O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto. / The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman\'s point of view.

INTRODUÇÃO: A continuidade das elevadas taxas de sífilis congênita (SC) no Brasil é preocupante, apesar do fácil diagnóstico e tratamento. Os objetivos deste estudo foram: descrever características sociodemográficas, clínico-laboratoriais, assistência ao pré-natal e terapêutica específica das gestantes com sífilis; descrever características clínico-laboratoriais, terapêutica específica e desfecho dos recém-nascidos expostos à sífilis; estimar taxa de incidência anual de SC; estimar frequência de SC entre os recém-nascidos e conceptos expostos; identificar fatores associados à ocorrência de SC entre os conceptos e recém-nascidos expostos. MÉTODOS: Estudo transversal com 149 gestantes com sífilis e 152 recém-nascidos / conceptos expostos, no município de Itapeva (SP), de janeiro de 2010 a dezembro de 2014. Os casos foram identificados pela Vigilância Epidemiológica (VE) e por busca ativa nas Unidades Básicas de Saúde, Centro Materno Infantil, Serviço de Ambulatório Especializado em Infectologia e Santa Casa de Misericórdia. Foi realizada coleta de dados das fichas de notificação de sífilis em gestante (SG) e SC e de prontuários das gestantes e recém-nascidos. Para avaliar a associação de SC com variáveis de interesse, foram calculadas razões de prevalência (RP) e IC95%. Na análise multivariada foi utilizado modelo de regressão de Poisson com variância robusta com nível de significância de p < 0,05. RESULTADOS: A média de idade das gestantes foi 24,3 anos. Oito gestantes não fizeram pré-natal, maioria iniciou pré-natal com idade gestacional <= 13 semanas, realizou mais de seis consultas e 97,2% realizou teste não treponêmico; 57% com resultado VDRL > 1:4. O diagnóstico de sífilis foi feito no momento do parto/curetagem em 11,4% das gestantes; no segundo trimestre da gravidez em 20,8% e no terceiro trimestre em 8,7%. Entre as 132 mulheres diagnosticadas durante a gestação, 77,2% recebeu tratamento adequado >= 30 dias antes do parto; 31,7% fizeram o VDRL mensal para controle de cura. Quanto aos parceiros, 48,3% foi tratado inadequadamente ou não tratado. Ocorreram dois abortos e três natimortos. Em relação aos 147 recém-nascidos vivos, 29,9% foram prematuros, 35,4% teve baixo peso e 51% apresentou sinais de SC ao nascer. Somente 132 recém-nascidos realizaram pelo menos um exame VDRL, com resultado positivo em 65,3%; 55,1% dos recém-nascidos receberam tratamento para sífilis, e a maioria (91,4%) iniciou tratamento no dia do nascimento. Ocorreram cinco óbitos por SC. O pesquisador confirmou 101 casos de sífilis congênita, dos quais 62 foram notificados à VE. Dez crianças apresentaram sequelas. As taxas de incidência de SC foram: 15,1/1.000 NV (2010); 12,1/1.000 NV (2011); 15,6/1.000 NV (2012); 9,1/1.000 NV (2013) e 22,3/1000 NV (2014). Na análise bivariada, tabagismo, <6 consultas pré-natal e idade gestacional >=14 semanas ao diagnóstico de sífilis foram associados à ocorrência de SC. No primeiro modelo da análise multivariada, a idade gestacional ao diagnóstico e o tabagismo foram independentemente associados à SC. No segundo modelo, idade gestacional ao diagnóstico, número de consultas no pré-natal e resultado do primeiro VDRL foram independentemente associados à ocorrência de SC. CONCLUSÃO: As taxas de incidência de SC encontradas pelo pesquisado foram maiores que as informadas pela VE. Os resultados sugerem subnotificação de SG e SC / INTRODUCTION: The continuity of high rates of congenital syphilis (CS) in Brazil is worrying, despite simple diagnosis and treatment. This study had the following objectives: To describe socio-demographic characteristics, clinical laboratory results, prenatal assistance and specific therapy of pregnant women with syphilis; To describe clinical-laboratory characteristics, specific therapeutics and outcome of newborns exposed to syphilis; To estimate annual incidence rate of CS; To determine CS frequency among newborns and proved conceptus; and To identify factors associated with the occurrence of CS between the conceptus and exposed newly born. METHODS: A cross-sectional study was carried out with 149 pregnant women with syphilis and 152 newborns / proved conceptus, in Itapeva (SP), from January 2010 to December 2014. Cases were identified by Epidemiological Surveillance (ES) and by active Basic Health Units, Maternal and Child Center, Specialized Clinic in Infectious Diseases and Santa Casa de Misericórdia. All data were collected from the records of syphilis notification in pregnant women and CS and the records of pregnant women and newborns. To assess the association of CS with variables of interest, prevalence, and 95% confidence interval were calculated. In the multivariate analysis, we used a Poisson Regression Model with robust variance with a significance level of p < 0.05. RESULTS: The mean age of pregnant women was 24.3 years. Eight pregnant women did not get prenatal exams, most started prenatal with gestational age <= 13 weeks, performed more than six medical appointments and 97.2% showed the non-treponemal test; 57% with VDRL result > 1: 4. The diagnosis of syphilis made at the time of childbirth / endometrial curettage was 11.4% of pregnant women; by the second trimester of pregnancy 20.8% and by the third quarter 8.7%. Among the 132 women diagnosed during pregnancy, 77.2% received adequate treatment >= 30 days before delivery; 31.7% did the monthly VDRL for cure control. As for the partners, 48.3% were treated improperly or untreated. There were two miscarriage and three stillbirths. Regarding the 147 live births (LB), 29.9% were premature, 35.4% were underweight, and 51% presented signs of CS at birth. Only 132 newborns performed at least one VDRL test, with a positive result in 65.3%; 55.1% of the newly born received treatment for syphilis, and the majority (91.4%) started treatment on the day of birth. There were five deaths per CS. The investigator confirmed 101 cases of congenital syphilis, of which 62 were notified to the ES. Ten children had sequelae. The incidence rates of CS were: 15.1 / 1000 LB (2010); 12.1 / 1000 LB (2011); 15.6 / 1000 LB (2012); 9.1 / 1000 LB (2013) and 22.3 / 1000 LB (2014). In the bivariate analysis, smoking, = 14 weeks at diagnosis of syphilis was associated with the occurrence of CS. In the first model of multivariate analysis, gestational age at diagnosis and smoking were independently associated with CS. In the second model, gestational age at diagnosis, the number of prenatal appointments, and the outcome of the first VDRL were independently associated with the occurrence of SC. CONCLUSION: The incidence rates of CS found by the researcher were higher than those reported by the ES. The results suggest underreporting of syphilis in pregnant women and CS

In an age of biomedicine, technologies, drugs, and treatments are expanding in new and diverse ways. Especially relevant to biomedicalization and this research is how such information is conveyed to the public through the media. Medical information is omnipresent in the media through direct-to-consumer (DTC) advertising and regular coverage of health topics in the news. The accessibility and proliferation of medical information provides an important opportunity to examine the ways in which these topics are framed in the media. This research specifically examines the framing of the HPV vaccine, Gardasil in the mass media. In this study, I explore how Gardasil was framed, how gender and sexuality were utilized within such frames, and what groups influenced these frames. I employ frame analysis to examine the presentation of Gardasil in the mass media. Due to the vaccine's intricate connection to gender and sexuality, I examine how these dimensions are utilized and reproduced in such frames. Gardasil was originally approved only for women, making gender a salient aspect of the vaccine. The current body of research examining Gardasil in the media presents data from the time the vaccine was only available to women. Now that the HPV vaccine is approved for men, this research seeks to contribute to a more comprehensive understanding of how Gardasil was framed in the media now that it is available to men and women. And given that Gardasil prevents a sexually transmitted infection (STI) in men and women, it is uniquely tied to issues of sexuality. To analyze Gardasil in the media, I examine newspaper articles, magazine articles, and media representations from stakeholder groups, including DTC advertising, official statements, and group websites. Analysis of key sources indicates that Merck dominated the framing of the vaccine in DTC advertisements and the news media, illustrating the power of the pharmaceutical industry. Findings indicate that the initial marketing of Gardasil constructed the vaccine as uniquely tied to femininity and later, women's empowerment. However, once the drug was approved for men, messages were reframed to appeal to a wider audience. Overall, the media continued to frame the vaccine specifically for women, further constructing HPV as a "woman's disease." The dominant focus on women concomitantly silenced the sexual health of men and sexual minorities. In conclusion, the marketing, discourse, and structural elements of Gardasil make it less accessible to those most in need, therefore contributing to the ongoing problem of cervical cancer and HPV.

Indiana University-Purdue University Indianapolis (IUPUI) / Human papillomavirus (HPV) infection results in serious health issues including cervical, anal, vulvar, penile and oropharyngeal cancers. There are three vaccines against HPV but vaccination rates in the United States remain low. One barrier to uptake is a concern that individuals who are vaccinated may increase their risky sexual behaviors or decrease their use of cervical cancer screenings, an adjustment in perceived level of risk for HPV that can be studied using risk compensation theory. Methods Three distinct studies examined risk compensation after HPV vaccination. A systematic review examined literature from January 1, 2008-June 30, 2015, using three databases. A qualitative study using semi-structured interviews of 22 healthcare providers that assessed their beliefs regarding sexual disinhibition and cervical cancer screening following vaccination. A cross-sectional survey that assessed cervical cancer screening practices, awareness and comfort with recommendations, and knowledge regarding the purpose of a Papanicolaou (Pap) test. Results Twenty articles were included in the systematic review. None of the studies of sexual behaviors and/or biological outcomes found evidence of riskier behaviors after HPV vaccination. Instead, the studies found vaccinated individuals were less likely to report risky sexual behaviors, sexually transmitted infections (STIs), and pregnancy. Qualitative interviews found no healthcare providers believed the HPV vaccine would result in increased risky sexual behavior or decreased cervical cancer screening, and these concerns would not influence their vaccination recommendations. The survey included 291 women 21-35 years old; 62% were non-Hispanic black, 84% had a Pap test in the last three years, and 33% had at least one HPV vaccine. Logistic regression showed that vaccinated women did not have greater odds of having a Pap test in the past three years (OR=1.32; 95% CI=0.66-2.65; p=0.427). However, this odds ratio was significant when controlling for age and race (AOR=3.06; 95% CI=1.37-6.83; p=0.006). Conclusion These studies found no evidence of increased risky sexual behaviors or decreased cervical cancer screening rates after HPV vaccination. Furthermore, vaccinated women showed less evidence of risk compensation. These results should alleviate concerns about administering the HPV vaccination among parents and providers.

All adolescents are vulnerable to get involved in risky sexual behavior but the adolescent in a children’s home is more vulnerable due to excessive pressure from the peer group, dysfunctional family involvement and the high occurrence of sexual abuse. A high number of children in children’s homes were exposed to serious trauma before being admitted to a children’s home and this influences their view of the world and the frame of reference through which problems and challenges are approached. In the children’s home sex education form part of lifeskills programmes that are presented by the social workers. Lifeskills programmes are usually presented to groups and sex education includes information on reproduction and sexually transmitted diseases. The sex education programmes presented by the children’s home and schools do not seem to change the adolescent’s attitude and behavior in terms of sexual aspects. It is necessary to take the adolescent’s needs in terms of sex education into consideration since the adolescent’s search for independence also creates a need to be able to have input in decisions that influences her life. The goal of this research project was to determine the needs of adolescent girls in a children’s home regarding sex education. To achieve this goal a thorough literature study was performed with regard to the developmental needs of adolescents and specifically the developmental needs of adolescents in a children’s home. An investigation was also done on the history of sex education in South Africa and the need for sex education today. The current programmes and sources regarding sex education in South Africa were investigated and information was obtained on the sex education of the child in the children’s home. The researcher attempted to fill the gaps in the literature regarding the needs of adolescents regarding sex education by means of an empirical study. Qualitative information collection techniques were used, namely semi-structured interviews. The empirical study took the form of one-on-one interviews with the assistance of a semi-structured interview schedule with 11 adolescent girls in a children’s home. The respondents were selected by using purposive sampling. The collective case study was utilised as the research strategy since the study focused on understanding a specific social issue (sex education) in a specific population (adolescent girls in the Abraham Kriel Maria Kloppers Children’s Home). Through this the researcher came to the conclusion that adolescent girls in a children’s home have many needs regarding sex education and these needs were identified. Recommendations were made with reference to the conclusions formed that would enable professionals to develop programmes on sex education that are based on the needs of adolescent girls in a children’s home. / Dissertation (MSD (Play Therapy))--University of Pretoria, 2006. / Social Work and Criminology / MSD (Play Therapy) / unrestricted