Borges Ana Luiza Vilela, Fujimori Elizabeth, Kuschnir Maria Cristina Caetano, Chofakian Christiane Borges do Nascimento, de Moraes Ana Júlia Pantoja, Azevedo George Dantas, dos Santos Karine Ferreira, de Vasconcellos Mauricio Teixeira Leite
Departamento de Enfermagem em Saúde Coletiva, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil.
Núcleo de Estudos da Saúde do Adolescente, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Rev Saude Publica. 2016 Feb;50 Suppl 1(Suppl 1):15s. doi: 10.1590/S01518-8787.2016050006686. Epub 2016 Feb 23.
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.
目的 根据社会人口学特征估计巴西青少年首次性行为及上次性行为时避孕措施使用情况的流行率。方法 数据来自青少年心血管风险研究(ERICA),这是一项基于全国学校的横断面研究。我们纳入了来自32个地理区域(27个首府以及该国五个宏观区域中每个区域人口超过10万的五组城市)的74589名青少年。使用了关于首次性行为及上次性行为时避孕措施使用情况(男用避孕套和口服避孕药)的信息。我们根据性别、年龄、学校类型、居住状况、宏观区域和首府情况,考虑样本权重估计了流行率和置信区间(95%CI)。结果 我们观察到28.1%(95%CI 27.0 - 29.2)的青少年已经开始性生活,其中17岁青少年的流行率更高(56.4%,95%CI 53.9 - 58.9),男性(33.5%,95%CI 31.8 - 35.2),就读于公立学校的青少年(29.9%,95%CI 28.5 - 31.4),以及来自北部地区的青少年(33.9%,95%CI 32.3 - 35.4),主要来自马卡帕、马瑙斯和里奥布兰科。在已经开始性生活的青少年中,82.3%(95%CI 81.1 - 83.4)报告在上次性行为时使用了避孕方法,使用避孕方法的流行率在17岁青少年中更高(85.3%,95%CI 82.7 - 87.6),女性(85.2%,95%CI 83.8 - 86.5)以及居住在南部地区的青少年(85.9%,95%CI 82.9 - 88.5)。68.8%(95%CI 66.9 - 70.7)的青少年使用男用避孕套,在学校类型或宏观区域方面无差异;13.4%(95%CI 12.2 - 14.6)的青少年使用口服避孕药,在城市地区(13.7%,95%CI 12.5 - 14.9)以及来自南部地区(22.6%,95%CI 19.0 - 26.8)的17岁青少年和女性(24.7%,95%CI 22.5 - 27.0)中使用更为频繁,而在北部地区使用较少。结论 ERICA对性与避孕的数据分析显示,巴西青少年首次性行为及避孕方法使用情况的流行率存在异质性,这取决于他们的年龄、居住地点以及就读学校的类型。年龄较小的青少年以及居住在北部地区的青少年似乎更容易受到无保护性行为后果的影响。