Tendencias temporales en el uso de métodos de barrera durante las relaciones sexuales en Argentina y eficacia de intervenciones para promover su implementación / Trends in the use of barrier methods during sexual intercourse in Argentina and the effectiveness of interventions to promote their implementation

Durante la última década, presenciamos en Argentina un aumento de la incidencia de infecciones de transmisión sexual(ITS) vinculado con una disminución en el uso de métodos de barrera (MB). De acuerdo a la bibliografía, existen varias categorías de obstáculos para el uso de MB: desigualdades de género, dificultades económicas y/o de accesibilidad, desconfianza respecto de los MB provistos por el Estado respecto de su calidad y/o fecha de vencimiento, o bien, creencias acerca de que la utilización de MB disminuye el placer sexual o que no es necesario su uso cuando la relación de pareja es estable y/o basada en la confianza, el amor y/o la fidelidad. A partir de esta problemática, los autores de este artículo realizamos una búsqueda bibliográfica y revisamos cual es la evidencia que respalda diferentes intervenciones para promover el uso de MB. Encontramos evidencia de moderada calidad que avala la eficacia de intervenciones a nivel comunitario basadas en la teoría sociocognitiva y en el aumento de la oferta y la disponibilidad de preservativos para mejorar el conocimiento sobre el HIV y el uso de estos métodos, sin impacto sobre la incidencia de ITS a nivel poblacional. (AU)

Over the last decade, Argentina has shown an increase in the incidence of sexually transmitted infections (STIs) linked to a decrease in the use of barrier methods (BM). According to the literature, there are several categories of obstacles for the use of BM: gender inequalities, economic and/or accessibility difficulties, mistrust regarding the quality and/or expiry date of state-provided BMs, as well as beliefs that the use of BMs reduces sexual pleasure or that their use is not necessary when the couple's relationship is stable and/or based on trust, love and/or fidelity. In light of this issue, the authors of this article conducted a literature search and reviewed the evidence supporting different interventions to promote the use of BM. They found moderate quality evidence that supports the efficacy of community-level interventions based on socio-cognitive theory and on increasing the supply and availability of condoms to improve knowledge about HIV and the use of these methods, with no impact on the incidence of STIs at the population level. (AU)

Análisis estructural de las representaciones sociales del noviazgo entre adolescentes / Structural analysis of social representations about dating between adolescents

OBJETIVO: identificar la estructura y organización de las representaciones sociales sobre el noviazgo construidas por las adolescentes que se reconocen en este contexto. MÉTODO: investigación descriptiva fundamentada por la Teoría del Núcleo Central de las representaciones sociales. Se aplicó la prueba de asociación libre de palabras con 106 adolescentes femeninas del municipio de Río de Janeiro/Brasil. Las evocaciones fueron procesadas por el software - EVOC, que generó un cuadro correspondiente a la probable estructura de la representación. RESULTADOS: El núcleo central fue integrado por los elementos: amor, beso y sexo. El sistema periférico se constituye en mayor frecuencia por: amistad, felicidad, traición, matrimonio, comprensión y lealtad. CONCLUSIÓN: Los sentimientos de amor y confianza en la pareja fomentan una percepción de salud sexual libre de riesgos, lo que significa que el noviazgo tiene una representación predominantemente afectiva y, por lo tanto, el uso de métodos de barrera para las infecciones de transmisión sexual está infravalorado

OBJECTIVE: to identify the structure and organization of social representations about dating built by the adolescents who are recognized in this context. METHOD: this is a descriptive research, based on the Central Core Theory of social representations. A free word association test was applied with 106 female adolescents of the city of Rio de Janeiro / Brazil. Software- EVOC processed the evocations, generating a chart corresponding to the probable representation structure. RESULTS: The central nucleus was composed of the elements of love, kiss and sex. The peripheral system is more frequently characterized by: friendship, happiness, betrayal, marriage, understanding and loyalty. CONCLUSION: Feelings of love and trust in the couple foster a sense of risk-free sexual health, which means that they have a predominantly affective representation and, therefore, the use of barrier methods for sexually transmitted infections is undervalued

Divergent trends in abortion and birth control practices in belarus, Russia and Ukraine.

CONTEXT: The last decade witnessed growing differences in abortion dynamics in Belarus, Russia, and Ukraine despite demographic, social, and historical similarities of these nations. This paper investigates changes in birth control practices in the three countries and searches for an explanation of the diverging trends in abortion. METHODS: Official abortion and contraceptive use statistics, provided by national statistical agencies, were analysed. Respective laws and other legal documents were examined and compared between the three countries. To disclose inter-country differences in prevalence of the modern methods of contraception and its association with major demographic and social factors, an analysis of data from national sample surveys was performed, including binary logistic regression. RESULTS: The growing gap in abortion rate in Belarus, Russia, and Ukraine is a genuine phenomenon, not a statistical artefact. The examination of abortion and prevalence of contraception based on official statistics and three national sample surveys did not reveal any unambiguous factors that could explain differences in abortion dynamics in Belarus, Russia, and Ukraine. However, it is very likely that the cause of the inter-country discrepancies lies in contraceptive behavior itself, in adequacies of contraceptive knowledge and practices. Additionally, large differences in government policies, which are very important in shaping contraceptive practices of the population, were detected. CONCLUSION: Since the end of the 1990s, the Russian government switched to archaic ideology in the area of reproductive health and family planning and neglects evidence-based arguments. Such an extreme turn in the governmental position is not observed in Belarus or Ukraine. This is an important factor contributing to the slowdown in the decrease of abortion rates in Russia.

Anticoncepción en la mujer con diabetes / Contraception in diabetic women

a mujer con diabetes, como cualquier mujer o incluso con más motivo, va a necesitar consejo contraceptivo, lo que en ocasiones puede resultar complejo. La elección del método más adecuado debe basarse en su efi cacia y en su interacción con la diabetes. El uso de anticoncepción hormonal es posible en mujeres sin enfermedad vascular ni factores de riesgo añadido y con un buen control glucémico. No es el método ideal, sino que su uso debe ser temporal y la Sociedad Española de Contracepción exhorta a un control más estricto por su endocrinólogo de referencia. Se recomienda el uso de preparados con dosis bajas de estrógenos y con gestágenos antiandrogénicos

Diabetic women may need, as other women or even more, contraceptive advice, which may be difficult in some cases. To determine the most adequate method, we need to take into consideration its efficacy and possible interaction with diabetes. It’s an acceptable choice the use of hormonal contraception’s methods among diabetic women with no vascular disease or additional risk factors, and with a good glycemic control. But it’s not the ideal method, and should not be used in the long-term, but always with strict periodic endocrinological controls. Low-dose estrogen and antiandrogenic gestagen combined contraceptives are recommended

New options for barrier contraception.

Barrier contraceptives are a safe alternative to hormonal methods of fertility management. Newer barrier method options include the Today Sponge, the FemCap, and the Lea's Shield. Understanding the use, benefits, and limitations of these barrier methods of birth control will assist women's health care providers to better meet the family planning needs of their patients.