Motherhood in early adolescence: a case-control study in Southern Brazil.

This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.

Motherhood in early adolescence: a case-control study in Southern Brazil / Maternidade na adolescência inicial: estudo caso-controle no sul do Brasil

Abstract This paper investigates factors associated with motherhood among adolescents from 14 to 16 years of age in Porto Alegre, Brazil. This is a case-control study with 431 adolescent mothers (cases) and 862 adolescents who had never given birth (controls). D. ata were obtained through home visits by an interviewer-applied questionnaire. Sociodemographic characteristics, quality of social and family relationships, lifestyle and history of abuse were studied as potential determinants to early adolescent motherhood. Conditional logistic regression was used for data analysis according to a two-stage hierarchical model. Results showed that lower economic class, schooling failure, tobacco consumption, alcoholic drunkenness at least once in life and having a mother who gave birth before 20 years of age were positively associated with early adolescent motherhood. Later menarche and having relatives or having friends in whom to trust remained as protective factors. Schooling failure, which obtained the highest risk, points to the important role of the school in this population's development and its potential to stimulate healthy life habits.

Resumo Este artigo visa investigar fatores associados à maternidade em adolescentes moradoras em Porto Alegre, com idade entre 14 e 16 anos. Estudo caso-controle com 431 mães adolescentes (casos) e 862 adolescentes que nunca tiveram filho (controles). Os dados foram obtidos através de visitas domiciliares e mediante aplicação de questionário estruturado. Foram estudadas variáveis sociodemográficas, qualidade das relações sociais e familiares, estilo de vida e histórico de abuso como possíveis determinantes da maternidade na adolescência. Os dados foram analisados através de regressão logística condicional, utilizando modelo hierarquizado. Os resultados mostram que pertencer aos estratos socioeconômicos mais baixos, possuir mãe que teve o seu primeiro filho até os 19 anos, defasagem escolar, uso de tabaco e embriaguez alcóolica pelo menos uma vez na vida foram positivamente associados à maternidade na adolescência. Menarca mais tardia e ter familiares ou ter amigos em quem confiar foram fatores de proteção. Defasagem escolar, que obteve razão de odds mais elevada, aponta o importante papel da escola na formação desta população e no seu potencial para estimular hábitos de vida sadios.

Sexualidade na adolescência em tempos de Aids: um estudo com escolares / Sexuality in adolescence in times of AIDS: a study with schoolchildren

Este trabalho objetiva investigar o conhecimento, atitudes e comportamentos relacionados à sexualidade dos adolescentes de escolas públicas de Canoas/RS. Uma amostra de 1091 estudantes de 12 a 19 anos responderam questionários autoaplicados sobre sexualidade, abuso sexual, gravidez, DST/AIDS. Cerca de 45% dos adolescentes já tiveram relação sexual. A idade média da primeira relação foi 14 anos para rapazes e 14,6 anos para moças. O preservativo foi usado na primeira relação sexual por 80,6% dos estudantes. Os adolescentes gostariam de aprender mais sobre sexualidade, sendo que moças gostariam de aprender mais que rapazes. Quanto à percepção da vulnerabilidade para HIV/AIDS, 54% dos rapazes acha quase impossível contrair a doença, enquanto que nas moças esse número sobe para 71,0%. Houve 5,6% de história de gravidez e 2,7% de história de abuso sexual. Apesar de um aumento no uso do preservativo, os resultados embasam intervenções para aumentar o sexo mais seguro entre adolescentes.

This work aims to investigate the knowledge, attitudes and behaviors related to sexuality of public schools'students of Canoas / RS. 1091 students aged 12 to 19 answered self-administered questionnaires on sexuality, sexual abuse, pregnancy, STD / AIDS. About 45% of adolescents have had sexual intercourse. The average age of the first relationship was 14 years for boys and 14.6 years for girls. The condom was used in the first intercourse by 80.6% of the students. Teens would like to learn more about sexuality, and girls would like to learn more than boys. Regarding the perception of vulnerability to HIV / AIDS, 54% of boys find it almost impossible to contract the disease, while in girls this figure rises to 71.0%. There was 5.6% of pregnancy history and 2.7% of sexual abuse history. Despite an increase in condom use, these results support interventions to increase safer sex among adolescents.

Factors associated with first sexual intercourse among mothers with 14-16 years of age from Porto Alegre/RS, Brazil. / Fatores associados à iniciação sexual em mães de 14 a 16 anos em Porto Alegre/RS, Brasil.

This study analyzed the factors associated with first sexual intercourse among 427 mothers with 14-16 years of age from Porto Alegre (RS), Brazil. Data on adolescent socio-demographic status (skin color, religion and schooling gap) and reproductive aspects (age at menarche, age at first sexual intercourse, partnership in first sexual intercourse and partner's age) were collected through household survey. Data analysis was performed using bivariate and multivariate analysis through Poisson regression with robust variance. Among adolescents with early first sexual intercourse (up to 14 years), 77.4% had menarche at up to 12 years of age and 16.4% had casual partners in the first sexual intercourse. These variables were associated with the outcome and showed that early menarche (OR=1.26; CI 95%:1.04-1.52) and casual partner at first sexual intercourse (OR=1.28; CI 95%:1.09-1.49) increase by respectively 26% and 28% the prevalence of early first sexual intercourse. This study highlights the need to strengthen health programs and policies already implemented, such as the School Health Program, as well as reinforces that parents and teachers need to be oriented in an integrated manner in order to facilitate dialogue with adolescents and provide adequate counseling.

O presente estudo analisou os fatores associados à iniciação sexual em 427 mães de 14 a 16 anos de Porto Alegre/RS/Brasil. Foram coletados dados referentes à condição sociodemográfica das adolescentes (cor da pele, religião e defasagem escolar) e dimensão reprodutiva (idade na menarca, idade na iniciação sexual, tipo de parceria na iniciação sexual e idade do parceiro) através de inquérito domiciliar. A avaliação dos dados foi realizada com o uso de análise bivariada e multivariada através de regressão de Poisson com variância robusta. Entre as adolescentes com iniciação sexual precoce (até os 14 anos), 77,4% tiveram menarca até os 12 anos e o parceiro na iniciação sexual foi casual em 16,4% dos casos. Essas variáveis foram associadas ao desfecho e mostram que menarca precoce (RP=1,26; IC95%:1,04-1,52) e parceiro casual na iniciação sexual (RP=1,28; IC95%:1,09-1,49) aumentam em, respectivamente, 26% e 28% a prevalência da iniciação sexual precoce. Este estudo evidencia a necessidade de fortalecer os programas e políticas de saúde já implantados, como o Programa Saúde do Escolar, e reforça que pais e professores precisam ser orientados de maneira integrada com o fim de facilitar o diálogo com as adolescentes e promover um aconselhamento adequado.

Fatores associados à iniciação sexual em mães de 14 a 16 anos em Porto Alegre/RS, Brasil / Factors associated with first sexual intercourse among mothers with 14-16 years of age from Porto Alegre/RS, Brazil

Resumo O presente estudo analisou os fatores associados à iniciação sexual em 427 mães de 14 a 16 anos de Porto Alegre/RS/Brasil. Foram coletados dados referentes à condição sociodemográfica das adolescentes (cor da pele, religião e defasagem escolar) e dimensão reprodutiva (idade na menarca, idade na iniciação sexual, tipo de parceria na iniciação sexual e idade do parceiro) através de inquérito domiciliar. A avaliação dos dados foi realizada com o uso de análise bivariada e multivariada através de regressão de Poisson com variância robusta. Entre as adolescentes com iniciação sexual precoce (até os 14 anos), 77,4% tiveram menarca até os 12 anos e o parceiro na iniciação sexual foi casual em 16,4% dos casos. Essas variáveis foram associadas ao desfecho e mostram que menarca precoce (RP=1,26; IC95%:1,04-1,52) e parceiro casual na iniciação sexual (RP=1,28; IC95%:1,09-1,49) aumentam em, respectivamente, 26% e 28% a prevalência da iniciação sexual precoce. Este estudo evidencia a necessidade de fortalecer os programas e políticas de saúde já implantados, como o Programa Saúde do Escolar, e reforça que pais e professores precisam ser orientados de maneira integrada com o fim de facilitar o diálogo com as adolescentes e promover um aconselhamento adequado.

Abstract This study analyzed the factors associated with first sexual intercourse among 427 mothers with 14-16 years of age from Porto Alegre (RS), Brazil. Data on adolescent socio-demographic status (skin color, religion and schooling gap) and reproductive aspects (age at menarche, age at first sexual intercourse, partnership in first sexual intercourse and partner's age) were collected through household survey. Data analysis was performed using bivariate and multivariate analysis through Poisson regression with robust variance. Among adolescents with early first sexual intercourse (up to 14 years), 77.4% had menarche at up to 12 years of age and 16.4% had casual partners in the first sexual intercourse. These variables were associated with the outcome and showed that early menarche (OR=1.26; CI 95%:1.04-1.52) and casual partner at first sexual intercourse (OR=1.28; CI 95%:1.09-1.49) increase by respectively 26% and 28% the prevalence of early first sexual intercourse. This study highlights the need to strengthen health programs and policies already implemented, such as the School Health Program, as well as reinforces that parents and teachers need to be oriented in an integrated manner in order to facilitate dialogue with adolescents and provide adequate counseling.

Analysis of the Association of Nonsynonymous Polymorphisms in ADH Genes with Hazardous Drinking in HIV-1-Positive Individuals.

BACKGROUND: Hazardous drinking (HD) is a serious health problem in people infected with human immunodeficiency virus type 1 (HIV-1). Single nucleotide polymorphisms (SNPs) in alcohol dehydrogenase (ADH) genes have been associated with HD in different populations, but there were no data about this in HIV-1-positive individuals. This study investigated the association of 4 nonsynonymous SNPs in ADH genes (Arg48His and Arg370Cys in ADH1B gene; Arg272Gln and Ile350Val in ADH1C gene) with HD in people living with HIV-1. METHODS: This case-control study included 365 HIV-1-positive individuals (121 with HD and 244 without HD). Sociodemographic variables were collected with a standardized individual questionnaire. HD (score ≥8) and binge drinking (BD) (drinks on the same occasion ≥5) were detected with the Alcohol Use Disorders Identification Test. The 4 SNPs were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis. The Bonferroni correction was used (considering the 4 SNPs studied). RESULTS: There were no significant differences in the frequencies of Arg370Cys, Arg272Gln, and Ile350Val polymorphisms between HD cases and controls. Otherwise, Arg/His genotype (rs1229984) in ADH1B gene showed a protective effect against HD (aOR = 0.36; 95% CI: 0.14 to 0.90) and BD (aOR = 0.49; 95% CI: 0.21 to 0.95). Nevertheless, these differences were no longer significant after Bonferroni correction. CONCLUSIONS: The results of this study suggest a possible effect of the Arg48His genotype on the protection against HD in HIV-1-positive individuals.

Sociodemographic profile, family aspects, perception of health, functional capacity and depression in institutionalized elderly persons from the north coastal region of Rio Grande do Sul, Brazil / Perfil sociodemográfico, aspectos familiares, percepção de saúde, capacidade funcional e depressão em idosos institucionalizados no Litoral Norte do Rio Grande do Sul, Brasil

Abstract Objective: to describe sociodemographic and family relationships, health status, depression and degree of functional capacity in institutionalized elderly persons in eleven long-term care facilities for the elderly in the north coastal region of Rio Grande do Sul, Brazil. Methods: a cross-sectional study was carried out of 60 institutionalized elderly persons without cognitive impairment, confirmed by a score greater than 13 in the Mini Mental State Exam. Questionnaires were used to obtain data on sociodemographic conditions, family relationships, and self-perception of health. Functional capacity was evaluated with the Barthel Index and the Geriatric Depression Scale was applied. Results: A predominance of women, widowed and single, with a of low level of education and precarious financial status, most of whom who did not have children, was observed. The elderly persons complained about difficulty walking (38.3%), generalized pain (16.7%) and vision problems (13.3%). The majority (95%) reported suffering from two to three chronic diseases and making daily use of three or more drugs. Although 55% of the participants presented depressive symptoms and morbidity, they reported functional independence and 50% rated their health as good. Conclusions: These data contributed to the knowledge of the health status and functional capacity of these institutionalized elderly persons, aiming to improve the care provided to this public. AU

Resumo Objetivo: descrever características sociodemográficas, familiares, situação de saúde, depressão e grau de capacidade funcional em idosos institucionalizados em 11 instituições de longa permanência para Idosos, na região do Litoral Norte do Rio Grande do Sul, Brasil. Métodos: Estudo descritivo transversal que utilizou questionários para obtenção de dados sobre condições sociodemográficas, aspectos familiares, sobre a autopercepção de saúde, bem como a capacidade funcional (Índice de Barthel) e a Escala de Depressão Geriátrica de 60 idosos institucionalizados sem deficiência cognitiva, confirmada após apresentarem pontuação superior a 13 no Miniexame de Estado Mental. Resultados: Houve predominância do sexo feminino, viúvos e solteiros, com baixa escolaridade e situação financeira precária, e a maioria, sem filhos. Os idosos queixaram-se das dificuldades para andar (38,3%), da dor generalizada (16,7%) e dos problemas de visão (13,3%). A grande maioria (95%) relatou ter de duas a três doenças crônicas e fazer uso diário de três ou mais medicamentos. Apesar de 55% apresentarem sintomas depressivos e morbidades, os idosos apresentaram valores compatíveis com independência funcional de acordo com o índice de Barthel e classificaram sua saúde como boa. Conclusões: Esses dados contribuíram para conhecer as condições de saúde e capacidade funcional desses idosos institucionalizados, visando qualificar a assistência a esse público. AU

Conhecimento e acesso aos programas de educação sexual e prevenção da Aids: um estudo com adolescentes escolares / Knowledge and access to sex education and Aids prevention programs: a study with in-school adolescents

Estudo transversal para analisar o conhecimento e o acesso aos programas de educação sexual e prevenção da Aids de adolescentes matriculados em escolas públicas da região metropolitana de Porto Alegre/RS. Foram avaliados 1190 adolescentes entre 12 e 19 anos, com um questionário auto aplicado. Os dados foram analisados através de estatística descritiva e inferencial. A grande maioria dos adolescentes não tem conhecimento de programas/oficinas de educação sexual e prevenção da Aids na escola e no município. Dos que conhecem os programas, cerca da metade não os frequenta na escola e 80.6% não os frequenta no município. Poucos adolescentes obtêm camisinha, informativos, testes para Aids e pílulas anticoncepcionais dos postos de saúde. A maioria dos adolescentes (78,4%) gostaria de aprender mais sobre sexualidade, gravidez e Aids. Esses resultados apontam a necessidade dos órgãos públicos tornarem mais acessível os programas de educação sexual nas escolas e especialmente nos serviços de saúde.

Cross-sectional study to analyze the knowledge and access to sex education and Aids prevention programs for adolescents enrolled in public schools in the metropolitan region of Porto Alegre / RS. A total of 1190 adolescents between 12 and 19 years old were evaluated, with a self-administered questionnaire. Data were analyzed through descriptive and inferential statistics. The vast majority of adolescents are not aware of sex education and Aids prevention programs / workshops at school and in the municipality. Of those who know the programs, about half do not attend them at school and 80.6% do not attend them in the municipality. Few teenagers get condoms, newsletters, Aids tests and contraceptive pills from health clinics. Most adolescents (78.4%) would like to learn more about sexuality, pregnancy and Aids. These results point to the need for public agencies to make sex education programs more accessible in schools and especially in health services.

Interferon lambda 4 (IFNL4) gene polymorphism is associated with spontaneous clearance of HCV in HIV-1 positive patients.

Approximately one-third of the individuals infected with human immunodeficiency virus type 1 (HIV-1) are co-infected with hepatitis C virus (HCV). Co-infected patients have an increased risk for developing end-stage liver diseases. Variants upstream of the IFNL3 gene have been associated with spontaneous and treatment-induced clearance of HCV infection. Recently, a novel polymorphism was discovered, denoted IFNL4 ΔG > TT (rs368234815), which seems to be a better predictor of spontaneous clearance than the IFNL4 rs12979860 polymorphism. We aimed to determine the prevalence of the IFNL4 ΔG > TT variants and to evaluate the association with spontaneous clearance of HCV infection in Brazilian HIV-1 patients. The IFNL4 ΔG > TT genotypes were analyzed by polymerase chain reaction followed by restriction digestion in 138 HIV-1 positive patients who had an anti-HCV positive result. Spontaneous clearance of HCV was observed in 34 individuals (24.6%). IFNL4 genotype distribution was significantly different between individuals who had spontaneous clearance and chronic HCV patients (p=0.002). The probability of spontaneous clearance of HCV infection for patients with the IFNL4 TT/TT genotype was 3.6 times higher than for patients carrying the IFNL4 ΔG allele (OR=3.63, 95% CI:1.51-8.89, p=0.001). The IFNL4 ΔG > TT polymorphism seems to be better than IFNL4 rs12979860 to predict spontaneous clearance of the HCV in Brazilian HIV-1 positive patients.

Gains in children's dental health differ by socioeconomic position: evidence of widening inequalities in southern Brazil.

UNLABELLED: Oral health inequalities are the measures by which equity in oral health is tracked. Despite widespread improvement in children's dental health globally, substantial socio-economic disparities persist and may be worsening. OBJECTIVES: Quantify 10-year changes in child caries occurrence by socio-economic position in a Southern Brazilian city and compare oral health inequalities over time. METHODS: Representative surveys of dental caries in children (age <6 years) in Canoas, Brazil, were conducted in 2000 and 2010 following standardized methods. For each survey year, we calculated disparities by socio-economic position (maternal education and family income) in age- and sex-standardized caries occurrence (prevalence: dmft > 0; severity: mean dmft) using absolute measures (difference and Slope Index of Inequality) and relative measures (ratio and Relative Index of Inequality). RESULTS: Comparing 2010 to 2000, caries occurrence was lower in all socio-economic strata. However, reductions were more pronounced among socio-economically advantaged groups, yielding no improvement in children's oral health disparities. Some disparity indicators were consistent with increasing inequality. CONCLUSIONS: Overall, dental caries levels among children in Canoas improved, but inequalities in disease distribution endured. Concerted public health efforts targeting socio-economically disadvantaged groups are needed to achieve greater equity in children's oral health.

[Maternity during adolescence: negative emotional indicators and associated factors in 14 to 16-year-old mothers from Porto Alegre in the State of Rio Grande do Sul, Brazil]. / Maternidade na adolescência: indicadores emocionais negativos e fatores associados em mães de 14 a 16 anos em Porto Alegre, RS, Brasil.

The prevalence of negative emotional indicators and associated factors in 430 adolescent mothers between 14 to 16 years of age in Porto Alegre in the State of Rio Grande do Sul was detected. Socio-demographic variables, social and family relationships, reproductive aspects, abuse and violence were studied. The prevalence rate (PR) was obtained by Poisson regression using hierarchical analyses. The prevalence of intense psychological distress was 32.6%, and it was associated with low social class, grade repetition, bad relationship with the mother, lack of acceptance of the pregnancy by the father, and lack of family support during pregnancy. The prevalence of negative self-esteem was 15.4%, and it was associated with the bad relationship with the mother and not having a person to confide in. Little or no expectation for the future was found in 7.5% of the adolescents and was associated with grade repetition, nurturing by the biological mother, early sexual initiation, and the occurrence of physical abuse. The high prevalence of psychological distress found in the adolescent mothers of this study deserves special attention from the public policies in health in order to include qualified professionals to manage the emotional aspects of early motherhood.

Maternidade na adolescência: indicadores emocionais negativos e fatores associados em mães de 14 a 16 anos em Porto Alegre, RS, Brasil / Maternity during adolescence: negative emotional indicators and associated factors in 14 to 16-year-old mothers from Porto Alegre in the State of Rio Grande do Sul, Brazil

Verificou-se a prevalência de indicadores emocionais negativos e fatores associados em 430 mães adolescentes de 14 a 16 anos de Porto Alegre, RS. Foram estudadas variáveis sociodemográficas, relações sociais e familiares, aspectos reprodutivos, abuso e violência. As razões de prevalência (RP) foram obtidas por regressão de Poisson mediante análise hierarquizada. A prevalência de sofrimento psíquico intenso foi 32,6%, estando associado à baixa classe social, à não repetência escolar, ao relacionamento ruim com a mãe, à não aceitação da gestação pelo parceiro e à falta de apoio da família frente à gestação. A prevalência de autovalorização negativa foi 15,4%, permanecendo associada ao relacionamento ruim com a mãe e a não possuir uma pessoa confidente. Pouca ou nenhuma expectativa em relação ao futuro foi encontrada em 7,5% das adolescentes, estando associada à repetência escolar, à criação pela mãe biológica, à idade precoce da primeira relação sexual e à ocorrência de abuso físico. A alta prevalência de sofrimento psíquico, encontrada nas mães adolescentes, merece atenção especial das políticas públicas de saúde para a inclusão de profissionais habilitados ao manejo dos aspectos emocionais no atendimento da maternidade precoce.

The prevalence of negative emotional indicators and associated factors in 430 adolescent mothers between 14 to 16 years of age in Porto Alegre in the State of Rio Grande do Sul was detected. Socio-demographic variables, social and family relationships, reproductive aspects, abuse and violence were studied. The prevalence rate (PR) was obtained by Poisson regression using hierarchical analyses. The prevalence of intense psychological distress was 32.6%, and it was associated with low social class, grade repetition, bad relationship with the mother, lack of acceptance of the pregnancy by the father, and lack of family support during pregnancy. The prevalence of negative self-esteem was 15.4%, and it was associated with the bad relationship with the mother and not having a person to confide in. Little or no expectation for the future was found in 7.5% of the adolescents and was associated with grade repetition, nurturing by the biological mother, early sexual initiation, and the occurrence of physical abuse. The high prevalence of psychological distress found in the adolescent mothers of this study deserves special attention from the public policies in health in order to include qualified professionals to manage the emotional aspects of early motherhood.

Sexualidade na adolescência: um estudo com escolares da cidade de Manaus/AM / Adolescent sexuality: a school-based study in the city of Manaus/AM, Brazil

Estudo transversal de base escolar com objetivo de investigar sexualidade de adolescentes da cidade de Manaus/AM, comparando rapazes e moças. Um total de 1747 adolescentes de 12 a 19 anos responderam questionário anônimo e autoaplicado. Cerca de 53,6% dos adolescentes já teve relação sexual, sendo o percentual mais elevado nos rapazes (68,0%). A idade média da iniciação sexual foi maior nas moças (14,6 anos) que nos rapazes (13,1 anos). O preservativo foi usado na primeira relação sexual por 65,8% dos adolescentes. As primeiras fontes de informações sobre relação sexual são família e professor/escola. Rapazes e moças conhecem programas de educação sexual oferecidos pela escola (66,5%) e município (33,7%). História de gravidez foi relatada por 12,8% da amostra e abuso sexual por 9,0%. Este estudo mostra precoce iniciação sexual dos adolescentes escolares de Manaus/AM. Família e escola possuem importante papel na educação sexual desta população, necessitando orientações específicas.(AU)

Cross-sectional study performed with students from state schools in the city of Manaus/AM. A sample of 1747 teenagers from 12 to 19 years-old answered an anonymous self-administered questionnaire about sexuality. About 53.6% of teenagers have already had sexual relation and the percentage is higher for boys (68.0%) than for girls (43.6%). The average age of their first sexual relation was higher among girls (14.6 years) than boys (13.1 years). Condom was used at first sexual relation by 65.8% of teenagers. Boys (80.3%), more than girls (73.8%), believe they have an excellent knowledge of sexuality. The primary sources of information about sex/pregnancy are: family and teachers/school. Teenagers are awared about sex education programs offered by schools (66.5%) and government actions (33.7%). Pregnancy cases were reported by 12.8% of the sample and sexual abuse by 9.0%. This study shows that sexual initiation in adolescent students of Manaus is precocious. Family and schools play an important role in sexual orientation among teenagers, requiring specific guidance.(AU)

Estresse em adolescentes: estudo com escolares de uma cidade do sul do Brasil / Stress in adolescencents: a study with schoolars from a city in southern Brazil

Estudo analítico transversal com objetivo de avaliar a prevalência e os fatores associados ao estresse em adolescentes escolares de Canoas/RS. Participaram do estudo 475 adolescentes, de 14 a 18 anos, que responderam a Escala de Stress para Adolescentes (ESA) e a um questionário sobre dados sociodemográficos, relações familiares, sexualidade, uso de drogas e comportamento de risco. Os resultados apontaram prevalência de estresse de 10,9 %. Além do ambiente familiar, os fatores associados a níveis mais elevados de estresse foram 'achar possível contrair AIDS', 'ter sofrido acidente no último ano', 'não ter usado camisinha na primeira e na última transa' e 'já ter tido alguma DST'. Conclui-se que especialmente o ambiente familiar e as práticas sexuais são significativos ao aumento de estresse em jovens e, portanto, necessitam de intervenções que promovam comportamentos saudáveis para esta população.(AU)

Study with analytic cross sectional design that aimed to evaluate the prevalence and associated factors related to stress in school adolescents from the city of Canoas/RS. The sample consisted of 475 adolescents, aged 14-18 years, who answered the Stress Scale for Adolescents and a questionnaire about socio-demographic data, family relations, sexuality, drug use and risk behavior. The results revealed 10.9% of stress prevalence in the adolescents. Besides the family environment, factors associated with higher levels of stress were 'possibility to contract AIDS', 'having suffered an injury in the last year', 'have not used a condom in the first and in last sex intercourse' and 'have had an STD'. In conclusion, the family environment and sexual practices are especially significant to the increased stress in the studied adolescents and therefore require interventions that promote healthy behaviors for this population.(AU)

Short communication: Prevalence and risk factors for human T cell lymphotropic virus infection in Southern Brazilian HIV-positive patients.

HIV/human T cell lymphotropic virus (HTLV) coinfection has a large range of prevalence in the different risk groups and geographic regions of the world. Most of the HTLV-infected people live in geographic areas where the virus is endemic, as it happens in Brazil. The aim of this study was to identify HTLV prevalence and risk factors in HIV-positive patients. A cross-sectional study was conducted with 580 HIV-positive patients (mean age of 40.6 years and 45.0% men) from a specialized HIV/AIDS diagnosis and treatment center in Southern Brazil. Sociodemographic data, HIV risk factors, and HTLV-1/2 antibodies were collected. HTLV proviral DNA was detected by polymerase chain reaction (PCR). A multivariate analysis was performed to identify risk factors for HTLV infection. HTLV antibodies were detected in 29 (5.0%) and HTLV provirus in 17 (2.9%) patients. HTLV-1 was identified in 11 (64.7%) patients and HTLV-2 in 6 (35.3%) patients. No significant differences were observed between mono and coinfected patients in clinical characteristics regarding HIV/AIDS (time since HIV diagnosis, HIV viral load, lymphocytes CD4(+) count, and use of highly active antiretroviral therapy). Blood transfusion history was significantly associated with HIV/HTLV coinfection (p=0.039). Alcohol abuse was more prevalent in HTLV-positive (47.1%) than in HIV mono-infected patients (20.4%; p=0.008). Tattooing was the only risk factor independently associated with HIV/HTLV coinfection (p=0.035). This information contributes to an understanding of the epidemiology of HIV/HTLV coinfection in Brazil.

[The prevalence of exclusive breastfeeding and associated factors: a cross-sectional study of teenage mothers between 14 and 16 years of age in the city of Porto Alegre in the State of Rio Grande do Sul, Brazil]. / Prevalência de aleitamento materno exclusivo e fatores associados: estudo transversal com mães adolescentes de 14 a 16 anos em Porto Alegre, RS, Brasil.

This is a cross-sectional study to verify the prevalence and associated factors related to exclusive breastfeeding in adolescent mothers between 14 and 16 years of age with 6-month-old or younger babies, born in Porto Alegre in the State of Rio Grande do Sul, Brazil, in 2009. The sample was based on 50% of the newborn babies from the population surveyed. A total of 341 adolescent mothers were interviewed in their homes. The variables considered as potential determinants of exclusive breastfeeding were social and demographic, pre- and post-natal assistance, emotional aspects of the mother, birth conditions and baby characteristics. Prevalence ratios (PR) were estimated by Poisson regression by means of hierarchical analysis. The prevalence of exclusive breastfeeding ranged from 47.8% in the first month of life up to 13.8% after six months and declined, on average, 24% for each month of life (RP = 0.76; CI95%: 0.68-0.85). Besides the baby's age, the factors associated with exclusive breastfeeding were maternal education (PR=1.53; CII95%: 1.18-1.98) and multiple births (PR=1.57; CI95%:1.02-2.46), the latter observed in only 4.7% of the sample. Teenage mothers with higher schooling and with live children from earlier pregnancies manifested higher prevalence of exclusive breastfeeding.

Prevalência de aleitamento materno exclusivo e fatores associados: estudo transversal com mães adolescentes de 14 a 16 anos em Porto Alegre, RS, Brasil / The prevalence of exclusive breastfeeding and associated factors: a cross-sectional study of teenage mothers between 14 and 16 years of age in the city of Porto Alegre in the State of Rio Grande do Sul, Brazil

Estudo transversal com objetivo de verificar a prevalência e os fatores associados ao aleitamento materno exclusivo (AME) em mães adolescentes de 14 a 16 anos cujos bebês de até seis meses nasceram em Porto Alegre (RS), no ano de 2009. A composição da amostra teve como base 50% dos nascidos vivos da população em estudo. Foram entrevistadas 341 mães adolescentes em seus domicílios. As variáveis investigadas como possíveis determinantes do AME foram: sociodemográficas, de assistência pré e pós-natal, aspectos psicoemocionais maternos, condições de nascimento e características do bebê. As razões de prevalência (RP) foram obtidas por regressão de Poisson mediante análise hierarquizada. A prevalência de aleitamento materno exclusivo variou de 47,8% no primeiro mês de vida do bebê até 13,8% aos seis meses, diminuindo, em média, 24% a cada mês de vida (RP = 0,76; IC95%: 0,68-0,85). Além da idade do bebê, também estiveram associadas ao aleitamento materno exclusivo a escolaridade materna (RP = 1,53; IC95%: 1,18-1,98) e a multiparidade (RP = 1,57; IC95%: 1,02-2,46), esta última observada em apenas 4,7% da amostra. As mães adolescentes com maior escolaridade e que possuem filhos vivos de gestações anteriores apresentaram maior prevalência de aleitamento materno exclusivo.

This is a cross-sectional study to verify the prevalence and associated factors related to exclusive breastfeeding in adolescent mothers between 14 and 16 years of age with 6-month-old or younger babies, born in Porto Alegre in the State of Rio Grande do Sul, Brazil, in 2009. The sample was based on 50% of the newborn babies from the population surveyed. A total of 341 adolescent mothers were interviewed in their homes. The variables considered as potential determinants of exclusive breastfeeding were social and demographic, pre- and post-natal assistance, emotional aspects of the mother, birth conditions and baby characteristics. Prevalence ratios (PR) were estimated by Poisson regression by means of hierarchical analysis. The prevalence of exclusive breastfeeding ranged from 47.8% in the first month of life up to 13.8% after six months and declined, on average, 24% for each month of life (RP = 0.76; CI95%: 0.68-0.85). Besides the baby's age, the factors associated with exclusive breastfeeding were maternal education (PR=1.53; CII95%: 1.18-1.98) and multiple births (PR=1.57; CI95%:1.02-2.46), the latter observed in only 4.7% of the sample. Teenage mothers with higher schooling and with live children from earlier pregnancies manifested higher prevalence of exclusive breastfeeding.

Family psychosocial characteristics, tobacco, alcohol, and other drug use, and teenage pregnancy.

The aim of this study was to analyze associations between demographic factors, family psychosocial characteristics, tobacco, alcohol, and other drug use, and adolescent motherhood. This was a case-control study in Porto Alegre, Rio Grande do Sul State, Brazil, with 431 adolescents 14 to 16 years of age who gave birth in 2009 (cases) and 862 adolescents who had never given birth (controls). Three-stage hierarchical logistic regression was performed (demographic, family psychosocial, and lifestyle variables). Lower economic class, not having lived with the parents from 10 to 14 years of age (OR = 1.67; 95%CI: 1.12-2.48), having taken care of other children (OR = 1.42; 95%CI: 1.09-1.87), siblings who had children before 20 years of age (OR = 1.56; 95%CI: 1.192.06), having tried smoking (OR = 1.94; 95%CI: 1.35-2.78), and having arrived home intoxicated (OR = 1.67; 95%CI: 1.12-2.48) were associated with adolescent motherhood. Greater attention should be given to family relations in association with tobacco and alcohol consumption, since the use of these substances is associated with adolescent motherhood.

Family psychosocial characteristics, tobacco, alcohol, and other drug use, and teenage pregnancy / Características psicossociais familiares e uso de tabaco, álcool e outras drogas relacionadas à gravidez na adolescência / Características psicosociales familiares y el uso del tabaco, alcohol y otras drogas relacionadas con el embarazo en la adolescencia

The aim of this study was to analyze associations between demographic factors, family psychosocial characteristics, tobacco, alcohol, and other drug use, and adolescent motherhood. This was a case-control study in Porto Alegre, Rio Grande do Sul State, Brazil, with 431 adolescents 14 to 16 years of age who gave birth in 2009 (cases) and 862 adolescents who had never given birth (controls). Three-stage hierarchical logistic regression was performed (demographic, family psychosocial, and lifestyle variables). Lower economic class, not having lived with the parents from 10 to 14 years of age (OR = 1.67; 95%CI: 1.12-2.48), having taken care of other children (OR = 1.42; 95%CI: 1.09-1.87), siblings who had children before 20 years of age (OR = 1.56; 95%CI: 1.192.06), having tried smoking (OR = 1.94; 95%CI: 1.35-2.78), and having arrived home intoxicated (OR = 1.67; 95%CI: 1.12-2.48) were associated with adolescent motherhood. Greater attention should be given to family relations in association with tobacco and alcohol consumption, since the use of these substances is associated with adolescent motherhood.

O objetivo foi estudar a associação entre fatores demográficos, características psicossociais familiares, uso de tabaco, álcool e outras drogas e a gravidez na adolescência. Estudo de casocontrole com 431 adolescentes, com idades entre 14 e 16 anos, de Porto Alegre, Rio Grande do Sul, Brasil, que tiveram filhos em 2009 (casos), e 858 adolescentes sem filhos (controles). A regressão logística hierárquica foi realizada em três etapas (variáveis demográficas, variáveis psicossociais familiares e variáveis de estilo de vida). A menor inserção econômica, não ter morado com os pais entre 10 e 14 anos (RC = 1,67; IC95%: 1,12-2,48), experiência no cuidado de crianças (RC = 1,42; IC95%: 1,09-1,87), irmãos que tiveram filhos antes dos 20 anos (RC = 1,56; IC95%: 1,19-2,06), experimentação de tabaco (RC = 1,94; IC95%: 1,35-2,78) e já ter chegado em casa embriagada (RC = 1,67; IC95%: 1,12-2,48) associaram-se à gravidez na adolescência. Maior atenção deve ser dada às relações familiares em relação ao consumo de tabaco e álcool, considerando que o uso destas substâncias se associam à gravidez na adolescência.

El objetivo del estudio fue estudiar la asociación entre factores demográficos, características psicosociales familiares, consumo de tabaco, alcohol y otras drogas y el embarazo en la adolescencia. Estudio de caso-control con 431 adolescentes de edades comprendidas entre los 14 y los 16 años de Porto Alegre, Rio Grande do Sul, Brasil, que dieron a luz en 2009 (casos) y 862 adolescentes sin hijos (controles). La regresión logística jerárquica se realizó en tres etapas. Variables demográficas, psicosociales, familiares y de estilo de vida. La menor inserción económica, no haber vivido con los padres entre 10 y 14 años (OR = 1,67; IC95%: 1,12-2,48), la experiencia en el cuidado de niños (OR = 1,42; IC95%: 1,09-1,87), hermanos que tuvieron hijos antes de los 20 años (OR = 1,56; IC95%: 1,19-2,06), el hecho de haber probado el tabaco (OR = 1,94; IC95%: 1,35-2,78) y el que ya hayan vuelto a casa embriagadas (OR = 1,67; IC95%: 1,12-2,48) se asoció con el embarazo en la adolescencia. Se debe prestar una mayor atención en las relaciones familiares al consumo de tabaco y alcohol y se debe tener en consideración que su uso se asocia al embarazo en la adolescencia.

Prevalências de adesão à terapia antirretroviral e fatores associados em pacientes adultos de três centros urbanos do Sul do Brasil / Prevalence of adherence to antiretroviral therapy and associated factors in adult patients of three urban centers of southern Brazil

OBJETIVO: Conhecer a prevalência e os fatores associados à adesão a terapia antirretroviral (TARV) em pacientes adultos atendidos no Serviço de Assistência Especializada aos portadores do HIV/Aids de três municípios do RS. MÉTODO: Estudo de delineamento transversal com coleta de dados através de questionários de dados sociodemográficos e referente ao esquema de tratamento; auto relato de medicamentos tomados; avaliações de problemas relacionados ao álcool (AUDIT); de transtornos psiquiátricos menores (SRQ-20) e do estado clínico no momento da entrevista. RESULTADOS: Foram entrevistados 453 pacientes dos quais 79,2% foram aderentes à TARV. Os homens apresentaram uma prevalência de adesão à TARV 37% maior em relação às mulheres. Os pacientes com estado clínico leve e moderado aderiram 18% mais do que os com estado clínico grave. CONCLUSÕES: As políticas de prevenção ao HIV/Aids devem considerar que a epidemia afeta homens e mulheres de forma heterogênea e que isto deve ser levado em conta para mobilizar, no paciente, o tratamento adequado.(AU)

OBJECTIVE: To determine the prevalence and associated factors to adherence in antiretroviral therapy (HAART) of adult patients treated at the Division of Specialized Care for HIV/Aids (SAE) of three cities in RS. METHODS: Cross-sectional multicenter study with data collected by a socio-demographic questionnaire with questions relative to the treatment regimen, self-report of medication taken and of minor psychiatric disorder (SRQ20), questionnaire Alcohol Use Disorders Identification Test (AUDIT), and assessment of the clinical status at the time of the interview. RESULTS: A total of 453 adult patients with HIV/Aids and users of the SAE was interviewed and 79.2% were adherent to HAART. Men presented 37% more prevalence of adherence to HAART in relation to women and patients with low and moderate clinical status presented 18% times more prevalence of adherence to HAART in relation to patients with grave clinical status. CONCLUSIONS: Policies to prevent HIV/Aids must consider that the epidemy affects men and women unequally which should be understood to mobilize, in the patient, appropriate treatment.(AU)