Associated factors and sex differences in condom non-use among adolescents: Brazilian National School Health Survey (PeNSE).

BACKGROUND: Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. AIM: Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. METHODS: The study participants were 100,962 adolescents 13-18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. RESULTS: Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. CONCLUSION: High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

Knowledge gaps and acquisition about HPV and its vaccine among Brazilian medical students.

OBJECTIVE: To analyze factors associated with knowledge gaps and acquisition about HPV and its vaccine among medical students. METHOD: Cross-sectional and analytical study conducted at the University of São Paulo Medicine School, in 2016. A convenience sample of students completed a data collection instrument containing questions on knowledge about HPV and its vaccine, and vaccine acceptability. The level of knowledge and acceptability established as a "good level" was 80% of correct answers on the questionnaire. Internal validity was calculated with Cronbach's alpha value (α) = 0.74. Bivariate and multiple analyzes were performed using the Stata® program (Stata Corp, College Station, USA) 14.0. RESULTS: To evaluate the internal consistency of the instrument applied, the Cronbach's alpha equation was used, obtaining the alpha value (α) = 0.74 for this population. This value attests that the consistency of the answers obtained with this questionnaire is considered substantial and acceptable. Among the 518 medical students who completed the survey, the majority were men 312 (60.4%) with a mean age of 23 (± 2.8) years old; 199 (38.3%) of the students were in the final years of graduation (5th and 6th years). Students in the first, second and third year of study had a 51% higher risk of a knowledge gap when compared to students in the final years of graduation [PR 1.51 (1.3:1.8); p <0.001]. Men were at 22% higher risk of unsatisfactory knowledge than women are [PR 1.22 (1.07: 1.39). There was no knowledge acquisition during medical school in the following questions (p <0.05), indication of vaccine for individuals with HIV and contraindication in pregnant patients. CONCLUSION: Male medical students, in the first year of medical school, and those who were not vaccinated had significant knowledge gaps about HPV. The novelty of the study includes the finding of non- acquisition of knowledge during the medical school graduation on safety and vaccination schedule and vaccine administration in specific populations.

Human Papillomavirus (HPV) and the quadrivalent HPV Vaccine among Brazilian adolescents and parents: Factors associated with and divergences in knowledge and acceptance.

BACKGROUND: Low national immunization coverage (44.64%) requires strengthening the vaccination campaign to improve knowledge about HPV and its vaccine among adolescents and parents/guardians. Our aim is to evaluate factors related to knowledge about HPV, its vaccine, acceptability and divergences among Brazilian adolescents and parents/guardians. METHODS: A cross-sectional study was performed at a health unit of Sao Paulo University, Brazil, from 2015 to 2016. The convenience sample comprised 1047 individuals, including 74% (n = 776) adolescents and 26% (n = 271) parents/guardians, who answered a survey (knowledge about HPV, its vaccine, barriers and acceptability). RESULTS: The main source of information for adolescents was school (39%, n = 298); for parents/guardians, it was health professionals (55%, n = 153). Parents/guardians were 2.48 times more likely than adolescents to know that HPV caused changes in the Pap smear test [RR 2.48, 95% CI 2.03-3.01 (p < 0.001)], 1.43 times likely to be aware that HPV was a sexually transmitted infection [RR 1.43, 95% CI 1.22-1.68 (p < 0.001)], and 2.77 times likely to be informed that the HPV vaccine decreased the chance of having genital warts [RR 2.77, 95% CI 2.22-2.47 (p < 0.001)]. Girls knew more about the topic than boys (RR 1.67; 95% CI 1.10-2.60); education increased parents' knowledge [(RR 3.38; 95% CI 1.71-6.69)]. CONCLUSION: Female adolescents and parents/guardians with a higher level of education are factors related to suitable knowledge about HPV and its vaccine among Brazilian respondents. There were differences between parents/guardians and adolescents in HPV awareness, clinical implications, vaccine knowledge and vaccine acceptance.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon.

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.

Questionnaires to evaluate pelvic floor dysfunction in the postpartum period: a systematic review.

BACKGROUND: Pelvic floor dysfunctions (PFDs) affect the female population, and the postpartum period can be related to the onset or aggravation of the disease. Early identification of the symptoms and the impact on quality of life can be achieved through assessment instruments. OBJECTIVE: The purpose of this systematic review is to evaluate questionnaires used to assess PFD in the postpartum period. METHODS: A systematic review study was conducted, following Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) criteria, using the databases: PubMed, Biblioteca Virtual de Saúde (BVS), Web of Science, and Scopus, and the keywords PFD or pelvic floor disorders, postpartum or puerperium, and questionnaire. Articles published up till May 2018 were included, searching for articles using validated questionnaires for the evaluation of PFDs in postpartum women. The articles included were evaluated according to a checklist, and the validation studies and translated versions of the questionnaires were identified. RESULTS: The search of the databases resulted in 359 papers, and 33 were selected to compose this systematic review, using nine validated questionnaires to assess PFDs in the postpartum period: International Consultation on Incontinence Questionnaire - Vaginal Symptoms (ICIQ-VS), Pelvic Floor Distress Inventory 20 (PFDI-20), Pelvic Floor Impact Questionnaire (PFIQ-7), PFDI-46, Pelvic Floor Impact Questionnaire (PFIQ-31), Pelvic Floor Bother Questionnaire (PFBQ), Female Pelvic Floor Questionnaire, electronic Personal Assessment Questionnaire - Pelvic Floor, and PFD questionnaire specific for pregnancy and postpartum. The most frequently reported questionnaires included PFDI-20, PFIQ-7, and ICIQ-VS and are recommended by ICI. In addition, the review identified a specific questionnaire, recently developed, to access PFD during pregnancy and postpartum. CONCLUSION: The questionnaires used to evaluate PFD during postpartum period are developed for general population or urology/gynecology patients with incontinence and reinforce the paucity of highly recommended questionnaires designed for postpartum, in order to improve early and specific approach for this period of life.

Incontinência Urinária e Qualidade de Vida em uma Unidade de Atenção Primária: Estudo Piloto / Urinary Incontinence and Quality of Life in a Primary Health Care Unit: a Pilot Study / Incontinencia Urinaria y Calidad de Vida en una Unidad de Atención Primaria: Estudio Piloto

Objetivo:Identificar a prevalência de incontinência urinária (IU) e avaliar a qualidade de vida de mulheres atendidas em uma Unidade Básica de Saúde (UBS) comparando a qualidade de vida geral de mulheres continentes e incontinentes. Métodos: Estudo piloto exploratório-descritivo, transversal e quantitativo. Amostra composta por mulheres acima de 18 anos que procuraram a UBS por qualquer motivo. Coleta de dados realizada no período de agosto a dezembro de 2021, por meio de um questionário padronizado com características demográficas, socioeconômicas, obstétricas, queixas urinárias e qualidade de vida. Resultados: Participaram 53 mulheres com idade média de 44,49 (± 15,38) anos. A maioria das mulheres se autodeclarou parda (62,3%), casada ou em união estável (52,8%), exercendo atividade ocupacional remunerada (64,2%); 35,8% das mulheres foram diagnosticadas como incontinentes, relatando perder urina uma vez por semana, quando tossem ou espirram, exercendo um impacto moderado na qualidade de vida. As diferenças nos valores dos domínios da qualidade de vida possuem correlação estatística significativa entre os grupos de mulheres continentes e incontinentes. Conclusão: As queixas urinárias prevalecem em uma parcela significativa das mulheres, e a IU é um fator capaz de impactar negativamente a qualidade de vida, porém se faz necessário comprovar os achados em uma amostra significante.

Objective:Characterize urinary incontinence (UI) prevalence and assess the quality of life (QoL) of women treated at a primary health care unit in order to compare the general QoL of continent and incontinent women. Methods: An exploratory-descriptive, cross-sectional pilot study with a quantitative approach. Sample composed of women over 18 years old who went to the unit for any reason. Data collection carried out from August to December 2021, through a standardized questionnaire with information on demographic, socioeconomic, obstetric, urinary habits and QoL. Results: Fifty-three women with a mean age of 44.49 (± 15.38) years participated. Most women declared themselves to be brown (62.3%), married or in a stable union (52.8%), exercising paid occupational activity (64.2%). As for urinary characteristics, 35.8% were diagnosed as incontinent, reporting that they lost urine once a week when they coughed or sneezed, and that this had a moderate impact on QoL. The differences in the values of QoL domains have a statistically significant correlation between the continent and incontinent groups. Conclusion: Urinary complaints prevail in a significant portion of women and UI is a factor capable of negatively impacting QoL, but it is necessary to prove the findings in a significant sample

Objetivo:Caracterizar la prevalencia de incontinencia urinaria (IU) y evaluar la calidad de vida de mujeres atendidas en una unidad básica de salud, comparando la calidad de vida general de mujeres continentes e incontinentes. Métodos:Estudio piloto exploratorio-descriptivo, transversal y cuantitativo. Muestra compuesta por mujeres mayores de 18 años que acudieron a la Unidad Básica de Salud por cualquier motivo. Recolección de datos realizada de agosto a diciembre de 2021, a través de un cuestionario estandarizado con características demográficas, socioeconómicas, obstétricas, urinarias y de calidad de vida. Resultados: Participaron 53 mujeres con una edad media de 44,49 (± 15,38) años. La mayoría de las mujeres se declaró parda (62,3%), casada o en unión estable (52,8%), ejerciendo actividad laboral remunerada (64,2%). El 35,8% de las mujeres fueron diagnosticadas como incontinentes, relatando que perdían orina una vez por semana al toser o estornudar, ejerciendo un impacto moderado en la calidad de vida. Las diferencias en los valores de los dominios de calidad de vida tienen una correlación estadísticamente significativa entre los grupos de mujeres continentes e incontinentes. Conclusión: Las quejas urinarias prevalecen en una porción significativa de mujeres y la IU es un factor capaz de impactar negativamente en la calidad de vida, pero es necesario comprobar los hallazgos en una muestra significativa.

Knowledge and acceptability of the human papillomavirus vaccine among health professionals in Acre state, western Amazon

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.