OBJECTIVE:To analyze sociocultural differences and perceptions of gynecological consultations for high school girls.
METHODS:A transversal study with 418 high school girls from three schools of different profi les in the city of Rio de Janeiro, Southeastern Brazil, in 2010. A structured questionnaire encompassing socio-demographic characteristics, sexual behavior and evaluation of gynecological consultations was completed. Yates' Chi-square test and the Student's t-test were utilized adopting a value of p < 0.05.
RESULTS:The students of private and federal public schools presented similar profi les but both were different from the state school girls. The latter had lower socioeconomic status, and their parents had lower levels of education, the predominance of afro-descendants was observed, as were a larger number of sexual partners, pregnancy and cases of sexual violence. The average age of menarche and sexarche among the students were similar, but the fi rst gynecological consultation was signifi cantly later among the state school students. The majority showed some knowledge of contraception and STDs, although only a minority received guidance from the consultations. Students expressed the desire that the professionals dedicate more time, patience and availability to them during consultations.
CONCLUSIONS:The provision of gynecological services for teenagers is not satisfactory, according to the teenagers' evaluations. Users of the private health system have gynecological consultations earlier than those who only have access to the public system. It is necessary to create mechanisms that facilitate access and adhesion to a routine of gynecological prevention for this age group.
RESUMENAntecedentes: El anticonceptivo hormonal oral es el método más usado por las adolescentes. Objetivo: Teniendo como objetivo contribuir con la reducción de las tasas de embarazos no previstos y sus riesgos médicos y sociales, estudiamos los factores que llevan al abandono de esta técnica. Método: Estudio experimental no controlado, con el uso de anticonceptivo oral, por seis meses, en adolescentes de 15 a 19 años, que concurren al Hospital Geral de Bonsucesso (Rio de Janeiro, Brasil) desde noviembre de 2004 a agosto de 2005. Las participantes fueron entrevistadas y se sometieron a los exámenes clínicos y de laboratorio, antes y después del uso de la medicación. Resultados: En el análisis de los datos fue utilizada la prueba Chi cuadrado con nivel de significación menor al 5%. Se constató que la edad precoz (15 a 16 años), la baja escolaridad y la relación conflictiva de la adolescente con la familia, son factores que están significativamente asociados a la no adhesión al método. Conclusiones: Para reducir la ocurrencia de embarazos no planeados son necesarios programas de salud reproductiva para adolescentes que incluyan la participación de sus familias, e inversiones que proporcionen el acceso universal y la valorización de la educación.PALABRAS CLAVES: Adolescencia, anticoncepción, abandono, embarazo en la adolescencia SUMMARY Background: The oral hormonal contraceptive is the most adopted method among adolescents. Objective: Seeking to reduce the rates of undesired pregnancy and all the medical and social risks, we studied the causing factors of the abandonment of this method. Methods: A non-controlled experimental study of the use of oral contraceptive was accomplished, for six months, with adolescents from 15 to 19 years old attended in the Hospital Geral de Bonsucesso (Rio de Janeiro, Brazil) between November 2004 and August 20005. The participants were interviewed and submitted to clinical and laboratorial tests before and after using the medication. In the data analysis the chi-square test was used with 5% level of significance. Results: It was verified that the precocious age (of 15 to 16 years old), the low education and the adolescent's conflicting relationship with their family are significant factors to the non-adhesion to the contraceptive method in question. Conclusions: We concluded that in order to reduce the occurrence of undesired pregnancies it will be necessary the adoption of programs of reproductive health for adolescents which include the participation of their families, as well as investments to provide the universal access and the valorization of the education.
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