Digital dual test syphilis/HIV detection based on Fourier Descriptors of Cyclic Voltammetry curves.

BACKGROUND: Effective and timely detection is vital for mitigating the severe impacts of Sexually Transmitted Infections (STI), including syphilis and HIV. Cyclic Voltammetry (CV) sensors have shown promise as diagnostic tools for these STI, offering a pathway towards cost-effective solutions in primary health care settings. OBJECTIVE: This study aims to pioneer the use of Fourier Descriptors (FDs) in analyzing CV curves as 2D closed contours, targeting the simultaneous detection of syphilis and HIV. METHODS: Raw CV signals are filtered, resampled, and transformed into 2D closed contours for FD extraction. Essential shape characteristics are captured through selected coefficients. A complementary geometrical analysis further extracts features like curve areas and principal axes lengths from CV curves. A Mahalanobis Distance Classifier is employed for differentiation between patient and control groups. RESULTS: The evaluation of the proposed method revealed promising results with classification performance metrics such as Accuracy and F1-Score consistently achieving values rounded to 0.95 for syphilis and 0.90 for HIV. These results underscore the potential efficacy of the proposed approach in differentiating between patient and control samples for STI detection. CONCLUSION: By integrating principles from biosensors, signal processing, image processing, machine learning, and medical diagnostics, this study presents a comprehensive approach to enhance the detection of both syphilis and HIV. This setts the stage for advanced and accessible STI diagnostic solutions.

Gender diversity and syphilis: something's going on?

Introduction: This study aims to analyze the influence of syphilis among people with sexual and gender diversity, different from the binary dimension. Materials and methods: A systematic review was conducted as a method to address the objective of the study, based on the Dialectical Structural Model of Care (DSM), to obtain the phenomenon from the perspective of cultural history. Results: In this review the analysis of 129 documents, of which 22 texts were used. The construction of sex and gender in Western civilization is based on the Judeo-Christian tradition, which permitted many people throughout history to be persecuted and mistreated for living a lifestyle different from that dictated by religious and traditional canons. Therefore, throughout history, gender-diverse people, sexual minorities, and prostitutes have suffered segregation, mockery, aggression, and health problems, including syphilis. Conclusions: Despite having a treatment and cure, syphilis has stood the test of time and has remained a secret pathology that is obscure and difficult to detect disease, which is still very much present in people of all social classes. It is necessary to review history to understand the reasons why syphilis is still prevalent in different societies today.

The Art of Childbirth of the Midwives of Al-Andalus: Social Assessment and Legal Implication of Health Assistance in the Cultural Diversity of the 10th-14th Centuries.

(1) Background: The role of Al-Andalus's women were the result of Arabization and Islamization in Spain. The 10th to the 14th centuries were a time of significant cultural diversity in the region. Female physicians and midwives were important for providing care to women. Despite existing studies, there is still a lack of focused research on the professionalization of these trades, including their requirements, intervention areas, and treatments. (2) Methods: To address this gap, we conducted a scoping review using the dialectical structural model of care (DSMC). Primary medical and legislative sources were used. (3) Results: two kinds of midwife, or qabila, were discovered, along with a woman physician, or tabiba, who also acted as a midwife. These professions underwent diverse training and fulfilled duties as obstetricians and pediatricians. Midwives were esteemed members of society and were the sole female professionals who needed qualified training. Their performance in the courts was exemplary. Tools for facilitating childbirth and interventions related to female health were discovered in the study. (4) Conclusions: The patriarchal societies suffer from significant inequality in terms of academic training, knowledge transmission, and healthcare provision. Midwives functioned in segregated domestic and legal spaces and were responsible for providing public care to communities from the 10th to 14th centuries.

Prevention of risky sexual behavior in primary healthcare: a best practice implementation project.

INTRODUCTION AND OBJECTIVES: Sexually transmitted infections are a public health problem affecting 45% of adolescents and young adults worldwide. The evidence suggests that primary care settings are uniquely positioned to provide an opportunity for these preventive interventions. The aim of this project is to improve nurses' interventions for preventing risky sexual behaviors in adolescents attending nursing consultations in a primary healthcare unit. METHODS: An audit and feedback were conducted by the JBI Model and Implementation Framework. Five audit criteria representing best practice recommendations for preventing risky sexual behaviors in adolescents were used. Barriers to compliance with the best practices were identified, and strategies were adopted to overcome them. A follow-up audit was conducted using the same approach as the baseline audit. RESULTS: Compliance rates improved in four criteria from baseline audit to follow-up audit. CONCLUSION: Through auditing and feedback, evidence-based interventions were implemented to prevent sexual risk behavior in adolescents in primary care settings. Further best practice implementation projects should be conducted to improve adolescent health outcomes.

Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil-A Comparative Analysis.

(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a new platform (Salus) developed by the Laboratory of Technological Innovation in Health in the scope of notification and management of disease data, including syphilis. In addition, this analysis aimed to assess whether Salus fully meets the necessary data management fields and can be indicated as a tool to improve health management in the context of syphilis in Brazil. (3) Results: In this study, the Salus functionalities were demonstrated and compared with the current Brazilian systems by discovering the existing gaps in the evaluated systems. The gaps found may explain the delay in meeting demands, the difficulty of making routine therapeutic follow-ups, in addition to interference with the vital purpose of follow-up in the epidemiological surveillance of diseases. As a result, Salus demonstrates functionalities that surpass all others and meet case management demands in a superior way to the systems currently used in the country. (4) Conclusions: The Brazilian health information systems related to the response to syphilis do not fulfill the purpose for which they were developed. Instead, they contribute to the fragmentation of health data and information, delays in diagnosis, incomplete case management, and loss of data due to inconsistencies and inadequate reporting. In addition, they are systems without interconnection, which do not articulate epidemiological surveillance actions with primary health care. All these factors may be obscuring accurate data on syphilis in Brazil, resulting in high and unnecessary public spending and late care for users of the Unified Health System (SUS).

Analysis of the Impact of Communication Campaigns under the Project "Syphilis No": A National Tool for Inducing and Promoting Health.

Syphilis is increasingly prevalent around the world as a result of complex factors. In Brazil, the government declared a syphilis epidemic in 2016 and then set a strategic agenda to respond to this serious public health problem. In a joint effort, Brazil's Federal Court of Accounts (TCU) recommended that novel and diversified health communication strategies should be developed, which the "Syphilis No" project (SNP) later conducted through nationwide mass communication campaigns. We performed exploratory data analysis to identify and understand the results of three health communication campaigns by considering syphilis data trends in Brazil. The SNP, by using traditional and innovative means of communication, focused on multiple target audiences to encourage behavior changes through awareness and syphilis knowledge acquisition via the internet. In addition, the SNP disseminated information on syphilis testing, prevention, and treatment through social media and multiple media outlets. We observed that the period of the health campaigns corresponded to the period when the syphilis testing uptake increased and the number of reported cases dropped. Thus, our findings indicate that public health responses could substantially benefit from the use of health communication campaigns as a tool for health promotion, education, and transformation.

Syphilis response policies and their assessments: A scoping review.

Syphilis is one of the most common sexually transmitted infections (STIs) worldwide and has shown a rising trend in recent years, according to a report published by the World Health Organization (WHO) in 2021. Given this problem, the present study aims to develop a scoping review of what has been done in the world after the publication of the global strategy for the elimination of STIs, with a specific focus on syphilis. Thus, we searched for papers on health policies in response to syphilis in Pubmed, Scopus, ScienceDirect, and EBSCO by CINAHL, as well as in official documents from international health organizations. The period from January 1, 2016, to August 14, 2022 was considered. Our search returned 880 papers addressing "Syphilis," "Health Policy," and "Health Policies" combined. Twenty-three papers fulfilled the inclusion and exclusion criteria according to two research questions set out for this scoping review. Our findings suggest that Brazil and Peru presented the greatest adequacy of the strategies provided by WHO in 2016 and the Pan American Health Organization (PAHO) in 2017, aiming tothe goals set out in the UN's 2030 Agenda for sustainable development. Among the studies found, six countries (Cuba, Thailand, Belarus, Armenia, Moldova, and Puerto Rico) reported the elimination of mother-to-child transmission (MTCT) of syphilis, but the most recent data are from 2016. Furthermore, it is essential to mention that no country has been found that has presented a comprehensive response to syphilis, noting the control or elimination of the disease in all key populations. Thus, it is necessary to constantly monitor national policies based on in-depth studies on the quality of the response, the challenges, and the national, regional, and global perspectives for the control of the disease until 2030, the year in which the SDGs will be reviewed. Systematic review registration: https://osf.io/x9er5/?view_only=0cc0062222ec45dcb2f4d41484d285b6, identifier: 10.17605/OSF.IO/X9ER5.

Clinical Protocols and Treatment Guidelines for the Management of Maternal and Congenital Syphilis in Brazil and Portugal: Analysis and Comparisons: A Narrative Review.

(1) Background: Maternal syphilis (MS) and congenital syphilis (CS) are serious public health problems worldwide due to their high morbidity and mortality rates. (2) Objective: Evaluating the applicability of Clinical Protocols and Treatment Guidelines on case incidence trends in Brazil and Portugal. (3) Methods: The review was done through bibliographic research in two public databases and government websites from both countries, published between 2007 and 2022. All guidelines that contained CS and MS were selected. (4) Results and discussion: After evaluation, we found that Brazil and Portugal have adequate protocols for screening and treating congenital and maternal syphilis. (5) Conclusion: The results suggest that CS and MS incidence are notably higher in Brazil than in Portugal due to economic, cultural, and social disparities and the differences in territory size. Therefore, these demographic and socioeconomic factors could strongly influence efforts to fight against syphilis and thus control the infection.

Theorising about child maltreatment: Narrative review on health education models, conceptual frameworks and the importance of the information and communication technologies.

Child maltreatment is conceived as a public health problem. Therefore, it is appropriate to analyse the explanatory models that deal with this behaviour, reflecting these postulates within the panorama of health education, which makes health professionals responsible for taking action. In order to do this, the theoretical context and the awareness of nursing students in relation to these theories must be analysed. In turn, the use of information and communication technologies in this field should be valued, due to their capacity to manage and systematise information, becoming a relevant tool when training future nursing professionals. Without forgetting that health informatics is a spectrum of multidisciplinary fields that includes the study of the design, development and application of computational techniques to improve healthcare. A review of the scientific literature was carried out, for which primary and secondary sources were consulted, tracing a search for data thanks to the keywords: 'nursing'; 'abuse'; 'children'; 'education' and 'theory'. During the second half of the 20th century, several health paradigms have been developed, which present different pathways to health education. There have also been three generations of theoretical models that attempt to analyse the public health problem of child maltreatment. This reflects the need for a transdisciplinary approach to child abuse, where there is no one explanatory model that is more appropriate than another, but where the choice of the health education paradigm and, within this, the most recommendable theory will depend on each situation.

Wet Nurse or Milk Bank? Evolution in the Model of Human Lactation: New Challenges for the Islamic Population.

(1) Introduction: The establishment of milk banks in the Islamic world as well as donation to Islamic families in Western countries remains a challenge in the context of human lactation. Religious reservations established since the Qur'an and regulated at the legal-religious and medical level equate milk kinship with consanguinity, which prevents donation. The aim of the study was to analyse the evolution in the model of breastfeeding and care in Islamic society. (2) Methods: The methodology of comparative history was applied, following the structural-dialectical model of care. Historical manuals, articles and databases were analysed. (3) Results: Paediatric care in medical manuals from the 10th-15th centuries is similar to that practiced by the Muslim population today, some beneficial, some harmful; the wet nurse had to follow a series of dietary habits and have a series of physical, moral and educational characteristics in order to be hired. They constituted a beginning of pseudo-professionalisation, in a domestic-family framework. Human milk was used as a remedy for different health problems. (4) Conclusions: Islamic society and nursing have to evolve towards transnational care adapted to the needs of the population.

Virtual Learning Environment of the Brazilian Health System (AVASUS): Efficiency of Results, Impacts, and Contributions.

The Virtual Learning Environment of the Brazilian Health System (AVASUS) is a free and open distance education platform of the Ministry of Health (MS). AVASUS is a scalable virtual learning environment that has surpassed 800,000 users, 2 million enrollments, and 310 courses in its catalog. The objective of this paper was to assess the impacts of the educational offerings on health services and AVASUS course participants' professional practice. This study analyzed data from AVASUS, the Brazilian National Registry of Health Care Facilities (CNES), the Brazilian Occupational Classification (CBO), and a questionnaire applied to 720-course participants from five regions of Brazil. After acquiring and extracting data, computational methods were used for the evaluation process. Only the responses of 462 participants were considered for data analysis, as they had a formal link to CNES. The results showed that respondents recommended 76.2% of AVASUS courses to peers. Accordingly, the quality of educational offerings motivated 81.3% of such recommendations. In addition, 75.6% of course participants who answered the questionnaire also indicated that AVASUS course contents contribute to enhancing existing health services in the health facilities where they work. Finally, 24.6% of all responses mentioned that courses available in AVASUS were essential in offering new health services in such facilities.

The Text Mining Technique Applied to the Analysis of Health Interventions to Combat Congenital Syphilis in Brazil: The Case of the "Syphilis No!" Project.

Congenital syphilis (CS) remains a threat to public health worldwide, especially in developing countries. To mitigate the impacts of the CS epidemic, the Brazilian government has developed a national intervention project called "Syphilis No." Thus, among its range of actions is the production of thousands of writings featuring the experiences of research and intervention supporters (RIS) of the project, called field researchers. In addition, this large volume of base data was subjected to analysis through data mining, which may contribute to better strategies for combating syphilis. Natural language processing is a form of knowledge extraction. First, the database extracted from the "LUES Platform" with 4,874 documents between 2018 and 2020 was employed. This was followed by text preprocessing, selecting texts referring to the field researchers' reports for analysis. Finally, for analyzing the documents, N-grams extraction (N = 2,3,4) was performed. The combination of the TF-IDF metric with the BoW algorithm was applied to assess terms' importance and frequency and text clustering. In total, 1019 field activity reports were mined. Word extraction from the text mining method set out the following guiding axioms from the bigrams: "confronting syphilis in primary health care;" "investigation committee for congenital syphilis in the territory;" "municipal plan for monitoring and investigating syphilis cases through health surveillance;" "women's healthcare networks for syphilis in pregnant;" "diagnosis and treatment with a focus on rapid testing." Text mining may serve public health research subjects when used in parallel with the conventional content analysis method. The computational method extracted intervention activities from field researchers, also providing inferences on how the strategies of the "Syphilis No" Project influenced the decrease in congenital syphilis cases in the territory.

As regulamentações de proteção de dados pessoais no Brasil e em Portugal: o tratamento de dados relativos à saúde no âmbito do Projeto "Sífilis Não" / Regulations for the protection of personal data in Brazil and Portugal: the processing of health data under the "No Syphilis" Project / Normativa para la protección de datos personales en Brasil y Portugal: el tratamiento de datos sanitários em el marco del Proyecto "Sífilis Não"

Objetivo: discutir se replicar o Projeto "Sífilis Não", naquilo que se refere ao tratamento de vastas quantidades de dados pessoais relativos à saúde sem o consentimento dos titulares, seria possível em solo português. Metodologia: análise da legislação referente à proteção de dados pessoais brasileira, portuguesa e europeia, tendo o Projeto "Sífilis Não" como o caso em estudo. Resultados: o tratamento de dados pessoais sensíveis sem o consentimento do titular é, em regra, proibido pelo Regulamento Geral de Proteção de Dados, entretanto, o tratamento por motivo de interesse público na área da saúde e para fins de pesquisa científica é autorizado, desde que sejam garantidas as liberdades fundamentais dos titulares. Conclusão: tendo em vista que o Projeto "Sífilis Não" é um projeto de pesquisa que envolve o enfrentamento e erradicação da sífilis em todas as suas formas, hipóteses específicas da legislação portuguesa e europeia autorizam o tratamento de dados pessoais sensíveis mesmo sem o consentimento dos titulares, notadamente o tratamento de dados pessoais por motivos de interesse público no domínio da saúde pública e para fins de investigação científica.

Objective: to discuss whether the reproduction of the "No Syphilis" Project regarding the processing of large scale of personal data related to health without the consent of the holders would be possible in Portugal. Methods: analysis of the Brazilian, Portuguese, and European legislation on personal data protection, with the "No Syphilis" Project as a case study. Results: the processing of sensitive personal data without the consent of the owner is, as a rule, prohibited by the General Data Protection Regulation, however the processing for reasons of public interest in the field of health and scientific research purposes is authorized, provided that the fundamental freedoms of the holders are guaranteed. Conclusion: considering that the "No Syphilis" Project is a research project that involves addressing and eradicating syphilis in all its forms, specific hypotheses of Portuguese and European legislation authorize the processing of sensitive personal data even without the consent of the holders, specifically, the processing of personal data for reasons of public interest in the field of public health and scientific research purposes.

Objetivo: discutir si la reproducción del Proyecto "Sífilis No", con respecto al procesamiento de grandes cantidades de datos personales relacionados con la salud sin el consentimiento de los titulares, sería posible en el terreno portugués. Metodología: análisis de la legislación sobre protección de datos personales brasileños, portugueses y europeos, con el Proyecto "Sífilis No" como caso en estudio. Resultados: el tratamiento de datos personales sensibles sin el consentimiento del titular está, por regla general, prohibido por el Reglamento General de Protección de Datos, sin embargo, el tratamiento por razones de interés público en el ámbito de la salud y con fines de investigación científica está autorizado, siempre que se garanticen las libertades fundamentales de los titulares. Conclusión: considerando que el Proyecto "Sífilis No" es un proyecto de investigación que implica hacer frente y erradicar la sífilis en todas sus formas, hipótesis específicas de la legislación portuguesa y europea autorizan el procesamiento de datos personales sensibles incluso sin el consentimiento de los titulares, en concreto, el tratamiento de datos personales por razones de interés público en el ámbito de la salud pública y con fines de investigación científica.

Use of Interrupted Time Series Analysis in Understanding the Course of the Congenital Syphilis Epidemic in Brazil.

Background: To fight against the rising incidence of syphilis, the Brazilian Ministry of Health (MoH) launched the "Syphilis No!" Project (SNP), with specific resources funded by a parliamentary amendment. Then, in 2018, a national rapid response started to be implemented on the Brazilian Unified Health System (SUS, Sistema Único de Saúde) in two strategic lines (1) to reinforce SUS's universal actions and (2) to implement specific ones to 100 municipalities chosen by the MoH as priorities for syphilis congenital response. In 2015, such localities represented 6895% of congenital syphilis cases in Brazil. In this context, SNP has implemented actions to strengthen epidemiological surveillance of acquired syphilis and congenital syphilis by instituting an integrated and collaborative response through health services networks and reinforcing interstate relations. Methods: A quasi-experimental study using time series analysis was conducted to assess immediate impacts and changes to the trend in national congenital syphilis before and after the project, from September 2016 to December 2019. Data were assessed considering rates of congenital syphilis per 1,000 live births in all priority municipalities (n=100) covered by the project and in non-priority municipalities (n=5,470) from all five macro-regions of Brazil. Findings: Priority municipalities showed a greater reduction (change in trend) in comparison to non-priority. The linear regression model revealed trend changes after the intervention, with both groups of municipalities showing a drop in the average monthly number of cases per 1,000 live births, with a reduction of -0·21 (CI 95% -0·33 to -0·09; p=0·0011) in priority municipalities and of -0·10 (CI 95% -0.19 to -0.02; p=0·0216) in non-priority municipalities. Interpretation: The study using ITS provides important evidence on the direction, timing, and magnitude of the effects of interventions introduced as part of the SNP on congenital syphilis in Brazil. Our results suggest that the Syphilis No! Project influenced the trends of congenital syphilis in Brazil from 2018, with higher reductions achieved in the priority municipalities. Funding: The research is funded by a grant to the Syphilis No! Project from Brazilian Ministry of Health (Project Number: 54/2017). The funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

Multicultural competencies training programs for health care staff and health students in academic and professional settings: a scoping review protocol.

OBJECTIVE: The aim of the proposed scoping review is to identify training programs in multicultural competencies for health care staff and health students in professional and academic settings. INTRODUCTION: Cultural competence training for health care professionals is an imperative challenge in today's culturally diverse societies to ensure that all people receive equitable and effective health care, particularly those from culturally diverse backgrounds. INCLUSION CRITERIA: This scoping review will consider literature with adult participants aged ≥ 18 years, health care staff, and health students who may have received or are receiving multicultural competencies training. Literature published since 1960 in English, Portuguese, Spanish, and French will be considered for inclusion. Literature will be excluded if it reports on multicultural competencies training programs for students outside the health domain or for non-professional high school programs. METHODS: The search strategy, designed according to the inclusion and exclusion criteria, will aim to find both published and unpublished literature. The following electronic databases will be searched: MEDLINE, CINAHL, Psychology and Behavioral Sciences Collection, Web of Science, Open Access Scientific Repository of Portugal (RCAAP), and Open Grey. Other sites to be searched include ClinicalTrials.gov; United Nations High Commissioner for Refugees (UNHCR); International Organization for Migration (IOM); and International Migration, Integration and Social Cohesion in Europe (IMISCOE). The screening process will consist of two steps carried out by two independent reviewers: firstly, screening by title and abstract; and secondly, by full text. Data will be charted to describe the body of literature according to the review research questions, which were defined following the Population, Concept, Context (PCC) mnemonic. Data will be presented graphically when possible, and accompanied by a narrative that describes the characteristics of the training programs.

Human trafficking, health care systems and sexually transmitted infections / Tráfico humano, sistemas de saúde e infecções sexualmente transmissíveis

Introduction: Data about the increase in human trafficking around the world are worrisome. Although there is legislation on the subject, its scope does not cover all forms and victims of trafficking. Thus, many women, children and men remain in a vulnerable situation. Objective: The purpose of this paper was to elucidate and understand, based on the literature, the relationship between human trafficking, health care systems and the increase in sexually transmitted diseases, and also to point out what is being done to combat the problem. Methods: A documentary research was conducted through an integrative review for the period from 2010 to 2020. The literature search was carried out on the basis of the CAPES journals portal using the keywords "human trafficking", "sexually transmitted diseases", "health care systems" and "education". Results: The results obtained indicated that the absence of access to information, health care and education are intrinsic to the process of illegal immigration and the destination of women and children for exploitation, whether sexual, for organ removal or forced labor, and that situations of violence, absence of health care or education and coercion, among others, are common both for the conditions of trafficking and for the conditions of the increase in sexually transmitted diseases. Conclusion: Given the information obtained, it is concluded that more research must be carried out together with the agencies that investigate and apply current laws to determine what are the most effective measures to combat human trafficking. Furthermore, we highlight the need for information on policies and projects that are able to reach vulnerable populations, with the promotion of education, health care and better living conditions.

Os dados sobre o crescimento do tráfico humano em todo o mundo são preocupantes. Apesar de haver legislação sobre o tema, seu escopo não abrange todas as formas e vítimas do tráfico. Assim, muitas mulheres, crianças e homens seguem em situação de vulnerabilidade. Objetivo: Compreender e elucidar, com base na literatura, a relação entre o tráfico de seres humanos, os sistemas de saúde e o aumento das infecções sexualmente transmissíveis, assim como apontar o que está sendo feito para combater o problema. Métodos: Pesquisa documental feita por meio de revisão integrativa no período de 2010 a 2020. A busca pela literatura foi realizada na base do portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) com a utilização das palavras-chave "tráfico humano", "infecções sexualmente transmissíveis", "sistemas de saúde" e "educação". Resultados: Os resultados obtidos indicam que a falta de acesso à informação, à saúde e à educação são intrínsecos ao processo de imigração ilegal e à destinação de mulheres e crianças para a exploração, seja sexual, seja para a retirada de órgãos ou o trabalho forçado, e que situações de violência, falta de assistência à saúde, educação, coerção, entre outras, são fatores comuns tanto para a condição do tráfico como para a condição do aumento das infecções sexualmente transmissíveis. Conclusão: Diante das informações obtidas, conclui-se que mais pesquisas devem ser realizadas em conjunto com os órgãos que investigam e aplicam a legislação vigente a fim de analisar quais as medidas mais eficazes para o combate do tráfico de seres humanos. Outrossim, destacamos a necessidade de formulação de políticas e projetos que consigam alcançar as populações vulneráveis, com a promoção da educação, a assistência à saúde e melhores condições de vida.

The Integration of Gender Perspective into Young People's Sexuality Education in Spain and Portugal: Legislation and Educational Models.

Throughout history, Sexuality Education (SE) has undergone many changes in formal education curricula. The education systems should incorporate SE and promote an understanding of sexuality from the critical perspective of gender. Objectives: To examine the approach to SE in young people in Spain and Portugal, considering the incorporation of the gender perspective, and analyze the legislation in both countries. A scoping review was conducted considering studies with SE programs, gender perspective, and legislation in Spanish, Portuguese, and English, without any time limits. The population consisted of young people aged 10 to 18 years who did not attend higher education. Databases used: CINAHL Complete, ERIC, LILACS, SciELO, MEDLINE, Psychology and Behavioral Sciences Collection, Scopus, Open Access Scientific Repository of Portugal, Base de Datos de Tesis Doctorales, Theses and Dissertations Online, and governmental websites. Thirty-two studies were found, including intervention, diagnosis, and documental programs. Eight of the studies adopted the gender perspective. Legislation in both countries is vast, with 23 main references. Although SE is legislated in both countries, the social-health and educational programs are insufficient. The relevance of the gender perspective is not incorporated into SE.

Atitudes e embaraço face ao preservativo em estudantes de enfermagem / Actitudes y vergüenza ante el preservativo en estudiantes de enfermería / Attitudes and embarrassment about condoms in nursing students

Resumo Objetivo Conhecer a perceção do risco individual de infeção HIV; avaliar conhecimentos sobre infeção HIV; conhecer atitudes face ao uso do preservativo em função do sexo; conhecer o embaraço na aquisição, negociação e uso do preservativo em função do sexo, independentemente de preservativo masculino ou feminino. Métodos Estudo analítico-transversal. Amostra não probabilística constituída por 102 estudantes de Enfermagem. Instrumentos: questionário sociodemográfico e perceção do risco; teste de conhecimentos; escala de embaraço no uso do preservativo; escala de atitudes face ao uso do preservativo. Resultados A perceção do risco de infeção HIV é favorável/muito favorável para mais de 50% dos jovens e não estatisticamente diferente entre sexos (X2= 2,213; GL= 4, p= 0,697). Dos jovens inquiridos, 86,3% nunca fez teste HIV e 86,1% não se recorda de qualquer campanha de prevenção. O teste de conhecimentos teve resultado global de 83,7%. A dimensão médico-científica mostrou os resultados mais baixos (77,8%). O embaraço na aquisição do preservativo é superior nas inquiridas comparativamente com os inquiridos (t= -2,08; p= 0,04). A atitude face ao uso do preservativo não é significativamente diferente em função do sexo (t= -1,20; p= 0,23). Conclusão Os estudantes têm boa perceção do risco de infeção de HIV, mas baixa adesão à realização do teste e a maioria não se recorda da última campanha de prevenção. Os conhecimentos revelados são elevados, mas necessitam de ser incrementados na dimensão médico-científica. As estudantes revelam mais embaraço do que os estudantes face ao preservativo, porém, as atitudes manifestadas são idênticas. Programas formativos continuam imprescindíveis.

Resumen Objetivo Conocer la percepción del riesgo individual de infección por VIH. Evaluar los conocimientos sobre infección por VIH. Conocer las actitudes ante el uso del preservativo en función del sexo. Conocer el nivel de vergüenza en la adquisición, negociación y uso de preservativos en función del sexo, tanto preservativos masculinos como femeninos. Métodos Estudio analítico transversal. Muestra no probabilística, formada por 102 estudiantes de enfermería. Instrumentos: cuestionario sociodemográfico y percepción del riesgo, prueba de conocimientos, escala de vergüenza en el uso de preservativos, escala de actitudes ante el uso de preservativos. Resultados La percepción del riesgo de infección por VIH es favorable/muy favorable para más del 50 % de los jóvenes y no es estadísticamente diferente entre sexos (X2= 2,213; GL= 4, p= 0,697). De los jóvenes encuestados, el 86,3 % nunca realizó una prueba de VIH y el 86,1 % no recuerda ninguna campaña de prevención. El resultado global de la prueba de conocimientos fue del 83,7 %. La dimensión médico-científica tuvo los resultados más bajos (77,8 %). La vergüenza en la adquisición de preservativos es superior en las encuestadas en comparación con los encuestados (t= -2,08; p= 0,04). La actitud ante el uso del preservativo no es significativamente diferente en función del sexo (t= -1,20; p= 0,23). Conclusión Los estudiantes tienen una buena percepción del riesgo de infección por VIH, pero una baja adherencia a la realización de pruebas y la mayoría no recuerda la última campaña de prevención. Los conocimientos revelados son altos, pero necesitan aumentar en la dimensión médico-científica. Las estudiantes revelan más vergüenza que los estudiantes ante el preservativo, pero las actitudes manifestadas son idénticas. Los programas educativos continúan siendo imprescindibles.

Abstract Objective To investigate the perception of individual risk of HIV infection; to assess knowledge about HIV infection; to learn about condom use attitudes according to gender; to investigate embarrassment about obtaining, negotiating and using condoms according to gender, whether male or female condom. Method This was an analytical cross-sectional study. A non-probabilistic sample was assembled consisting of 102 nursing students. Instruments: sociodemographic and risk perception questionnaire; knowledge test; scale of embarrassment about condom use; condom attitudes scale. Results Perception of risk of HIV infection is favorable/very favorable for more than 50% of young people and there was no statistical difference between the sexes (X 2=2.213; GL= 4, p= 0.697). Of the participants, 86.3% had never been tested for HIV and 86.1% did not recall any HIV prevention campaign. The global result of the knowledge test was 83.7%. The medical-scientific dimension presented the lowest results (77.8%) Embarrassment about obtaining condoms was higher among the women than men (t=-2.08; p=0.04). Attitude towards using condoms was not significantly different between the genders (t= -1.20; p= 0.23). Conclusion The students had a good perception of the risk of HIV infection, but presented low adherence to HIV testing and most did not remember the last prevention campaign. They presented having a high level of knowledge, but they need to improve their knowledge in the medical-scientific dimension. Female students were more embarrassed than the male students about condoms, however, the attitudes towards them were identical. Educational programs continue to be essential.