharmony of chong （thorough vessel， 冲脉）and ren （conception vessel， 任脉） is the key pathogenesis of infertility patients who adopted controlled ovarian hyperstimulation of in vitro fertilization-embryo transfer （IVF-ET） programme. Therefore， the method of tonifying the kidneys dominantly and treating the liver and spleen simultaneously is proposed， and Chinese herbal medicine is suggested to be used in adjuvant treatment of staged IVF-ET controlled ovrian hyperstimulation. In the regulation stage， modified Liuwei Dihuang Pill （六味地黄丸） can be used to tonify kidney and supplement essence， fortify spleen and nourish liver； in the ovulation promotion stage， modified Wenjing Decoction （温经汤） should be used to warm kidney and assist yang， dispel stasis and nourish blood； in the pre-transplantation endothelial preparation stage， modified Shenling Baizhu Powder （参苓白术散） is suggested to fortify spleen and replenish qi， invigorate blood and resolve stasis； after the transplantation stage， modified Shoutai Pill （寿胎丸） or Taiyuan Decoction （胎元饮） can be taken to fortify spleen and tonify kidney， benefit qi and nourish blood.

Exploration of "Strengthening Kidney Yin" Method to Alleviate Female Reproductive Damage Caused by Glycosides of Tripterygium wilfordii Polyglycoside / 中国实验方剂学杂志

Tripterygium wilfordii polyglycosides are one of the most commonly used Tripterygium wilfordii preparations， which have anti-inflammatory and immune-regulating effects. Their unique therapeutic effect on some autoimmune diseases and kidney diseases is almost irreplaceable by other similar drugs， but the possible reproductive damage is the bottleneck that hinders their clinical application. In clinical use， female patients often suffer from menstrual cycle disorders， decreased menstrual flow， even amenorrhea， infertility， and other symptoms， and the main toxic mechanism lies in damaging the reproductive and endocrine functions of the ovary and inhibiting the growth and development of follicles. Therefore， it is particularly necessary to understand the toxic and side effects of Tripterygium wilfordii polyglycosides on female reproduction and master the detoxification methods during clinical use. However， there is no clear solution to these problems. According to the theory of traditional Chinese medicine， "kidney governs reproduction"， and the relationship between kidney Yin， kidney essence， and female ovum is close. Therefore， by considering that the damage to the reproductive system caused by Tripterygium wilfordii polyglycosides belongs to the category of kidney deficiency， Yin damage， and essence deficiency， the "strengthening kidney Yin" method is proposed. It points out that the reproductive toxicity damage of Tripterygium wilfordii polyglycosides on the female can be effectively alleviated by tonifying kidney and Yin essence in clinical use. The relevant research on traditional Chinese medicine， classical prescription， test prescription， and acupuncture is summarized to verify the necessity of the "strengthening kidney Yin" method， so as to provide a theoretical basis for the safe and rational clinical use of Tripterygium wilfordii.

Lycium barbarian seed oil activates Nrf2/ARE pathway to reduce oxidative damage in testis of subacute aging rats / 中国药理学通报

Aim To explore the effects of Lycium berry seed oil on Nrf2/ARE pathway and oxidative damage in testis of subacute aging rats. Methods Fifty out of 60 male SD rats, aged 8 weeks, were subcutaneously injected with 125 mg • kg"D-galactosidase in the neck for 8 weeks to establish a subacute senescent rat model. The presence of senescent cells was observed using P-galactosidase ((3-gal), while testicular morphology was examined using HE staining. Serum levels of testosterone (testosterone, T), follicle-stimulating hormone ( follicle stimulating hormone, FSH ) , luteinizing hormone ( luteinizing hormone, LH ) , superoxide dis-mutase ( superoxide dismutase, SOD ) , glutathione ( glutathione, GSH) and malondialdehyde ( malondial-dehyde, MDA) were measured through ELISA, and the expressions of factors related to aging, oxidative damage, and the Nrf2/ARE pathway were assessed via immunohistochemical analysis and Western blotting. Results After successfully identifying the model, the morphology of the testis was improved and the intervention of Lycium seed oil led to a down-regulation in the expression of [3-gal and -yH2AX. The serum levels of SOD, GSH, T, and FSH increased while MDA and LH decreased (P 0. 05) . Additionally, there was an up-regulated expression of Nrf2, GCLC, NQOl, and SOD2 proteins in testicular tissue ( P 0. 05 ) and nuclear expression of Nrf2 in sertoli cells. Conclusion Lycium barbarum seed oil may reduce oxidative damage in testes of subacute senescent rats by activating the Nrf2/ARE signaling pathway.

Effects of soybean isoflavones on the reproductive development of young mice / 中国药房

OBJECTIVE To investigate the effects of soybean isoflavones （SI） on the reproductive development of young mice. METHODS C57BL/6 young mice were randomly divided into control group， SI low-dose and high-dose groups （10， 100 mg/kg）， with 10 mice in each group （half male and half female）. The young mice in each group were given corresponding liquid intragastrically， once a day， for 2 consecutive weeks. After the last administration， the percentage of body weight increase was calculated； serum estradiol and testosterone levels， malondialdehyde （MDA） content， total antioxidant capacity （T-AOC）， superoxide dismutase （SOD） and glutathione peroxidase （GSH-Px） activities in the reproductive organs of the young mice were determined. The histopathological changes in the reproductive organs were observed. The cell apoptosis of reproductive organs was detected. RESULTS Compared with the control group， the percentage of body weight increase in female mice was increased significantly in the SI high-dose group， while that of male mice was decreased significantly （P＜0.05 or P＜0.01）. Cystic follicles could be seen in the ovarian tissue in SI groups， a loose arrangement of spermatocytes could be seen in the testicular tissue， and partial epithelial cell shedding could be seen in epididymal tissue. The serum level of testosterone in female young mice and the serum levels of testosterone and estradiol in male young mice in SI groups， GSH-Px activity in the ovarian tissue of female young mice in the SI low-dose group， T-AOC activities in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in testicular and epididymal tissue of male young mice in SI groups were increased significantly （P＜0.05 or P＜ 0.01）； the serum level of estradiol in female young mice in SI groups， SOD activity in the ovarian tissue of female young mice in the SI high-dose group， and MDA contents in the ovarian tissue of female young mice in SI groups as well as the apoptotic rates of cells in ovarian tissue of female mice in SI groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS SI can enhance the antioxidant stress capacity of ovarian tissue in female young mice and reduce their oxidative stress damage， but it has certain toxicity to reproductive organs in male mice.

Discussion on the Continued Use of Assisted Reproductive Technology for Widowed Single Women / 中国医学伦理学

Assisted Reproductive Technology(ART) as a medical technology to treat infertility is gradually increasing the applications in domestic and foreign countries. In fact, some single women have birth demands for the application of ART in China. This paper described the reasons why some single women in China have demands for the application of ART, and analyzed the relevant legal, ethical and social issues that may be faced in the applying of technologies. Besides, the paper suggested that the using of ART in single women should be banned in principle, but for some widowed single women who lost their husbands during the process of ART, considering allowing them to complete the unfinished applications at their request. Meanwhile, a self-assessment mechanism should be established for these widowed single women, and ethical principles and managements should be strictly followed in the process of ART application to prevent the abuse of technology and fully protect the interests of offspring.

Reflection on Assisted Reproductive Technology Cases based on WAS Syndrome Gene Mutation / 中国医学伦理学

With the development of assisted reproductive technology, there will be more and more complex conflicts of interest issues and challenges. This paper used clinical medicine, legal and ethical analysis of WAS syndrome gene mutation assisted reproductive technology cases, emphasized that the law is the bottom line of morality, strengthen the consulting duty of the ethics committee of reproductive medicine, and pointed out that medical staff must fully perform the obligation of notification, respect their autonomy and provide patients with best medical assistance.

Design and baseline characteristics of a population-based birth cohort in Shanghai / 上海预防医学

ObjectiveTo introduce the basic design， development plan and objectives of a population-based birth cohort in Shanghai， and further present the main data and baseline characteristics of enrolled participants in the cohort， and to provide key information for reproductive health-related studies. MethodsThe Shanghai population-based birth cohort initiated on January 1， 2005， included newborns born in Shanghai every year and their parents， and collected information on reproductive health， reproductive treatment， birth characteristics， growth and development status， as well as the incidence， treatment and death of diseases by employing data linkage technology and investigations. This formed a birth cohort spanning the entire life cycle. ResultsAs of October 2022， a total of 2 978 538 newborns and their parents were included in the cohort. Among them， 2 905 135 （97.54%） were naturally conceived （NC）， and 73 403 （2.46%） were born through assisted reproductive technologies （ART）. The average age of parents was （32.56±4.12） years old for females and （34.62±5.34） years old for males in the ART group， which was higher than （28.02±4.71） years and （30.07±5.54） years for parents in the NC group. Among parents， females and males aged 30 and above accounted for 77.12% and 85.08%， respectively， which were higher than that of parents （35.28% for females and 49.66% for males） in the NC group. Furthermore， the percentage of parents with a college degree or above in the ART group was 73.23% for females and 73.66% for males， which were higher than those in the NC group （49.98% and 50.91%， respectively）. The multiple births rate in the ART group was 33.81%， which was higher than that in the NC group （1.88%）. The incidence of premature birth and low birth weight in the ART group were 24.47% and 19.08%， respectively， which was higher than that in the NC group （5.47% and 3.73%）. ConclusionThe comprehensive collection of reproductive health-related information in the birth cohort in Shanghai can provide essential resources to determine the influence of genetics， environment， reproductive treatment and other related factors on the health of offspring after birth.

Lacunas e propostas de práticas educativas de saúde sexual e reprodutiva para população LGBTQIA+: revisão integrativa / Gap and proposals for educational practices of sexual and reproductive health for the LGBTQIA+ population: an integrative review / Lagunas y propuestas de prácticas educativas de salud sexual y reproductiva para la población LGBTQIA+: una revisión integrativa

Objetivo: analisar as publicações científicas nacionais sobre a atenção à saúde sexual e reprodutiva oferecida para população LGBTQIA+ com relação às principais lacunas e possibilidades das práticas educativas referentes a essa temática no contexto brasileiro. Método: revisão integrativa, em seis etapas, com busca dos estudos realizada em junho de 2022 nas bases de dados LILACS, MEDLINE, SCIELO e Web of Science e SCOPUS. Resultados: foram recuperados 5.643 estudos e selecionados 14 para análise e discussão. Destacaram-se os temas: saúde sexual e reprodutiva com foco na reprodução e nas técnicas reprodutivas, infecções sexualmente transmissíveis e educação em saúde sexual e, por fim, direitos sexuais e reprodutivos. Conclusão: foram evidenciadas as principais lacunas quanto ao tema de saúde sexual e reprodutiva, assim como sugestões para práticas educativas ligadas à temática.

Objective: to analyze national scientific publications on the attention to sexual and reproductive health offered to the LGBTQIA+ population about the main gaps and possibilities of educational practices referring to this topic in the Brazilian context. Method: integrative review in six stages, with two studies, carried out in June 2022 in the LILACS, MEDLINE, SCIELO Web of Science, and SCOPUS databases. Results: 5,643 studies were recovered 14 were selected for analysis and discussion. Highlights the topics: sexual and reproductive health with a focus on reproduction and techniques, sexually transmitted infections, education in sexual health, and finally sexual and reproductive rights. Conclusion: found highlighted the main gaps regarding the topics of sexual and reproductive health, as well as suggestions for educational practices.

Objetivos: analizar las publicaciones científicas nacionales sobre la atención a la salud sexual y reproductiva ofrecida para la población LGBTQIA+ con la relación con las principales lagunas y posibilidades de las prácticas educativas referentes a esa temática en el contexto brasileño. Método: revisión integrativa, en seis etapas, con búsqueda de estudios realizados en junio de 2022 en bases de datos LILACS, MEDLINE, SCIELO y Web of Science y SCOPUS. Resultados: foram recuperados 5.643 estudios y seleccionados 14 para análisis y discusión. Destacaram-se os temas: saúde sexual e reprodutiva com foco na reprodução e nas técnicas reproductivas, infecções sexualmente transmissíveis e educação em saúde sexual e, por fim, direitos sexuais e reprodutivos. Conclusión: foram evidenciadas como principales lagunas en cuanto al tema de salud sexual y reproductiva, así como sugerencias para prácticas educativas ligadas a temáticas.

Direitos sexuais e direitos reprodutivos na percepção de: mulheres privadas de liberdade / Sexual rights and reproductive rights in the perception of: women deprived of freedom / Derechos sexuales y derechos reproductivos percibidos por: mujeres privadas de libertad

Objetivo: analisar a percepção de mulheres privadas de liberdade quanto aos seus direitos sexuais e direitos reprodutivos. Método: pesquisa descritiva, com abordagem qualitativa. Foram realizadas entrevistas com mulheres que estavam vivenciando a gestação (9) e o puerpério (4), em duas unidades prisionais do Rio de Janeiro. O método de análise foi o Hermenêutico dialético. Resultados: foram elencadas duas categorias: 1) Violações institucionais como infração dos direitos sexuais e dos direitos reprodutivos e 2) Contradições entre a possibilidade de exercer os direitos e as limitações impostas pelo sistema carcerário. Conclusão: as violações que essas mulheres sofrem, não estão restritas a elas. A luta pelos direitos das mulheres é um movimento constante. Os avanços são significativos, contudo, há amarras reais que impedem que as mulheres usufruam seus direitos sexuais e seus direitos reprodutivos, mesmo que eles existam no plano legal e normativo

Objective: analyze the perception of women deprived of liberty regarding their sexual rights and reproductive rights. Method: descriptive research, with a qualitative approach. Interviews were conducted with women who were experiencing pregnancy (9) and the puerperium (4), in two prison units in Rio de Janeiro. The analysis method was the dialectic hermeneutic. Results: two categories were listed: 1) Institutional violations as infractions of sexual rights and reproductive rights and 2) Contradictions between the possibility of exercising rights and the limitations imposed by the prison system. Conclusion: the violations that these women suffer are not restricted to them. The fight for women's rights is a constant movement. The advances are significant, however, there are real obstacles that prevent women from enjoying their sexual rights and their reproductive rights, even though they exist in the legal and normative plan

Objetivos: respecto a sus derechos sexuales y derechos reproductivos. Método: investigación descriptiva, con un enfoque cualitativo. Las entrevistas fueron realizadas a mujeres en situación de embarazo (9) y de puerperio (4), en dos unidades penitenciarias de Río de Janeiro. El método de análisis fue la hermenéutica dialéctica. Resultados: se han dividido en dos categorías: 1) Violaciones institucionales como la infracción de los derechos sexuales y los derechos reproductivos y 2) Contradicciones entre la posibilidad de ejercer los derechos y las limitaciones impuestas por el sistema carcelario. Conclusión: las violaciones que sufren estas mujeres no se limitan a ellas. La lucha por los derechos de la mujer es un movimiento constante. Los avances son significativos, sin embargo, existen ataduras reales que impiden a las mujeres disfrutar de sus derechos sexuales y sus derechos reproductivos, aunque existan a nivel legal y normativo

Reproduction technologies in pig farming: artificial insemination - literature review / Tecnologias de reprodução na suinocultura: inseminação artificial - revisão de literatura / Tecnologías de reproducción en la porcicultura: inseminación artificial - revisión de literatura

This summary addresses the use of reproduction technologies in swine farming, with an emphasis on artificial insemination (AI). Brazilian swine farming has been growing significantly and seeks new technologies to achieve high productive indices sustainably and competitively. Pigs present favorable characteristics such as high prolificacy, fertility, rapid growth, feed efficiency, and carcass yield, which has led to intensive development of the activity with advanced genetic selection. AI is widely employed to disseminate genetic material among different regions and farms. Several AI techniques are used in modern swine farming: intrauterine insemination (IUI) allows semen deposition in the uterine region, reducing costs; fixed-time insemination (FTAI) synchronizes estrus in various females, facilitating management and increasing efficiency; deep intrauterine insemination (DIUI) deposits semen in the uterine horns, obtaining better results; and cervical insemination (CI), a traditional technique widely used, although it may be more time-consuming and present higher reflux rates. The success of AI is related to knowledge of the reproductive cycle of sows, proper nutrition, and genetic and environmental factors. Semen quality is essential, requiring collection by trained professionals and evaluation of sperm motility and morphology. Although it is a consolidated technique, there are issues to be further explored to optimize its application, defining the exact moment for insemination, reducing reflux, and adopting effective protocols. AI is an essential tool for the growth of Brazilian swine farming, but it requires continuous studies to maximize its efficiency and results, considering the farm's production goal and the size of the enterprise to achieve high reproductive and productive indices.

Este resumo aborda o uso de tecnologias de reprodução na suinocultura, com ênfase na inseminação artificial (IA). A suinocultura brasileira vem crescendo significativamente e busca novas tecnologias para alcançar altos índices produtivos de maneira sustentável e competitiva. Os suínos apresentam características favoráveis, como alta prolificidade, fertilidade, rápido crescimento, eficiência alimentar e rendimento de carcaça, o que levou ao desenvolvimento intensivo da atividade com seleção genética avançada. A IA é amplamente empregada para disseminar material genético entre diferentes regiões e granjas. Diversas técnicas de IA são utilizadas na suinocultura moderna: a inseminação intrauterina (IAIU) permite a deposição do sêmen na região uterina, reduzindo custos; a inseminação em tempo fixo (IATF) sincroniza o estro em várias fêmeas, facilitando o manejo e aumentando a eficiência; a inseminação intrauterina profunda (IAUP) deposita o sêmen nos cornos uterinos, obtendo melhores resultados; e a inseminação cervical (IAC), técnica tradicional amplamente utilizada, embora possa ser mais demorada e apresentar maiores taxas de refluxo. O sucesso da IA estar relacionado ao conhecimento do ciclo reprodutivo das matrizes, à nutrição adequada e aos fatores genéticos e ambientais. A qualidade do sêmen é essencial, exigindo coleta por profissionais treinados e avaliação da motilidade e morfologia dos espermatozoides. Apesar de ser uma técnica consolidada, há questões a serem aprofundadas para otimizar sua aplicação, definindo o momento exato para a realização da inseminação, a redução do refluxo e adoção de protocolos eficazes. A IA é uma ferramenta essencial para o crescimento da suinocultura brasileira, mas requer estudos contínuos para maximizar sua eficiência e resultados, considerando o objetivo produtivo da granja e o tamanho do empreendimento para alcançar altos índices reprodutivos e produtivos.

Este resumen aborda el uso de tecnologías de reproducción en la producción porcina, con énfasis en la inseminación artificial (IA). La producción porcina brasileña ha crecido significativamente y busca nuevas tecnologías para alcanzar altos índices de productividad de manera sostenible y competitiva. Los cerdos presentan características favorables, como alta prolificidad, fertilidad, rápido crecimiento, eficiencia alimentaria y rendimiento de la canal, lo que ha llevado al desarrollo intensivo de la actividad con selección genética avanzada. La IA se utiliza ampliamente para difundir material genético entre diferentes regiones y granjas. Diversas técnicas de IA son utilizadas en la producción porcina moderna: la inseminación intrauterina (IAIU) permite la deposición del semen en la región uterina, reduciendo costos; la inseminación a tiempo fijo (IATF) sincroniza el estro en varias hembras, facilitando el manejo y aumentando la eficiencia; la inseminación intrauterina profunda (IAUP) deposita el semen en los cuernos uterinos, obteniendo mejores resultados; y la inseminación cervical (IAC), técnica tradicional ampliamente utilizada, aunque puede ser más demorada y presentar mayores tasas de reflujo. El éxito de la IA está relacionado con el conocimiento del ciclo reproductivo de las hembras, la nutrición adecuada y los factores genéticos y ambientales. La calidad del semen es esencial, requiriendo la recolección por profesionales capacitados y la evaluación de la motilidad y morfología de los espermatozoides. A pesar de ser una técnica consolidada, hay aspectos que deben ser profundizados para optimizar su aplicación, como la definición precisa del momento de la inseminación, la reducción del reflujo y la adopción de protocolos eficaces. La IA es una herramienta esencial para el crecimiento de la producción porcina brasileña, pero requiere estudios continuos para maximizar su eficiencia y resultados, considerando el objetivo productivo de la granja y el tamaño del emprendimiento para alcanzar altos índices reproductivos y productivos.

Acceso y prácticas de higiene menstrual en América Latina: revisión de alcance / Menstrual hygiene access and practices in Latin America: scoping review / Acesso e práticas de higiene menstrual na América Latina: revisão de escopo

Objetivo: sintetizar la evidencia disponible relacionada con el acceso y las prácticas de higiene menstrual en América Latina y el Caribe. Método: revisión de alcance de la literatura con protocolo de investigación registrado en el Open Science Framework, realizada en las bases de datos bibliográficas: PubMed, Scopus, Web of Science y Portal Regional da Biblioteca Virtual em Saúde. Los datos fueron analizados mediante estadística descriptiva simple y análisis temático. Resultados: se incluyeron 15 publicaciones, la mayoría de las cuales trataban sobre adolescentes en Brasil: 12 artículos, dos informes técnicos y una monografía de trabajo de conclusión de curso. Como temas recurrentes en las publicaciones se destacan: acceso a condiciones dignas para el manejo de la higiene menstrual; necesidad de acceso a información sobre el manejo de la higiene menstrual; y prácticas para el manejo de la higiene menstrual. Conclusión: adolescentes informan dificultades para acceder a baños, agua y materiales absorbentes, y falta de información sobre la salud menstrual, incluso en las escuelas, lo que lleva al ausentismo escolar. De esta manera, las lagunas en la literatura científica latinoamericana revelan desigualdades y diversidad en las experiencias menstruales interseccionadas por categorías como género, clase social y etnia.

Objective: to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean. Method: literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis. Results: 15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene. Conclusion: adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity

Objetivo: sintetizar evidências disponíveis relacionadas ao acesso e práticas de higiene menstrual na América Latina e Caribe. Método: revisão de escopo da literatura com protocolo de pesquisa registrado no Open Science Framework, realizada nas bases de dados bibliográficas: PubMed, Scopus, Web of Science e Portal Regional da Biblioteca Virtual em Saúde. Os dados foram analisados por estatística descritiva simples e análise temática. Resultados: foram incluídas 15 publicações, cuja maioria abordava adolescentes no Brasil: 12 artigos, dois relatórios técnicos e uma monografia de trabalho de conclusão de curso. Como temas recorrentes nas publicações, destacam-se: acesso a condições dignas para o manejo da higiene menstrual; necessidade de acesso à informação sobre manejo da higiene menstrual; e práticas para manejo da higiene menstrual. Conclusão: adolescentes relatam dificuldades de acesso a sanitários, água e materiais absorventes, e falta de informação sobre saúde menstrual, inclusive nas escolas, levando ao absenteísmo escolar. Assim, lacunas na literatura científica latino-americana revelam desigualdades e diversidade nas experiências menstruais interseccionadas por categorias como gênero, classe social e etnia.

Información recibida sobre salud sexual y reproductiva asociada a conductas sexuales en universitarias. Medellín, Colombia 2021

Introducción: La juventud representa un periodo de vulnerabilidad acompañado de cambios físicos y psicológicos que predisponen a conductas sexuales de riesgo, en un contexto en el que la calidad de la educación en salud sexual y reproductiva no satisface las necesidades de la población. Objetivo: Identificar la asociación existente entre conductas sexuales de riesgo en mujeres universitarias y su satisfacción frente a la información que han recibido sobre salud sexual y reproductiva a lo largo de sus vidas. Métodos: Estudio descriptivo de tipo transversal aplicado a una muestra por conveniencia de 182 universitarias. Se analizaron variables relacionadas con características sociodemográficas, conductas sexuales de riesgo, fuentes de información y satisfacción frente a la información recibida sobre salud sexual y reproductiva. Se determinó la asociación entre las variables aplicando la prueba chi2 (p < 0,05) y la medida estadística OR. Resultados: Predominaron las mujeres sexualmente activas 70,3 % y mujeres que no deseaban quedar embarazadas al momento de ser encuestadas 98,9 %. Un 10,9 % de las mujeres encuestadas, son sexualmente activas y no planifican aunque no deseen quedar en embarazo. La fuente de educación que predominó fueron los profesionales de la salud (75,3 %). No se evidenció discrepancia significativa entre el porcentaje de mujeres satisfechas con la información que han recibido (51 %) y las no satisfechas (49 %). No se encontró asociación entre conductas sexuales de riesgo y la satisfacción con la información sobre salud sexual y reproductiva que han recibido a lo largo de su vida, teniendo en consideración que esta no representa en su totalidad una educación de calidad. Conclusión: Las estudiantes matriculadas en universidades ubicadas en la ciudad de Medellín muestran conductas sexuales de riesgo, que no se asocian a la satisfacción que poseen frente a la información en salud sexual y reproductiva que han obtenido a lo largo de su vida.

Introduction: Youth represents a period of vulnerability accompanied by physical and psychological changes that predispose individuals to risky sexual behaviors, from a context in which the quality of education in sexual and reproductive health does not meet the needs of the population. Objective: To identify the association between risky sexual behaviors in university women and their satisfaction with the information they have received on sexual and reproductive health throughout their lives. Methods: Descriptive cross-sectional study applied to a convenience sample of 182 university students. Variables related to sociodemographic characteristics, risky sexual behaviors, sources of information and satisfaction with the information received on sexual and reproductive health were analyzed. The association between the variables was determined by applying the chi2 test (p<0.05) and the OR statistical measure. Results: Sexually active women predominated (70.3%) and women who did not want to get pregnant at the time of being surveyed (98.9%);. 10.9% of the women surveyed, are sexually active, do not plan and do not want to get pregnant, the source of education that prevailed were the professionals of health (75.3%). There was no significant discrepancy between the percentage of women satisfied with the information they received (51%) and those who were not satisfied (49%). No association was found between risky sexual behaviors and satisfaction with the information on sexual and reproductive health received throughout their lives, considering that this does not fully represent quality education. Conclusión: The students enrolled in universities located in the city of Medellín show risky sexual behaviors that are not associated with the satisfaction they have with the information on sexual and reproductive health that they have obtained throughout their lives.

Interrupciones voluntarias del embarazo recurrentes. Estudio de prevalencia y exploración de factores asociados. Antioquia, Colombia, 2015 - 2021 / Recurrent voluntary termination of pregnancy. Prevalence study and exploration of associated factors. Antioquia, Colombia, 2015 ­ 2021

Objetivos: Describir la prevalencia de las interrupciones voluntarias del embarazo (IVE) recurrentes y efectuar una exploración de los factores asociados a esta. Materiales y métodos: Estudio de corte trasversal descriptivo, en el que se incluyeron mujeres atendidas entre 2015 y 2021 en cinco sedes, en el Departamento de Antioquia, de una Institución que promueve la atención en salud sexual y reproductiva (SSR) en Colombia. Se midieron variables sociodemográficas, de SSR, así como la realización de IVE recurrente, tipo de procedimiento utilizado en la primera IVE, y método de anticoncepción elegido posterior a esta. Se presenta la prevalencia de período de aborto recurrente global y por año. Se hace exploración de los factores asociados por medio de análisis multivariado. Se obtuvo aval del comité de investigación de la institución. Resultados: Se incluyó un total de 20.423 mujeres. La prevalencia de IVE recurrente fue del 4,07 % (n = 831) en todo el período, y varió del 2,3 al 6 % en los 6 años. El método más utilizado para la IVE recurrente fue inducción farmacológica (48,50 %). Después de la primera IVE, el 69,81 % de las mujeres utilizó métodos anticonceptivos clasificados como "muy efectivos", según la Organización Mundial de la Salud. Se identificaron como factores de riesgo de la IVE recurrente pertenecer al régimen de aseguramiento subsidiado por el Estado (Odds ratio ajustado (ORa) = 1,35; IC 95 %: 1,05-1,72) y haber tenido dos o más gestaciones (ORa = 1,23; IC 95 %: 1,06 - 1,44). Como factores protectores se identificaron: contratación del servicio de IVE bajo modalidad de pago de bolsillo (ORa = 0,71; IC 95 %: 0,61-0,82), el antecedente de IVE tardía (ORa = 0,30; IC 95 %: 0,11-0,81), y la elección del implante subdérmico posterior al primer aborto primer aborto como (ORa =0,64; IC 95 %: 0,49 - 0,83). Conclusiones: La prevalencia de IVE recurrente posiblemente está incrementando. Se requieren estudios prospectivos que evalúen si existe una tendencia al incremento y que verifiquen posibles hipótesis de asociación que surgen de este trabajo.

Objectives: To describe the prevalence of recurrent voluntary termination of pregnancy (VTP) and to explore associated factors. Material and methods: Descriptive, cross-sectional cohort study which included women seen between 2015 and 2021 in five sites of an institution located in the Department of Antioquia which promotes sexual and reproductive health (SRH) care in Colombia. Measured variables included sociodemographics, SRH, recurrent performance of VTP, type of procedure used in the first VTP and contraception method selected afterwards. The prevalence of global and yearly recurrent abortion period is presented. Associated factors were explored using a multivariate analysis. The research committee of the institution approved the study. Results: In total, 20,423 women were included. The prevalence of recurrent VTP was 4.07 % (n = 831) during the entire period, ranging between 2.3 and 6 % over the 7 years. The most commonly used method for recurrent VTP was pharmacological induction (48.50 %). After the first VTP, 69.81 % of women used contraceptive methods classified as "very effective" according to the World Health Organization. The risk factors identified as being associated with recurrent VTP included being part of the state-subsidized health insurance system (adjusted odds ratio [aOR] = 1.35; 95 % CI:1.05-1.72) and having had two or more pregnancies (aOR = 1.23; 95% CI: 1.06 - 1.44). Protective factors were identified and included out-of-pocket payment for VTP service (aOR = 0.71; 95% CI: 0.61-0.82), a history of late VTP (aOR = 0.30; 95% CI: 0.11-0.81), and the selection of a subdermal implant for contraception following the first abortion (sOR = 0.64; 95% CI: 0.49 - 0.83). Conclusions: It is possible that the prevalence of recurrent VTP is increasing. Prospective studies are required in order to determine whether there is a growing trend and to verify potential association hypotheses derived from this work.

Os impactos da pandemia de COVID-19 na prática dos direitos sexuais e reprodutivos na América Latina / The impacts of the COVID-19 pandemic on the exercise of sexual and reproductive rights in Latin America / Los impactos de la pandemia de COVID-19 en la práctica de los derechos sexuales y reproductivos en América Latina

Este editorial apresenta o dossiê temático sobre os impactos da pandemia de COVID-19 na prática dos direitos sexuais e reprodutivos na América Latina. Nele, propomos uma reflexão sobre os efeitos da pandemia no exercício legal e vivencial dos referidos direitos. Ao mesmo tempo, consideramos importante recuperar, partindo dos debates de Veena Das, a ideia de extraordinário e de ordinário da violência de gênero e da violação dos direitos humanos. Por fim, os artigos deste dossiê são brevemente apresentados, mostrando como permitiram realizar um registro histórico e operar como denúncia de práticas e situações que não podem se repetir ou se manterem banalizadas.

This editorial introduces a thematic issue addressing the ramifications of the COVID-19 pandemic on the practice of sexual and reproductive rights in Latin America. We critically reflect on the pandemic's impact on both the legal and experiential dimensions of these rights. Drawing inspiration from Veena Das' debates, we emphasize the significance of reexamining the concepts of the extraordinary and the ordinary in gender violence and human rights violations. Furthermore, we provide a concise overview of the articles contributed to this dossier, highlighting their role in creating a historical record and serving as a denunciation of practices and situations that should neither be replicated nor trivialized.

Este editorial presenta el dossier temático sobre los impactos de la pandemia de COVID-19 en la práctica de los derechos sexuales y reproductivos en América Latina. En él proponemos una reflexión sobre los efectos de la pandemia en el ejercicio jurídico y vivencial de dichos derechos. Al mismo tiempo, consideramos importante recuperar, a partir de los debates de Veena Das, la idea de lo extraordinario y lo ordinario en la violencia de género y las violaciones de derechos humanos. Finalmente, se presentan brevemente los artículos escritos para este dossier, evidenciando cómo permitirán crear un registro histórico y también operarán como denuncia de prácticas y situaciones que no pueden repetirse ni banalizarse.

Infertilidade, justiça reprodutiva e pandemia de COVID-19: reflexões sobre acesso e barreiras / Infertility, reproductive justice and the COVID-19 pandemic: reflections on access and barriers / Infertilidad, justicia reproductiva y la pandemia de COVID-19: reflexiones sobre acceso y barreras

Objetivo: refletir sobre o acesso a serviços de saúde para infertilidade e reprodução humana assistida durante o período da pandemia de COVID-19, na perspectiva da justiça reprodutiva. Metodologia: utilizou-se dados do inquérito online da pesquisa Pandemia de COVID-19e práticas reprodutivas de mulheres no Brasil, que obteve 8.313 respostas de mulheres residentes em todas as regiões do país, de 18 anos ou mais. O questionário autoaplicável circulou entre julho e outubro de 2021, contendo questões fechadas e abertas. A análise descritiva das respostas objetivas de 242 mulheres que referiram buscar atendimento para infertilidade contou com o cálculo de frequências simples das variáveis. Já os textos escritos nos espaços abertos do questionário foram submetidos à análise temática. Resultados: o estudo verificou a existência de barreiras institucionais e não institucionais para os cuidados da infertilidade, ambas incrementadas pela pandemia. Conclusão: recomenda-se a efetivação de política pública que garanta acesso pleno a todas as pessoas, haja vista que o tratamento para infertilidade e reprodução assistida tende a se restringir a mulheres cisgênero, de camadas médias e altas, mais escolarizadas e majoritariamente brancas.

Objective: to critically examine access to health services for infertility and assisted human reproduction during the COVID-19 pandemic, emphasizing the perspective of reproductive justice. Methods: data for analysis were derived from the online survey titled COVID-19 Pandemic and Women's Reproductive Practices in Brazil, garnering 8,313 responses from women aged 18 years or older residing in all regions of the country. The self-administered questionnaire circulated from July to October 2021 and comprised both closed and open-ended questions. Descriptive analysis of the objective responses obtained from 242 women actively seeking infertility care involved the calculation of simple frequencies for relevant variables. Responses provided in the open-ended sections of the questionnaire underwent thematic analysis. Results: revealed the presence of both institutional and non-institutional barriers to infertility care, with a notable exacerbation during the pandemic. Conclusion: given that infertility and assisted reproduction treatment predominantly cater to cisgender women from middle and upper socio-economic strata, characterized by higher education levels and mostly white, there is a compelling need for the implementation of public policies that ensure equitable access for all individuals.

Objetivo: reflexionar sobre el acceso a los servicios de salud para la infertilidad y la reproducción humana asistida durante el período de la pandemia de COVID-19, desde la perspectiva de la justicia reproductiva. Metodología: se utilizaron datos de la encuesta en línea de la Pandemia de COVID-19y prácticas reproductivas de las mujeres en Brasil, que obtuvo 8.313 respuestas de mujeres residentes en todas las regiones del país, con edad igual o superior a 18 años. El cuestionario autoaplicado circuló entre julio y octubre de 2021, conteniendo preguntas cerradas y abiertas. El análisis descriptivo de las respuestas objetivas de 242 mujeres que relataron buscar atención por infertilidad implicó el cálculo de frecuencias simples de las variables. Los textos escritos en los espacios abiertos del cuestionario fueron sometidos a análisis temático. Resultados:el estudio verificó la existencia de barreras institucionales y no institucionales para la atención de la infertilidad, ambas aumentadas por la pandemia. Conclusión: se recomiendala implementación de una política pública que garantice el pleno acceso a todas las personas, dado que el tratamiento de la infertilidad y reproducción asistida tiende a estar restringido a mujeres cisgénero de clase media y alta, con mayor educación y en su mayoría blancas.

Acciones para el aborto seguro durante la pandemia: el caso de las prácticas de dos organizaciones de Argentina / Actions for safe abortion during the pandemic: The case of the practices of two organizations in Argentina / Ações para o aborto seguro durante a pandemia: o caso das práticas de duas organizações na Argentina

Objetivo: abordar las acciones de acompañamiento a la interrupción legal y voluntaria del embarazo en el contexto de la pandemia por COVID-19 por parte de las organizaciones Socorristas en Red y la Red de Profesionales de la Salud por el Derecho a Decidir en Argentina. Metodología: se adoptó una metodología de investigación de tipo cualitativa con base en la realización de entrevistas en profundidad, semiestructurada, y cuestionarios de preguntas abiertas on-line orientados a conocer las experiencias de accionar de las integrantes de ambas redes respecto a los desafíos que significó la pandemia para continuar procesos de acompañamientos de abortos seguros. Conclusión: las medidas gubernamentales de Aislamiento Social, Preventivo y Obligatorio (ASPO) llevaron a una profundización de la obstrucción de derechos con relación al aborto que agravó procesos de desigualdades y vulnerabilidades existentes. Sin embargo, la pandemia del COVID-19 obligó a reforzar una red de cuidados feministas orientada a garantizar políticas de atencióny acompañamiento de aborto seguro.

Objective: to examine the initiatives undertakenby the organizations Socorristas en Redand Red de Profesionales de la Salud por el Derecho a Decidirin Argentina concerning the support and facilitation of legal and voluntary termination of pregnancy amidst the COVID-19 pandemic. Methodology:the research employs a qualitative approach, relying on in-depth, semi-structured interviews, and online questionnaires. These methodologies were designed to capture the experiential insights of network members, shedding light on the challenges encountered during the pandemic in sustaining the provision of support for safe abortion procedures. Conclusion:the implementation of Social, Preventive, and Compulsory Isolation (ASPO) measures during the COVID-19 pandemic heightened infringements on abortion-related rights, exacerbating societal inequalities and vulnerabilities. However, the COVID-19 pandemic prompted the reinforcement of a resilient feminist care network dedicated to providing safe abortion services and supportive policies.

Objetivo: abordar as acções de acompanhamento desenvolvidas pelas organizações Socorristas en Red e Red de Profesionales de la Salud por el Derecho a Decidir na Argentina para apoiar a interrupção legal e voluntária da gravidez no contexto da pandemia da COVID-19. Metodologia: foi adoptada uma metodologia de investigação qualitativa baseada em entrevistas aprofundadas e semiestruturadase em questionários on-line, com o objetivo de conhecer as experiências de ação dos membros de ambas as redes no que diz respeito aos desafios colocados pela pandemia para a continuação dos processos de acompanhamento do aborto seguro. Conclusão: as medidas governamentais de Isolamento Social, Preventivo e Compulsório (ASPO) levaram a um aprofundamento da obstrução de direitos em relação ao aborto, o que agravou processos de desigualdade e vulnerabilidade já existentes. No entanto, a pandemia da COVID-19 forçou o fortalecimento de uma rede de atendimento feminista voltada para a garantia de políticas de atenção e acompanhamento ao aborto seguro

Los derechos sexuales y (no) reproductivos en suspenso en territorios rurales y urbanos de Santiago del Estero, Argentina / Sexual and (non) reproductive rights put on holdin rural and urban territories of Santiago del Estero, Argentina / Direitos sexuais e (não) reprodutivos suspensos nos territórios rurais e urbanos de Santiago del Estero, Argentina

Objetivo: analizar el acceso a derechos sexuales y (no) reproductivos de mujeres y niñas en el contexto de la pandemia por COVID-19; y las políticas implementadas (o no) por los gobiernos de la provincia de Santiago del Estero y nacional. Metodología: desde métodos cualitativos se ha indagado a través de entrevistas no estructuradas y en profundidad por medio de videollamadas por las plataformas disponibles: a funcionarias/os, agentes de salud y referentes de organizaciones sociales. Resultados: el acceso a los derechos sexuales y (no) reproductivos enfrentó graves dificultades entre las que podemos destacar las restricciones a la circulación, sobre todo durante el 2020, y la priorización en los servicios públicos a la atención de los casos de COVID-19. Las respuestas institucionales a las demandas de interrupciones legales de las niñas y mujeres embarazadas han seguido circuitos largos y laberínticos. Conclusión:los diversos obstáculos que enfrentan las mujeres y las niñas para que el Estado garantice sus derechos, deben situarse en la perduración de un contexto histórico y estructural, donde la sexualidad y la reproducción están sometidas a estricto control y el ejercicio de los derechos se enfrenta con morales restrictivas. Las respuestas ofrecidas por el Estado no fueron suficientes y las organizaciones sociales cumplieron un rol sustitutivo. Y allí en donde no hay una red de contención o una organización social, la vida de mujeres y niñas presenta mayor vulnerabilidad.

Objective: this study aims to assess the access to sexual and (non) reproductive rights of women and girls within the context of the COVID-19 pandemic, examining the policies implemented (or not) by the governments of Santiago del Estero province and nationally. Methods: utilizing qualitative approaches, the research conducted unstructured and in-depth interviews via video calls with officials, health agents, and representatives of social organizations.Results: Access to sexual and (non) reproductive rights encountered substantial challenges, notably movement restrictions, particularly in 2020, and the prioritization of public services for COVID-19 cases. Institutional responses to legal interruptions for pregnant girls and women involved complex and protracted procedures.Conclusion: the barriers faced by women and girls in obtaining state-guaranteed rights must be contextualized within a historical and structural framework, characterized by strict control over sexuality and reproduction. State responses proved insufficient, leading social organizations to assume a substitute role. In the absence of a support network or social organization, the vulnerability of women and girls is heightened.

Objetivo: analisar o acesso aos direitos sexuais e (não) reprodutivos de mulheres e meninas no contexto da pandemia da COVID-19 e as políticas implementadas (ou não) pelos governos da província de Santiago del Estero e a nível nacional. Metodologia: utilizando métodos qualitativos, a investigação foi realizada por meio de entrevistas não estruturadas e em profundidade por meio de videochamadas: a autoridades, agentes de saúde e representantes de organizações sociais. Resultados: o acesso aos direitos sexuais e (não) reprodutivos enfrentou sérias dificuldades, entre as quais podemos destacar as restrições à circulação, especialmente durante 2020, e a priorização dos serviços públicos para atendimento aos casos de COVID-19. As respostas institucionais às exigências de interrupções legais por parte de meninas e mulheres grávidas seguiram circuitos longos e labirínticos. Conclusão: os diversos obstáculos que as mulheres e as meninas enfrentam para que o Estado garanta os seus direitos devem ser colocados na continuidade de um contexto histórico e estrutural, onde a sexualidade e a reprodução estão sujeitas a um controle rigoroso e o exercício dos direitos enfrenta morais restritivas. As respostas oferecidas pelo Estado não foram suficientes e as organizações sociais desempenharam um papel substituto. E onde não existe rede de apoio ou organização social, as vidas das mulheres e das meninas são mais vulneráveis.