The Interactions Between Vulnerabilities for HIV and Syphilis among Cisgender and Transgender People Who Use Drugs.

In Brazil, transgender people are most affected by HIV, and crack cocaine addiction may contribute to social vulnerability and exposure to sexual and violence-related risks. This cross-sectional study comprised 2393 individuals seeking addiction treatment, consisting of 43 trans women, 1995 cisgender men, and 355 cisgender women. Records of rapid test results for HIV and syphilis and screening responses of trans women were compared to both cisgender groups using a logistic regression model to identify associated risk factors. HIV prevalence was higher in the transgender group (39.5%) than in cis women and men (5.9% and 3.6%, respectively). Our study showed an eightfold higher chance of a positive HIV test among transgender individuals who used drugs (OR: 8.79, p < .01, 95% CI: 3.90-19.78) compared to cisgender people who used drugs. A lifetime history of syphilis infection was more common in transgender people (60.0%) and cis women (32.8%) than in cis men (9.5%). Active syphilis was also more common in the transgender population (OR: 5.46, p < .01, 95% CI: 2.63 11.32). In our sample, 44.2% of transgender individuals had a history of at least one suicide attempt in their lifetime. Our results showed that transgender women were at higher risk of crack cocaine use (OR: 5.51, p < .01, 95% CI: 2.16-14.06) than cisgender men and women. The study showed that trans women had a higher prevalence of syphilis and HIV, and a greater chance of being homeless. The synergy of these vulnerabilities may have led to our findings of high psychotic symptoms and a history of suicide attempts in transgender individuals.

Forensic Implications of the New Classification of ICD-11 Paraphilic Disorders in Brazil.

INTRODUCTION: The World Health Organization (WHO) Department of Mental Health and Substance Abuse appointed a Working Group on Sexual Disorders and Sexual Health in order to revise and propose changes to ICD-10 categories. AIM: Analyze ethical and legal implications in Brazil of the proposed ICD-11 diagnostic criteria for paraphilic disorders. METHODS: A forensic working group of Brazilian experts in collaboration with representatives of WHO reviewed the proposed modifications to the classification of Disorders of Sexual Preference in ICD-10 (F65), which is recommended to be replaced by Paraphilic Disorders in ICD-11. Proposals were reviewed through a medicolegal lens, using a legal and policy analysis guide put forth by WHO. The premise of this review was to understand that, although the ICD classification is intended to provide a basis for clinical and statistical health interventions, medical diagnostics may also be entangled in the complex legal, normative, and political environment of various countries. MAIN OUTCOME MEASURE: The most important proposed change to this section is to limit the concept of paraphilic disorders primarily to patterns of sexual arousal involving a focus on others who are unwilling or unable to consent, but this change has not affected the ethical and legal aspects of psychiatric functioning in the Brazil. RESULTS: Because Brazilian criminal law is directed toward criminal behavior and not to specific psychiatric diagnoses, the changes proposed for ICD-11 are not expected to create obstacles to health services or to modify criminal sentencing. CLINICAL IMPLICATIONS: Although ICD-11 has a number of changes in its content, there are no significant clinical implications in the Brazilian context, but a better clarity of conceptual definitions and diagnostic criteria. STRENGTHS & LIMITATIONS: The study is conducted with people from different Brazilian states, which is important for a comprehensive view. On the other hand, considering that it is a very heterogeneous country, there is the limitation that an even wider scope of the study is not possible. CONCLUSION: In the Brazilian context, the new guidelines for paraphilic disorders contribute to clinical utility and are not expected to create difficulties related to the legal, social, and economic consequences of sexual offenses in the country. Abdalla-Filho E, de Jesus Mari J, Diehl A, et al. Forensic Implications of the New Classification of ICD-11 Paraphilic Disorders in Brazil. J Sex Med 2019; 16:1814-1819.

Perfil sociodemográfico de pessoas trans acompanhadas pelo serviço de atenção especializada e transdisciplinar da Universidade Federal de São Paulo / Socio-demographic profile of trans persons followed by the specialized and transdisciplinary care service of the Federal University of Sao Paulo

Introdução: O ambulatório do Núcleo de Estudos, Pesquisa, Extensão e Assistência à Pessoa trans Professor Roberto Farina da Universidade Federal de São Paulo - Núcleo TransUnifesp (NTU) - desenvolve um conjunto de atividades transdisciplinares sobre transgeneridade e intersexualidade. Sua equipe é composta por profissionais de diferentes áreas que possuem como diretriz o cuidado do sujeito em sua integralidade. Objetivos: Descrever, na forma de relato de experiência, o perfil sociodemográfico das pessoas atendidas. Métodos: Estudo transversal exploratório sobre as características sociodemográficas das pessoas atendidas no ambulatório do NTU entre 2017 e 2022 (5 anos). As informações foram obtidas por autodeclaração a partir do preenchimento do cadastro por ocasião do acolhimento. Resultados: Dos 255 cadastros, verificamos que a idade das pessoas variou de 18 aos 73 anos (média 29,8 anos). Dessas, 109 (42,5%) declararam terem feito a retificação de seus documentos. Quanto à raça/cor, 143 (56,0%) se declararam brancas, 66 (25,8%) pardas, 29 (11,3%) pretas, 4 (1,5%) amarelas, 3 (1,1%) indígenas e de 10 (3,9%) não obtivemos informação. Do total, 191 (74,9%) referiram ser casadas, 48 (18,9%) solteiras e 16 (6,2%) não informaram. Em relação ao gênero, 122 (47,8%) são mulheres, 87 (34,1%) homens trans, 22 (8,6%) travestis, 10 (3,9%) não binárias, 3 (1,2%) sem gênero; 2 (0,8%) queer; 1 (0,4%) cross-dresser, 4 (1,5%) outra e 4 (1,5%) não informaram. Quanto à escolaridade, 21 (8,2%) possuem o fundamental incompleto, (2,3%) fundamental completo, 19 (7,4%) médio incompleto, 87 (34,1%) médio completo; 70 (27,4%) superior incompleto, 37 (14,5%) superior completo, 8 (3,1%) com pós-graduação e 7 (2,7%) não informaram. Quanto a procedência, 105 (41,2%) moram na capital (São Paulo) e 143 (56,1%) fora. Em relação à orientação sexual, 137 (53,7%) se declararam heterossexuais, 22 (8,6%) bissexuais, 17 (6,7%) homossexuais, 7 (2,7%) assexuais, 4 (1,6%) pansexuais, 6 (2,4%) com outras orientações e 62 (24,3%) não informaram. Do total, 41 (16%) eram estudantes, 38 (14,9%) trabalhadores(as) de serviços, 30 (11,7%) do comércio, 19 (7,4%) desempregadas, 17 (6,6%) trabalham como técnicas de nível médio, 16 (6,2%) na indústria, 12 (4,7%) em serviço administrativo, 12 (4,7%) e 11 (4,3%) como profissionais das ciências sociais ou humanas e ciências biológicas ou da saúde respectivamente, 10 (3,9%) educadoras, 7 (2,7%) do lar; 4 (1,5%) trabalhadoras da lavoura, 23 (9%) em outras ocupações e 15 (5,9%) não informaram. Três pessoas declararam serem trabalhadoras do sexo. Quanto aos procedimentos realizados previamente, 139 (54,5%) fizeram hormonização sem orientação de profissional de saúde, das quais 83 (59,7%) eram mulheres trans, 34 (24,4%) homens trans, 14 (10,0%) travestis, 4 (2,8%) pessoas de gênero não binário e outras 4 com outra identidade. Do total, 25 pessoas (9,8%) relataram a aplicação de silicone industrial. Quanto às demandas em saúde, a busca na clínica pela endocrinologia e saúde mental (psicologia e psiquiatria), e a mastectomia e neovulvovaginoplastia na cirurgia, foram as mais procuradas. Conclusões: A experiência de equipe do NTU reconhece a importância da atenção primária transdisciplinar como porta de entrada para o atendimento de pessoas trans, e da atenção especializada ofertada em rede, especialmente quando ligado à universidade, na produção de conhecimento e formação de profissionais, garantindo maior suporte em situações de demandas complexas, contribuindo com a ampliação do atendimento integral e com o acesso aos equipamentos de saúde específicos.

[Alcohol and adolescents: study to implement municipal policies]. / Alcool e adolescentes: estudo para implementar políticas municipais.

OBJECTIVE: To build students' profile regarding alcohol consumption and risk behavior. METHODS: A total of 1,990 students were included in the study, aged 11 to 21 years old, from both genders, enrolled in public and private schools, in Southeastern Brazil, in 2004. A self-administered questionnaire was answered in the classroom without the presence of the teacher. The questionnaire also assessed the perception of how easy it was to get alcoholic beverages, the contexts where they drunk, and the consequences of drinking. RESULTS: Prevalence of lifetime alcohol use was 62.2%. Regarding consumption in the last 30 days, 17.3% of students reported at least one episode of binge drinking (five or more drinks). Adolescents reported that they had gotten alcoholic drinks very easily from shops, and also in social contexts with relatives and friends. Only 1% of underaged reported that they had tried and could not buy alcoholic beverages. As negative consequences of alcohol use in the last 12 months, students reported feeling sick due to drinking (17.9%), regret for doing something under the influence of alcohol (11%), blackouts (9.8%), and getting involved in a fight after drinking (5%). Over half of the students (55%) reported knowing someone who had been involved in a car accident because of a drunk driver. CONCLUSIONS: Data showed high prevalence of alcohol use among adolescents studied and how easy access to alcoholic beverages is, including to underaged people. Youngsters put themselves at risk and presented negative consequences of alcohol consumption. Prompt actions regarding public alcohol policies in Brazil are needed.

Evidence of association between early alcohol use and risk of later problems.

OBJECTIVES: To investigate the relationship between age of onset, alcohol consumption patterns and related problems. METHOD: In 2004, one self-administered questionnaire was completed by 1,990 students from the 5th to 11th grades of schools in Paulínia-SP. Data collection was conducted at the classroom without the presence of the teacher. The participation in the study was voluntary and anonymous. RESULTS: Prevalence of lifetime alcohol use was 62.2%. The mean age of first use of alcohol was 12.35 (sd=2.72) and ranged between 5 and 19 years of age. In 78% of the cases, the first use occurred before the age of 15, and more than 22% of the students reported having tried alcohol before 10 years of age. There were significant differences regarding current pattern of use: those who started earlier consumed more drinks per occasion (p=0.013) and had more drunkenness episodes in the last 30 days (p=0.05). A relationship between the age of first alcohol use and the use of tobacco (p=0.017) and other drugs (p=0.047) was observed. CONCLUSIONS: Adolescents first use alcohol in early ages, what impacts the current consumption patterns. This study emphasizes the need of actions regarding public alcohol policies in Brazil in order to prevent or delay the initiation of alcohol use and its related problems.

Social stigma, legal and public health barriers faced by the third gender phenomena in Brazil, India and Mexico: Travestis, hijras and muxes.

AIM AND METHODS: The aim of this article is to provide a narrative literature review of the 'third gender' phenomenon in Brazil ( Travestis), India ( Hijras) and Mexico ( Muxes), considering the social stigma, the legal and health aspects of these identities. RESULTS: These three groups share similar experiences of stigmatisation, marginalisation, sexual abuse, HIV infection, infringement of civil rights and harassment accessing health services. Brazil, India and Mexico public services for the third gender conditions are still very scarce and inadequate for the heavy demand from potential users. DISCUSSION AND CONCLUSION: Although all three countries have used legislation to promote provision of comprehensive healthcare services for third gender, there is still strong resistance to implementation of such laws and policies. Brazil, India and Mexico face a huge challenge to become countries where all human rights are respected.

Transdisciplinaridade e participacdo social na construção de uma linha de cuidado singularizada: o Núcleo TransUnifesp segue o lema "Nada sobre nós, sem nós" / Transdisciplinarity and social participation in the construction of a singularized care line: the TransUnifesp Center follows the slogan "Nothing about us, without us"

0 trabalho transdisciplinar, a participação de movimentos sociais e o reconhecimento dos saberes de pessoas trans e travestis, especialmente quando sistematizados por atividades de extensão universitária, tem sido eixos potentes na construção de linhas de cuidado pautadas na integralidade em saúde. Neste relato de experiência, expor-se-á como a formulação, estruturação e condução de um serviço pensado com e para pessoas trans e travestis, atuando conjuntamente em diferentes frentes com os movimentos sociais e acadêmico-profissionais, necessitam do apoio e do diálogo constante com a comunidade, desde o planejamento & avaliação dos resultados. Esse diálogo formativo - e em constante construção - se constitui pela necessidade de compartilhamento de saberes vivenciados pelas pessoas trans e pela equipe multiprofissional frente ao alinhamento e delineamento de ações de promoção da saúde com base na psicodespatologização das identidades trans e na autonomia do sujeito.

Clinical and demographic profile of anesthesiologists using alcohol and other drugs under treatment in a pioneering program in Brazil.

BACKGROUND AND OBJECTIVES: Anesthesiologists are the majority in impaired-physician programs that assist physicians who abuse psychoactive substances. The aim of this paper is to show a descriptive study about the clinical and sociodemographic profile of a sample of chemically dependent anesthesiologists treated in a reference program. In addition, the objective is to cite the psychiatric comorbities, the most frequently used drugs and the psychosocial and professional repercussions of substance abuse. METHOD: A cross-sectional and prospective study was conducted, and a socio-occupational questionnaire and a structured interview were carried out to diagnose mental and psychoactive substance use disorders, according to the International Classification of Diseases (the ICD-10). The questionnaire and the structured interview were carried out by two skilled researchers. RESULTS: Fifty-seven anesthesiologists were interviewed. Most of them were male (77.2%), and the mean age was 36.1 years (SD=8.5%). A high prevalence of abuse of opioid (59.6%), benzodiazepine (3.1%) and alcohol (35.1%) was observed. Opioid users sought treatment earlier than other substance users and usually they were under pressure from their colleagues and the Regional Council of Medicine. The incidence of drug abuse for self-medication was high in this subgroup. CONCLUSIONS: Anesthesiologists may present a different profile concerning the risks of opioid use. Opioid abuse usually begins during medical residency or during the first years of clinical practice, which supports the hypothesis that addiction to opioids is an occupational issue among anesthesiologists.

Longitudinal outcomes among a cohort of crack users after 12 years from treatment discharge.

Follow-ups of crack consumption are scarce in literature. The aim of this article was to investigate the evolution of a cohort of crack users and identify longitudinal outcomes. For the study, 131 consecutive crack users who were admitted to treatment (1992?1994) were interviewed. After 12 years, 107 participants were assessed. Among them, 43 were abstainers, 22 were crack users, 13 had been arrested, 2 were missing, and 27 were dead. The study showed dynamic changes of crack use patterns over time and a high involvement in illegal activities (p = 0.00) among drug users. Discontinuation of care and stigmatization of crack users has been discussed.

Perfil clínico e demográfico de anestesiologistas usuários de álcool e outras drogas atendidos em um serviço pioneiro no Brasil / Clinical and demographic profile of anesthesiologists using alcohol and other drugs under treatment in a pioneering program in Brazil / Perfil clínico y demográfico de los anestesiólogos usuarios de alcohol y otras drogas atendidos en un servicio pionero en Brasil

JUSTIFICATIVA E OBJETIVOS: Anestesiologistas são os mais representados em serviços de atendimento a médicos com transtornos por uso de substâncias psicoativas. O objetivo deste trabalho é apresentar um estudo descritivo sobre o perfil clínico e sociodemográfico de uma amostra de anestesiologistas dependentes químicos atendidos em um serviço de referência, bem como elencar comorbidades psiquiátricas, drogas frequentemente utilizadas e repercussões psicossociais e profissionais do consumo. MÉTODO: Realizou-se estudo transversal, prospectivo, tendo sido aplicadas entrevistas estruturadas para diagnóstico de transtornos mentais e transtornos por uso de substâncias psicoativas, com base na Classificação Internacional de Doenças - Versão 10 - e questionário sócio-ocupacional, aplicados por dois pesquisadores treinados. RESULTADOS: Cinquenta e sete anestesiologistas foram entrevistados, em sua maioria do sexo masculino (77,2%), idade média de 36,1 anos (DP = 8,5). Observou-se uma alta prevalência de uso de opioides (59,6%), benzodiazepínicos (35,1%) e álcool (35,1%). Usuários de opioides procuraram tratamento mais precocemente comparado aos não usuários desta substância e, geralmente, sob influência da pressão de colegas ou do conselho regional de medicina. O uso de drogas como automedicação foi elevado dentro deste subgrupo. CONCLUSÕES: Anestesiologistas podem apresentar um perfil distinto de risco de uso de opioides. O padrão de início de consumo, associado aos anos de residência médica ou aos primeiros anos da prática médica, reforça a hipótese de dependência de opioides como problema ocupacional entre anestesiologistas.

BACKGROUND AND OBJECTIVES: Anesthesiologists are the majority in impaired-physician programs that assist physicians who abuse psychoactive substances. The aim of this paper is to show a descriptive study about the clinical and sociodemographic profile of a sample of chemically dependent anesthesiologists treated in a reference program. In addition, the objective is to cite the psychiatric comorbities, the most frequently used drugs and the psychosocial and professional repercussions of substance abuse. METHOD: A cross-sectional and prospective study was conducted, and a socio-occupational questionnaire and a structured interview were carried out to diagnose mental and psychoactive substance use disorders, according to the International Classification of Diseases (the ICD-10). The questionnaire and the structured interview were carried out by two skilled researchers. RESULTS: Fifty-seven anesthesiologists were interviewed. Most of them were male (77.2%), and the mean age was 36.1 years (SD = 8.5%). A high prevalence of abuse of opioid (59.6%), benzodiazepine (3.1%) and alcohol (35.1%) was observed. Opioid users sought treatment earlier than other substance users and usually they were under pressure from their colleagues and the Regional Council of Medicine. The incidence of drug abuse for self-medication was high in this subgroup. CONCLUSIONS: Anesthesiologists may present a different profile concerning the risks of opioid use. Opioid abuse usually begins during medical residency or during the first years of clinical practice, which supports the hypothesis that addiction to opioids is an occupational issue among anesthesiologists.

JUSTIFICATIVA Y OBJETIVOS: Los anestesiólogos son los más representados en los servicios de atención a médicos con trastornos por el uso de sustancias psicoactivas. El objetivo de este trabajo, es presentar un estudio descriptivo sobre el perfil clínico y socio-demográfico de una muestra de anestesiólogos dependientes químicos, atendidos en un servicio de referencia, como también discriminar las comorbilidades psiquiátricas, las drogas a menudo utilizadas y las repercusiones psicosociales y profesionales del consumo. MÉTODO: Se hizo un estudio transversal, prospectivo, y se aplicaron entrevistas estructuradas para el diagnóstico de los trastornos mentales y de los trastornos por el uso de sustancias psicoactivas, con base en la Clasificación Internacional de Enfermedades (Versión 10) y cuestionario socio-ocupacional, aplicados por dos investigadores entrenados para tal función. RESULTADOS: Cincuenta y siete anestesiólogos fueron entrevistados, en su mayoría del sexo masculino (77,2%), edad promedio de 36,1 años (DE = 8,5). Se observó una alta prevalencia del uso de opioides (59,6%), benzodiazepínicos (35,1%) y alcohol (35,1%). Los usuarios de opioides buscaron tratamiento más rápidamente si los comparamos con los no usuarios de esa sustancia y generalmente, bajo la influencia de la presión de colegas o del Órgano Regional de Medicina. El uso de drogas como automedicación fue elevado dentro de este subgrupo. CONCLUSIONES: Los anestesiólogos pueden presentar un perfil distinto de riesgo de uso de opioides. El estándar de inicio de consumo, asociado a los años de residencia o a los primeros años de la práctica médica, refuerza la hipótesis de dependencia de opioides como el problema ocupacional entre los anestesiólogos.

Evidence of association between early alcohol use and risk of later problems

OBJECTIVES: To investigate the relationship between age of onset, alcohol consumption patterns and related problems. METHOD: In 2004, one self-administered questionnaire was completed by 1,990 students from the 5th to 11th grades of schools in Paulínia-SP. Data collection was conducted at the classroom without the presence of the teacher. The participation in the study was voluntary and anonymous. RESULTS: Prevalence of lifetime alcohol use was 62.2 percent. The mean age of first use of alcohol was 12.35 (sd = 2.72) and ranged between 5 and 19 years of age. In 78 percent of the cases, the first use occurred before the age of 15, and more than 22 percent of the students reported having tried alcohol before 10 years of age. There were significant differences regarding current pattern of use: those who started earlier consumed more drinks per occasion (p = 0.013) and had more drunkenness episodes in the last 30 days (p = 0.05). A relationship between the age of first alcohol use and the use of tobacco (p = 0.017) and other drugs (p = 0.047) was observed. CONCLUSIONS: Adolescents first use alcohol in early ages, what impacts the current consumption patterns. This study emphasizes the need of actions regarding public alcohol policies in Brazil in order to prevent or delay the initiation of alcohol use and its related problems.

OBJETIVOS: Investigar a relação entre idade de início de uso de álcool, padrão de consumo e problemas relacionados. MÉTODO: Em 2004, um questionário de autopreenchimento foi respondido por 1.990 alunos de 5ª série do ensino fundamental a 3ª série do ensino médio do município de Paulínia-SP. A coleta de dados foi realizada em sala de aula, sem a presença do professor. A participação no estudo era voluntária e anônima. RESULTADOS: A prevalência de uso de álcool na vida foi de 62,2 por cento. A média de idade de primeiro uso de álcool foi de 12,35 (sd = 2,72), variando entre 5 e 19 anos. Em 78 por cento dos casos, o primeiro uso de álcool ocorreu antes dos 15 anos, sendo que mais de 22 por cento dos adolescentes relataram que experimentaram bebida alcoólica antes dos 10 anos. Houve diferenças significantes para padrão de consumo atual: aqueles que começaram mais cedo consumiram mais doses por ocasião (p = 0,013) e tiveram mais episódios de embriaguez nos últimos 30 dias (p = 0,05). Houve associação entre a idade de experimentação do álcool e o uso de tabaco (p = 0,017) e outras drogas (p = 0,047). CONCLUSÕES: Jovens experimentam álcool em idade precoce e isto tem impacto no padrão de consumo atual. Esse artigo enfatiza a necessidade de ações imediatas em relação às políticas públicas do álcool no Brasil para prevenir ou adiar o início do consumo de álcool e problemas relacionados.

Álcool e adolescentes: estudo para implementar políticas municipais / Alcohol and adolescents: study to implement municipal policies

OBJETIVO: Traçar um perfil de estudantes em relação ao consumo de álcool e comportamentos de risco. MÉTODOS: Participaram do estudo 1.990 alunos, com idade entre 11 e 21 anos, de ambos os sexos, matriculados em escolas públicas e privadas de Paulínia, SP, 2004. Um questionário de auto-preenchimento foi respondido em sala de aula, sem a presença do professor. Analisou-se a percepção da disponibilidade e facilidade de acesso às bebidas alcoólicas, contexto do beber e conseqüências do consumo. RESULTADOS: A prevalência de uso de álcool na vida foi de 62,2 por cento. Em relação aos últimos 30 dias, 17,3 por cento dos alunos relataram pelo menos um episódio de abuso agudo. Os adolescentes reportaram que adquiram facilmente bebidas alcoólicas de estabelecimentos comerciais e também em contextos sociais com parentes e amigos. Apenas 1 por cento dos menores de idade relatou que tentou, mas não conseguiu comprar bebida alcoólica. Como conseqüências negativas do consumo nos últimos 12 meses, os estudantes relataram ter passado mal por ter bebido (17,9 por cento), arrependimento por algo que fizeram sob o efeito do álcool (11 por cento), blackout (9,8 por cento) e ter brigado após beber (5 por cento). Mais da metade (55 por cento) dos estudantes conhecia alguém que sofreu acidente de trânsito provocado por motorista embriagado. CONCLUSÕES: Os dados revelaram alta prevalência de consumo de álcool entre os adolescentes estudados e fácil acesso às bebidas alcoólicas, inclusive por menores de idade. Os jovens se colocaram em risco e apresentaram conseqüências negativas do consumo de álcool. Há necessidade de ações imediatas em relação às políticas públicas para o consumo de álcool no Brasil.

OBJECTIVE: To build students' profile regarding alcohol consumption and risk behavior. METHODS: A total of 1,990 students were included in the study, aged 11 to 21 years old, from both genders, enrolled in public and private schools, in Southeastern Brazil, in 2004. A self-administered questionnaire was answered in the classroom without the presence of the teacher. The questionnaire also assessed the perception of how easy it was to get alcoholic beverages, the contexts where they drunk, and the consequences of drinking. RESULTS: Prevalence of lifetime alcohol use was 62.2 percent. Regarding consumption in the last 30 days, 17.3 percent of students reported at least one episode of binge drinking (five or more drinks). Adolescents reported that they had gotten alcoholic drinks very easily from shops, and also in social contexts with relatives and friends. Only 1 percent of underaged reported that they had tried and could not buy alcoholic beverages. As negative consequences of alcohol use in the last 12 months, students reported feeling sick due to drinking (17.9 percent), regret for doing something under the influence of alcohol (11 percent), blackouts (9.8 percent), and getting involved in a fight after drinking (5 percent). Over half of the students (55 percent) reported knowing someone who had been involved in a car accident because of a drunk driver. CONCLUSIONS: Data showed high prevalence of alcohol use among adolescents studied and how easy access to alcoholic beverages is, including to underaged people. Youngsters put themselves at risk and presented negative consequences of alcohol consumption. Prompt actions regarding public alcohol policies in Brazil are needed.