ERICA: sexual initiation and contraception in Brazilian adolescents

Abstract

OBJECTIVE To estimate the prevalence of sexual initiation and contraceptive use at the last sexual intercourse of Brazilian adolescents, according to sociodemographic features.METHODS The data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional study. We included 74,589 adolescents from 32 geographic strata (27 capitals and five sets of municipalities with more than 100,000 inhabitants of each of the five macro-regions of the Country). Information on sexual initiation and contraceptive use at the last sexual intercourse (male condom and oral contraceptive pill) has been used. We have estimated prevalence and confidence intervals (95%CI) considering sample weights according to sex, age, type of school, residence status, macro-region and capitals.RESULTS We observed that 28.1% (95%CI 27.0-29.2) of the adolescents had already initiated sexual life, with higher prevalence among those aged 17 years (56.4%, 95%CI 53.9-58.9), males (33.5%, 95%CI 31.8-35.2), studying at public schools (29.9%, 95%CI 28.5-31.4), and from the Northern region (33.9%, 95%CI 32.3-35.4), mainly from Macapa, Manaus, and Rio Branco. Among those who had started their sexual life, 82.3% (95%CI 81.1-83.4) reported the use of contraceptive methods at the last intercourse, and the prevalence of use was higher among adolescents aged 17 years (85.3%, 95%CI 82.7-87.6), females (85.2%, 95%CI 83.8-86.5) and those living in the Southern region (85.9%, 95%CI 82.9-88.5). Male condom was used by 68.8% (95%CI 66.9-70.7), with no difference by type of school or macro-regions; the contraceptive pill was used by 13.4% (CI95% 12.2-14.6), and more frequently used among women (24.7%, 95%CI 22.5-27,0) and 17-year-old adolescents (20.8%, 95%CI 18.2-23.6) from urban settings(13.7%, 95%CI 12.5-14.9) and from the Southern region (22.6%, 95%CI 19.0-26.8), and less often in the Northern region.CONCLUSIONS ERICA’s data analysis on sexuality and contraception shows heterogeneities in the prevalence of sexual initiation and use of contraceptive methods among Brazilian adolescents, depending on their age, where they live, and the type of school they study at. Younger adolescents and those living in the Northern region seem to be more vulnerable to the consequences of unprotected sexual intercourses.

Nível de conhecimento dos acadêmicos de medicina sobre o HPV e o câncer do colo uterino

“…15 Grande estudo nacional com 74.589 adolescentes brasileiros (estudo ERICA), também encontrou resultado semelhante, sendo que 28,1% dos adolescentes já iniciaram a vida sexual, com maior prevalência entre os jovens de 17 anos (56,4%) e homens (33,5%). 16 No presente estudo, percebe-se que importante parcela (32%) não utiliza o preservativo e a dupla proteção é somente praticada por 13%. Importante ressaltar que a população de estudo é constituída por estudantes de medicina, com acesso à informação sobre prevenção de infecções sexualmente transmissíveis.…”

“…No estudo ERICA, o resultado foi idêntico, mostrando que o preservativo masculino foi utilizado por 68,8% (IC95% 66,9-70,7). 16 Sabendo que o HPV é comprovadamente causa importante de vários tipos de neoplasias, constatou-se que, dentre os entrevistados, o conhecimento sobre doenças relacionadas a ele fica muito aquém do esperado. Embora grande parte reconheça o HPV como causa do câncer de colo uterino (70% G1 e 100% G2), a associação com outros tipos de câncer como o anal e o oral é pouco conhecida.…”

“…7 Ambas as vacinas mostram que a imunogenicidade é cerca de duas a três vezes maior em mulheres jovens com menos de quinze anos. 7,8 O Ministério da Saúde, juntamente com as Secretarias Estaduais e Municipais de Saúde iniciou, em 2014, a vacinação gratuita com a vacina quadrivalente HPV6, 11,16,18. A primeira dose (D1), foi aplicada nas escolas para as meninas de 11 a 13 anos de idade, em todo território nacional.…”

Profile of access and use of medicines in the Brazilian population – contributions and challenges of PNAUM – Household Survey

“…The percentage of catastrophic household expenditure proved to be inferior to those of other countries, as verified in prior studies developed in various countries and in Brazil 2,17 . The authors 9 conclude that Brazilian policies appear to be protecting the families from these expenses.…”

“…Research on catastrophic health expenditure have been developed around the world and the study of this supplement that focused on this theme, conducted by Luiza et al 9 , detected that catastrophic health expenditure occurred in 5.3% of Brazilian households and medicines were one of the items mentioned in 3.2%. Catastrophic expenditure was considered when the individual stopped buying something to pay for health expenses.…”