More comprehensive sex education reduced teen births: Quasi-experimental evidence.

Women in the United States are much more likely to become mothers as teens than those in other rich countries. Teen births are particularly likely to be reported as unintended, leading to debate over whether better information on sex and contraception might lead to reductions in teen births. We contribute to this debate by providing causal evidence at the population level. Our causal identification strategy exploits county-level variation in the timing and receipt of federal funding for more comprehensive sex education and data on age-specific teen birth rates at the county level constructed from birth certificate natality data covering all births in the United States. Our results show that federal funding for more comprehensive sex education reduced county-level teen birth rates by more than 3%. Our findings thus complement the mixed evidence to date from randomized control trials on teen pregnancies and births by providing population-level causal evidence that federal funding for more comprehensive sex education led to reductions in teen births.

Práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência: uma revisão realista / Educational practices for the prevention of sexually transmitted infections in adolescence: a realistic review / Prácticas educativas para la prevención de infecciones de transmisión sexual en la adolescencia: una revisión realista

Objetivo: analisar as evidências científicas acerca das práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência. Método: foi realizada uma revisão realista, utilizada para o embasamento de práticas e políticas de intervenção em realidades sociais complexas, em fevereiro de 2022, para responder à questão norteadora: quais são as práticas educativas para a prevenção de infecções sexualmente transmissíveis na adolescência? Resultados: foram incluídos 17 estudos, dos quais emergiu o preceito teórico: práticas dialógicas e participativas a respeito das infecções sexualmente transmissíveis, realizadas em grupo, no ambiente escolar e de longa duração favorecem a adesão à participação nas atividades educativas e são mais bem recebidas e avaliadas pelos adolescentes. Conclusão: a revisão realista alcançou os seus propósitos em determinar: o que, como, para quem e em quais circunstâncias, determinada intervenção funciona em um contexto social.

Objective: to analyze the scientific evidence about educational practices for the prevention of sexually transmitted infections in adolescence. Method: a realistic review was carried out, used as a basis for intervention practices and policies in complex social realities, in February 2022, to answer the guiding question: what are the educational practices for the prevention of sexually transmitted infections in adolescence? Results: 17 studies were included, from which the theoretical precept emerged: dialogic and participatory practices regarding sexually transmitted infections, carried out in groups, in the school environment and on a long-term basis, favor adherence to participation in educational activities and are better received and evaluated by adolescents. Conclusion: the realist review achieved its purposes in determining what, how, for whom and under what circumstances a given intervention works in a social context.

Objetivo: analizar la evidencia científica sobre prácticas educativas para la prevención de infecciones de transmisión sexual en la adolescencia. Método: se realizó una revisión realista, utilizada para sustentar prácticas y políticas de intervención en realidades sociales complejas, en febrero de 2022, para responder a la pregunta orientadora: ¿cuáles son las prácticas educativas para la prevención de las ITS en la adolescencia? Resultados: se incluyeron 17 estudios, de los cuales surgió el precepto teórico: las prácticas dialógicas y participativas en torno a las infecciones de transmisión sexual, realizadas en grupo, en el ámbito escolar y a largo plazo, favorecen la adherencia a la participación en las actividades educativas y son mejor recibidas y evaluadas por adolescentes. Conclusión: la revisión realista logró sus propósitos al determinar: qué, cómo, para quién y en qué circunstancias funciona una determinada intervención en un contexto social.

Guia para la provisión de métodos anticonceptivos en el subsistema público de salud de la Ciudad de Buenos Aires / Guide for the provision of contraceptive methods in the public health subsystem of the City of Buenos Aires

La presente Guía para la provisión de métodos anticonceptivos en el subsistema público de salud de la ciudad de Buenos Aires propone pautas para los equipos y profesionales vinculados a la salud sexual y reproductiva de los hospitales y centros de salud y acción comunitaria que integran la red de cuidados progresivos. Aborda tres aspectos centrales: la población destinataria de los métodos, las prácticas previas que son indispensables para el uso de cada uno de ellos y la modalidad de provisión recomendada. Las definiciones sobre población destinataria, así como las prácticas previas indispensables, están basadas en los criterios de la Guía Práctica para el uso de métodos anticonceptivos del Ministerio de Salud de la Nación (Dirección de Salud Sexual y Reproductiva, 2019). La modalidad de provisión recomendada surge de decisiones técnico-políticas orientadas a mejorar el acceso y la adherencia a los métodos anticonceptivos, en particular a la anticoncepción hormonal de emergencia y los métodos de corta duración (pastillas e inyectables). Debido a la especificidad territorial que tiene la Guía, se han incluido aquellos métodos que forman parte de la canasta de disponible en el ámbito público porteño al momento de preparar este material. (AU)

Educação sexual e reprodutiva no puerpério: questões de gênero e atenção à saúde das mulheres no contexto da Atenção Primária à Saúde / Sexual and reproductive education in the puerperium: gender issues and women's healthcare in the context of primary care / Educación sexual y reproductiva en el puerperio: cuestiones de género y atención de la salud de las mujeres en el contexto de la atención primaria de la salud

Estudo qualitativo que teve como objetivo compreender os desafios de profissionais de saúde para a realização de ações de educação sexual e reprodutiva durante o puerpério no contexto da Atenção Primária. Foram realizadas entrevistas com a equipe de saúde de uma Unidade de Saúde da Família em um município do interior de São Paulo. A análise foi conduzida por meio da análise dos sentidos. Evidenciou-se que a discussão de gênero e os aspectos culturais influenciam na forma da abordagem da temática, além de existirem resistências na esfera da gestão, na falta de investimento em recursos humanos e materiais que favoreçam a problematização, e na sensibilização sobre o papel da Atenção Primária para a garantia dos direitos sexuais e reprodutivos das mulheres no período puerperal. (AU)

This qualitative study aimed to understand the challenges faced by health professionals when carrying out sexual and reproductive education actions during the puerperium in the context of Primary Care. Interviews were conducted with the health team of a Family Health Unit in an inland city of the state of São Paulo. The analysis was carried out by means of the analysis of meanings and showed that the gender discussion and cultural aspects influence the way in which the theme is approached. Furthermore, there is resistance in the sphere of management, manifested in lack of investments in human and material resources that could favor problematization and awareness-raising about the role of Primary Care in guaranteeing women's sexual and reproductive rights in the puerperium. (AU)

Estudio cualitativo cuyo objetivo fue comprender los desafíos de profesionales de salud para la realización de acciones de educación sexual y reproductiva durante el puerperio en el contexto de la Atención Primaria. Se realizaron entrevistas con el equipo de salud de una Unidad de Salud de la Familia en un municipio del interior del Estado de São Paulo. El análisis se dirigió por medio del análisis de los sentidos. Quedó en evidencia que la discusión de género y aspectos culturales influyen sobre la forma del abordaje de la temática, además de haber resistencias en la esfera de la gestión, en la falta de inversión en recursos humanos y materiales que favorezcan la problematización y sensibilización sobre el papel de la atención primaria para la garantía de los derechos sexuales y reproductivos de las mujeres en el período puerperal. (AU)

Mobile sex-tech apps: How use differs across global areas of high and low gender equality.

Digital technologies are increasingly intertwined into people's sexual lives, with growing scholarly interest in the intersection of sex and technology (sex-tech). However, much of the literature is limited by its over emphasis on negative outcomes and the predominance of work by and about North Americans, creating the impression that sex-tech is largely a Western phenomenon. Based on responses from 130,885 women in 191 countries, we assessed how women around the world interact with mobile technology for sex-related purposes, and whether in areas of greater gender inequality, technological accessibility may be empowering women with knowledge about sexuality. We investigated women's use of technology to find sexual partners, learn about sex and improve their sexual relationships, and track their own sexual health. About one-fifth reported using mobile apps to find sexual partners. This use varied by region: about one-third in Oceania, one-fourth in Europe and the Americas, and one-fifth in Asia and Africa. Staying connected when apart was the most commonly selected reason for app use with a sexual partner. About one-third had used an app to track their own sexual activity. Very few reported that the app they used to improve their sexual relationships was detrimental (0.2%) or not useful (0.6%). Women in countries with greater gender inequality were less likely to have used mobile apps to find a sexual partner, but nearly four times more likely to have engaged in sending and receiving sexts. To our knowledge, this study provides the most comprehensive global data on sex-tech use thus far, demonstrates significant regional variations in sex-tech use, and is the first to examine women's engagement in sex-related mobile technology in locations with greater gender disparities. These findings may inform large-scale targeted studies, interventions, and sex education to improve the lives of women around the world.

Infografías en las ciencias de la salud: aplicación en las enfermedades de transmisión sexual / Infographics in the health sciences: application to the sexually transmitted diseases

OBJETIVO: Describir las infografías sobre las enfermedades de transmisión sexual (ETS) recuperadas mediante Google Images® y analizar su información y posibilidades de uso. MÉTODO: Estudio descriptivo transversal. Las infografías se obtuvieron mediante búsqueda con los términos «infographic», «sexually transmitted diseases» y «sexually transmitted infections». Para seleccionar las imágenes a estudio se calculó el tamaño muestral mediante la estimación de parámetros poblacionales en una población infinita. La fecha de la búsqueda fue el 15 de marzo de 2018. RESULTADOS: Se seleccionaron 386 infografías para cada término (diseases/infections), descartándose 198 (20,4%) imágenes por ruido documental; 718 infográfias (99,5%) tenían carácter informativo. La mayoría provenían de Blogs personales, 129 (16,7%) o de persona individual, 54 (7,0%). Presentaron algún tipo de licencia 31 (4,0%) infografías. Más de la mitad (Mediana = 0,4 Mpx) de las imágenes analizadas presentaron adecuada resolución. CONCLUSIONES: Se consiguió recuperar infografías sobre ETS, en su mayoría eran de tipo informativo, pero con un alto "ruido documental". Se observó una baja filiación institucional de estas imágenes que tampoco disponían de un conveniente uso de licencias Creative Commons, no obstante, existió una buena resolución de imagen

OBJECTIVE: To describe the infographics on sexually transmitted diseases (STDs) recovered through Google Images® and analyze their information and possibilities of use. METHODS: Cross-sectional descriptive study. The infographics were obtained by searching with the terms "infographic", "sexually transmitted diseases" and "sexually transmitted infections". To select the images for the study, a sample size was calculated by estimating parameters in an infinite population. The date of the search was 15 of March 2018. RESULTS: 386 infographics were selected for each term (diseases/infections), discarding 198 (20.4%) images due to documentary noise; 718 infographics (99.5%) were informative. Most of them, came from personal blogs, 129 (16.7%) or individual, 54 (7.0%). They presented some type of license 31 (4.0%) infographics. More than half (Median = 0.4 Mpx) of the analyzed images presented adequate resolution. CONCLUSIONS: It was possible to recover infographics about STDs but with a high "documentary noise" that was mostly informative. There was a low institutional affiliation of these images that did not have a convenient use of Creative Commons licenses, although most of them presented a good image resolution

Conhecimentos dos adolescentes sobre sexualidade e afetos / Adolescent knowledge on sexuality and affects

Background: In the school environment, sex education is included in health education, and it is essential to address it clearly in the various age groups. With a view to healthy sexuality, adolescents should acquire knowledge in this area. Objectives: To identify the interlocutor of adolescents, attending the 6th grade, to talk about sexuality and affections. To evaluate the effect of formative intervention on adolescents' level of knowledge on the subject. Methods: Longitudinal study in a short panel, conducted in an accidental nonprobabilistic sample, for convenience, consisting of 110 adolescents attending the 6th grade. A self-completed questionnaire with sociodemographic characterization of students / parents, a person with whom they talk about sexuality and affections and a scale of knowledge was used. Results: Participants are between 10 and 14 years old with an average of 11.53 (+/- 0.591SD). The adolescents are mostly male (60.1%), living in urban areas (82.5%) with their father and mother (82.2%). They revealed adequate knowledge on the theme of sexuality and affection (44.7%); they highlighted teachers as interlocutors to talk about sex (54.5%) and parents to talk about affect (60.0%). In the present study, it is the younger adolescents and those living in urban areas who have the best levels of knowledge about sexuality and affection. Conclusion: Adolescents improved their level of knowledge after the formative intervention on "Sexuality & Affections", a fact that reinforces the importance of this type of health education sessions in the school context

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O direito à prevenção da Aids em tempos de retrocesso: religiosidade e sexualidade na escola / El derecho a la prevención del Sida en tiempos de retroceso: religiosidad y sexualidad en la escuela / The right to Aids prevention in times of policy reversals: religiosity and sexuality in Brazilian schools

Esse artigo discute os desafios da prevenção em tempos de crescimento de casos de Aids entre jovens. Opiniões e práticas de estudantes no ensino médio, coletadas em pesquisa realizada de 2013-2017, indicaram que estavam incorporando o discurso preventivo e que a religiosidade tem efeito em crenças e valores antes da iniciação sexual, mas pode interferir negativamente no uso de preservativo desde a primeira relação. Sustentar o direito à prevenção dependerá de ampliarmos a compreensão pública sobre como a religiosidade vivida difere da política-religiosa. Sugere-se monitorar o efeito da retomada de discursos morais que remontam à ditadura civil-militar e da possível descontinuidade de programas de prevenção bem-sucedidos junto aos jovens desde os anos 1990. É urgente compreender a dinâmica entre velhos e novos discursos que estruturam a sexualização (frequentemente via redes sociais) assim como o acesso à recomendada "prevenção combinada" das Infecções Sexualmente Transmissíveis (IST/Aids).(AU)

Este artículo discute los desafíos de la prevención en tiempos de aumento de casos de Sida entre jóvenes. Opiniones y prácticas de estudiantes en la enseñanza media, recolectadas en un estudio realizado entre 2013-2017, indicaron que incorporaron el discurso preventivo y que la religiosidad tiene efecto en creencias y valores antes de la iniciación sexual, pero que puede interferir negativamente en el uso del preservativo desde la primera relación. Mantener el derecho a la prevención dependerá de que ampliemos la comprensión pública sobre cómo la religiosidad vivida difiere de la política-religiosa. Se sugiere el monitoreo del efecto de la reanudación de discursos morales que remiten a la dictadura civil-militar y de la posible discontinuidad de programas de prevención exitosos con los jóvenes desde la década de 1990. Es urgente comprender la dinámica entre viejos y nuevos discursos que estructuran la sexualización (frecuentemente vía redes sociales) así como el acceso a la recomendada "prevención combinada" de las Infecciones de Transmisión Sexual (ITS)/Sida.(AU)

This article discusses Aids prevention in Brazil in the midst of growing numbers of cases of the disease among young people. A study was conducted between 2013 and 2017 to explore the sexual behavior of high school students and their opinions regarding sexuality. The findings show that students have adopted the prevention discourse and that religiosity influences beliefs and values relating to sexual initiation, negatively affecting condom use from the onset of sexual activity. To ensure the right to prevention is upheld, it will be necessary to broaden public understanding about how religion as it is actually lived differs from religious politics. The effects of the reversion to moral discourses reminiscent of the military dictatorship and possible discontinuity of successful longstanding prevention programs targeting young people should be monitored. There is an urgent need to understand the dynamic between the old and new discourses that shape sexualization (often via social media) and access to "combination prevention" of Sexually Transmitted Infections (STI)/Aids.(AU)

Historia del condón y otros métodos anticonceptivos / History of condoms and other contraceptive methods

El uso del condón es un método eficaz para prevenir enfermedades venéreas y un embarazo no deseado. Años atrás se puede apreciar cómo se debate dónde y cómo los llamados dispositivos intrauterinos fueron utilizados por primera vez. La siguiente investigación se realizó con el objetivo de explicar el surgimiento y la evolución del condón y otros métodos anticonceptivos, para ello se utilizaron un total de 15 referencias bibliográficas. Es indudable que la anticoncepción tiene que figurar como elemento básico de la atención en medicina, el conocimiento de sus orígenes, historia y evolución es fundamental. (AU)

The use of the condom is an effective method to prevent venereal diseases and an unwanted pregnancy. Years ago you can see how it is discussed where and how the so-called intrauterine devices were used for the first time. The following investigation was carried out with the objective of explaining the emergence and evolution of the condom and other contraceptive methods, for which a total of 15 bibliographical references were used. Undoubtedly, contraception must figure as a basic element of medical care, knowledge of its origins, history and evolution is fundamental. (AU)

Historia del condón y otros métodos anticonceptivos / History of condoms and other contraceptive methods

El uso del condón es un método eficaz para prevenir enfermedades venéreas y un embarazo no deseado. Años atrás se puede apreciar cómo se debate dónde y cómo los llamados dispositivos intrauterinos fueron utilizados por primera vez. La siguiente investigación se realizó con el objetivo de explicar el surgimiento y la evolución del condón y otros métodos anticonceptivos, para ello se utilizaron un total de 15 referencias bibliográficas. Es indudable que la anticoncepción tiene que figurar como elemento básico de la atención en medicina, el conocimiento de sus orígenes, historia y evolución es fundamental. (AU)

The use of the condom is an effective method to prevent venereal diseases and an unwanted pregnancy. Years ago you can see how it is discussed where and how the so-called intrauterine devices were used for the first time. The following investigation was carried out with the objective of explaining the emergence and evolution of the condom and other contraceptive methods, for which a total of 15 bibliographical references were used. Undoubtedly, contraception must figure as a basic element of medical care, knowledge of its origins, history and evolution is fundamental. (AU)

Funding for Abstinence-Only Education and Adolescent Pregnancy Prevention: Does State Ideology Affect Outcomes?

OBJECTIVES: To examine the relationship between adolescent pregnancy-prevention and sexuality and abstinence-only education funding and adolescent birthrates over time. Also, to determine whether state ideology plays a moderating role on adolescent reproductive health, that is, whether the funding has its intended effect at reducing the number of adolescent births in conservative but not in liberal states. METHODS: We modeled time-series data on federal abstinence-only and adolescent pregnancy-prevention and sexuality education block grants to US states and rates of adolescent births (1998-2016) and adjusted for state-level confounders using 2-way fixed-effects models. RESULTS: Federal abstinence-only funding had no effect on adolescent birthrates overall but displayed a perverse effect, increasing adolescent birthrates in conservative states. Adolescent pregnancy-prevention and sexuality education funding eclipsed this effect, reducing adolescent birthrates in those states. CONCLUSIONS: The millions of dollars spent on abstinence-only education has had no effect on adolescent birthrates, although conservative states, which experience the greatest burden of adolescent births, are the most responsive to changes in sexuality education-funding streams.

Sexuality, emotionality, healthy responsibility: take care of yourself a sexual education project

Introduction: Adolescence is a period of doubt and discovery, during which the bi-ggest problems related to the discovery of sexuality arise. Portugal is part of the European countries with the largest number of teenage mothers. Despite the rising availability of information in this area, this phenomenon still occurs with all the negative consequences involved. This project intends to develop and implement a Sexual Education project named "Sexuality, Emotionality, Responsibility: Take Care of Yourself ", which aims at promoting healthy behaviours on an individual and group level (prevention, self-protection and protection of others). Methods: This is an action research project. During first phase, a questionnaire will be applied to teenagers (10 to 18 years of age), who attend a group of schools in Lisbon area. Subsequently, "Love Workshops" will be implemented, aiming at progressively developing self-responsibilization, promoting physical, psychologi-cal, and social health. In schools, dialogue and discussion areas between students, parents, teachers and, eventually, other professionals will be created. Peer educa-tion will be one of the used strategies because prevention messages will thus be adapted to different values and needs of each peer group, mediated by "Affection Ambassadors", facilitating behavioural change. At the final phase, people involved will assess the intervention process. Conclusions: We hope to be able to promote prioritization of sexual education as a determinant of health, contributing to empowerment and emotional develop-ment of teenagers, aiming at healthy and responsible sexuality, through nursing interventions that use dynamic methods focused on the teenager and the group.

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Setting the scene, setting the targets. The Joint United Nations Programme on HIV/AIDS prevention targets of 2016 and estimating global pre-exposure prophylaxis targets.

Commitment to ambitious and time-bound targets for HIV interventions has been part of the response from the beginning of the HIV epidemic. The Joint United Nations Programme on HIV/AIDS (UNAIDS) HIV primary prevention workA is built on five pillars that include offering pre-exposure prophylaxis (PrEP) to population groups at substantial risk of HIV infection. After a slow start, countries are now setting coverage targets for PrEP, but the weakness of epidemiological, demographic and behavioural data at subnational level in many countries where there is a high burden of new HIV infections, makes it difficult to define the locations and populations where to offer PrEP. This article reviews the history and challenges of PrEP target setting and suggests some possible ways of strengthening the process. Reviewing program data will identify gaps in reaching key and other priority populations for whom coverage targets were set and help to refine the offer of PrEP.

Does sex education before college protect students from sexual assault in college?

PURPOSE: College-bound young people experience sexual assault, both before and after they enter college. This study examines historical risk factors (experiences and exposures that occurred prior to college) for penetrative sexual assault (PSA) victimization since entering college. METHODS: A cross-sectional study, including an online population-based quantitiative survey with undergraduate students was conducted in spring 2016. Bivariate analyses and multivariable regressions examined risk and protective factors associated with ever experiencing PSA since entering college. Concurrently-collected in-depth ethnographic interviews with 151 students were reviewed for information related to factors identified in the survey. RESULTS: In bivariate analyses, multiple historical factors were significantly associated with PSA in college including adverse childhood experiences and having experienced unwanted sexual contact before college (for women) and initiation of alcohol, marijuana, and sexual behaviors before age 18. Significant independent risk factors for college PSA included female gender, experiencing unwanted sexual contact before college, first oral sex before age 18, and "hooking up" (e.g., causual sex or sex outside a committed partnership) in high school. Receipt of school-based sex education promoting refusal skills before age 18 was an independent protective factor; abstinence-only instruction was not. In the ethnographic interviews, students reported variable experiences with sex education before college; many reported it was awkward and poorly delivered. CONCLUSIONS: Multiple experiences and exposures prior to college influenced the risk of penetrative sexual assault in college. Pre-college comprehensive sexuality education, including skills-based training in refusing unwanted sex, may be an effective strategy for preventing sexual assault in college. Sexual assault prevention needs to begin earlier; successful prevention before college should complement prevention efforts once students enter college.