In the United Kingdom (UK) there is easy access to a wide range of contraceptive methods, available at no cost. In addition, oral emergency contraception (EC) (1.5 mg levonorgestrel) is now widely available from the community pharmacy. In spite of this, unintended pregnancy is common. In 2014 in England and Wales, 184,571 induced abortions were performed, and in Scotland, the corresponding figure was 11,475. Long acting reversible methods such as contraceptive implants and intrauterine contraception, are amongst the most effective methods available and National Institute for Health and Care Excellence (NICE) recommends that increased uptake can lead to fewer unintended pregnancies. However, uptake of long acting reversible contraceptive (LARC) methods remains low. The majority of women who require to use EC do so following unprotected sex or an accident with a condom. Increasingly women in Great Britain prefer to attend a pharmacy for EC rather than a sexual and reproductive health (SRH) service or general practitioner (GP). Starting an effective on-going method of contraception after EC use is clearly important if women are to avoid unintended pregnancy. Community pharmacists in the UK and most other high income countries are usually unable to provide any on-going contraception except condoms. So we have created a situation where EC is provided almost solely from settings where other more effective methods of contraception cannot be immediately provided. Novel strategies are therefore required to facilitate both uptake and continuation of the most effective methods of contraception, in order to prevent unintended pregnancy for more women. This thesis presents a mixture of biomedical, clinical and health services research to evaluate a series of strategies aimed at improving uptake of the most effective methods of contraception. Two studies investigated patient knowledge and information provision relating to contraceptive methods. The first sought to determine if women held misconceptions about intrauterine methods of contraception, and revealed that although myths persist in a small number of women, a lack of knowledge about these methods was also evident. The second study aimed to determine if the use of a digital video disc (DVD) to provide contraceptive information was acceptable and informative to women, and identified that it is, and could possibly enhance patient consultations. Studies three, four and five investigated strategies aimed at increasing the uptake of effective on-going contraception, following emergency contraception provided from a community pharmacy, and patient and health care provider attitudes to such approaches. They showed that simple interventions such as supplying one month of a progestogen only pill (POP), or offering rapid access to a family planning clinic (FPC), hold promise as strategies to increase the uptake of effective contraception after EC and that both women and clinicians were positive about such measures. Additionally, the problems encountered in conducting these studies provided valuable feedback to inform further development of research methods in the community pharmacy setting, and larger scale studies of such interventions. Community SRH services may be well placed to deliver more abortion care in the UK, and consequently this may result in greater uptake of contraception post abortion. Study six aimed to determine the views of health professionals working in SRH regarding their attitudes towards providing more abortion services and also the views of staff within one community SRH centre in Scotland where a service providing early medical abortion was due to commence. It showed there is clear support amongst health professionals in community SRH in the UK towards greater participation in provision of abortion care services.

The concept of responsible sexual behavior (RSB) gained popularity when it was introduced in Healthy People 2010 as a leading health indicator. The Healthy People initiatives organize the top health priorities and create guidelines for improving the health of Americans. Promoting RSB was intended to address problems such as unintended pregnancy and sexually transmitted infections (STIs), however the guidelines never conceptually define behavior that would be considered sexually responsible. Thus, the purpose of this dissertation research was to examine how responsible sexual behavior (RSB) was defined in the context of public health literature, collegiate women, and rural women with the intention to contribute to a clearer conceptual understanding of RSB. First, an evolutionary concept analysis was conducted to define the attributes of RSB and develop a conceptual definition of responsible sexual behavior (RSB) as it applies to women 18 years and older who have sex with men from a synthesis of lay and public health literature. According to the literature, RSB is a desirable and deliberative pattern of behaviors that promote sexual health, manage risk, and foster respect of sexual partners within the context of community influences. This study also concludes that a purposeful redefinition maybe necessary to maintain a concept that is useful for guiding and evaluating sexual behavior. Second, a secondary data analysis was completed to identify college women definition of “sexual responsibility.” Data came from interviews collected as part of a mixed methods study of college women and unintended pregnancy. A total of 35 interviews were analyzed using within and across case methodology to derive a working definition of RSB for collegiate women. Women in this sample described being sexually responsible as self-advocating through actions that were consistent with personal goals and values while being aware of consequences that could threaten those goals or values. Actions included mindful partner selection, communicating boundaries, and preventing pregnancy. Women’s academic goals were closely linked to women’s sexual health decision making. Third, an exploratory descriptive study was completed to identify how rural women who have sex with men define RSB and to understand the role of the rural context on definitions and enactment of RSB. A total of ten rural Iowa women aged 18-29 participated in phone interviews. Within and across case analysis was used to describe the contextual influences of how rural dwelling women defined and enacted responsible sexual behavior. For rural women in this sample, RSB is understanding the consequences of sex and taking action to manage risks by preventing pregnancy and STIs, mindfully selecting of partners, and seeking appropriate resources. The social context of the rural environment acted as both a facilitator and barrier for women to acquire information enact RSB. In conclusion, RSB was an accessible concept for college and rural women to define and understand. However, the collective research indicated that a new definition of RSB was necessary to maintain its purpose in improving sexual and reproductive health. Thus, being sexually responsible is having an awareness of consequences and managing risks in a way that is reflective of a woman’s personal experiences, beliefs, values, and goals. How BSR is defined is fluid and subject to redefinition based on personal experiences and movement through the lifespan. Future research should focus on understanding how other populations of women define and manage BSR and that public health interventions and policy support women’s ability to be sexually responsible.

The purpose of this research project was to determine if there was a significant difference between women who had unplanned pregnancies and the amount of information those women received about their pregnancy options regarding parenting, adoption, and abortion, and those who were not. Additionally, the level of information about pregnancy options, and whether it would reduce termination of pregnancies was examined. The aspects explored included the information available to clients and the decision making process for women who have experienced an unplanned pregnancy. The methods for this study involved using an anonymous survey via Survey Monkey. Additionally, this study examined the importance of clients being informed and the role information plays in the social work field. A detailed examination of the research which has been conducted in pregnancy options counseling and what that counseling consists of was conducted and discussed. An overview of "Woman’s Right to Know Laws" was also addressed and what theories have an impact on what woman experience during an unplanned pregnancy. Finally, an independent samples t-test was conducted to determine if there were significant differences between groups of women who had chosen to keep and parent their child, those who chose to have an abortion, and those who chose to relinquish their child for adoption and the amount of information they received about their pregnancy options. The study found a significant difference between women who chose to parent their children and women who iv chose to have an abortion in terms of the level of information they were provided about those options. The abortion group received significantly more information about abortion than the parenting group. This may be due to the type of information received being more about cost and recovery periods versus the actual abortion procedure and mental health concerns post-abortion. Based on the findings, most women know what they will do in the case of an unplanned pregnancy and only a significant intervention will change their course of action. Based on the findings, educating women about their pregnancy options will not change their decision to keep, abort or relinquish their child for adoption. Instead, prevention efforts are more effective in preventing abortion than providing them with information.

In the United States, the rates of unplanned pregnancies and sexually transmitted diseases, including HIV infection, caused by unprotected sex is alarmingly high. Adverse outcomes of unprotected sexual intercourse continue to be a burden, not only for affected adolescents but for the community at large. Using data from the National Longitudinal Study of Adolescent Health, this study applied the PRECEDE model as a means to identify those salient risk factors and risk conditions of sex initiation and engagement in unprotected sex among adolescent students. Results showed that 52.6% of the students have had sexual intercourse and 54.5% of sexually experienced students reported inconsistent condom use during sexual intercourse. Logistic regression analysis showed that risks factors for having had sexual intercourse differ from those for having engaged in unprotected sex in sexually experienced students. Furthermore, these factors also differed between male and female students. Only students’ age and perceived hardships related to pregnancy were found to be common risk factors for both outcomes in both sex groups. Results suggest that the PRECEDE is a practical tool to aid program planners identify the intervention priorities most relevant to their target populations.

Diante da importância que a gravidez não planejada vem adquirindo no cenário mundial, apesar da melhoria nas tecnologias contraceptivas e ampliação do acesso aos serviços de saúde e métodos contraceptivos, faz-se necessário mensurar com maior precisão este fenômeno. Por esta razão, pesquisadores da área de saúde sexual e reprodutiva têm procurado desenvolver medidas que possam oferecer estimativas confiáveis de mulheres que vivenciam a gravidez não planejada. A maior parte dos instrumentos utilizados para mensurar a gravidez não planejada são unidimensionais e não levam em consideração a parceria, a intencionalidade ou o uso de métodos anticonceptivos de forma simultânea, aspecto não observado no London Measure of Unplanned Pregnancy (LMUP), desenvolvido no Reino Unido. Nesse contexto, este estudo transversal tem como objetivo traduzir e adaptar o instrumento LMUP para a língua portuguesa e validar suas propriedades, visando à sua utilização como instrumento de mensuração de gravidez não planejada no Brasil. A adaptação cultural e validação do LMUP foram realizadas conforme o método preconizado pela literatura. O cenário de estudo foram unidades da rede de Atenção Básica do município de Marília-SP. A população de estudo foi composta por 126 mulheres com idade 18 e 42 anos, usuárias dessas unidades, que procuraram a Unidade para confirmação do diagnóstico da gravidez por meio de um teste imunológico para gravidez cujo resultado foi positivo. Os resultados obtidos demonstraram que em relação às propriedades psicométricas, o instrumento apresenta um valor de apha de Cronbach de 0,75 para a escala total. A análise fatorial exploratória dos componentes principais do instrumento LMUP na versão Português aqui apresentada resultou em um único fator, que explicou 66,5% da variância total dos dados. As propriedades psicométricas do instrumento foram demonstradas e, portanto ele pode ser utilizado para mensurar a gravidez não planejada na população brasileira. / Facing the impact that unplanned pregnancy is acquiring world wide, despite the improvement in contraceptive technologies and increasing access to health services and contraceptive methods, it is necessary to measure this phenomenon more accurately. For this reason, researchers in the sexual and reproductive health field have sought to develop measures that can provide reliable estimates of women experiencing unplanned pregnancies. Most instruments used to measure the unplanned pregnancy are unidimensional and do not take into account the partnership, the intent or the use of contraceptive methods simultaneously, a not observed aspect at London Measure of Unplanned Pregnancy (LMUP), developed in the United Kingdom. Thus, this cross-sectional study is aimed to translate and adapt the instrument LMUP to Portuguese and validate its properties, aiming at its use as an instrument for measuring unintended pregnancy in Brazil. Cultural adaptation and validation of LMUP were done according to the method recommended by the literature. The scenery for the study was units of the network of Primary Care in Marília-SP. The studied population consisted of 126 women aged between 18 and 42 years, users of these units, who sought for this Unit to confirm the diagnosis of pregnancy by means of an immunological test for pregnancy and the result was positive. The results showed that in relation to psychometric properties, the instrument has a Cronbach\'s alpha value of 0.75 for the total scale. The factor analysis of the main components of the LMUP to the Portuguese version presented here has resulted in one factor, which explained 66.5% of the total variance of the data. The instrument\'s psychometric properties were demonstrated, and, therefore, it can be used to measure the unplanned pregnancy of the Brazilian population.

Aspects of ADHD, such as inattention, may be predictive of unplanned pregnancy. An unplanned pregnancy can have negative effects on both maternal and child health. Women surprised by pregnancy may not be physically, emotionally, or financially capable of caring for a child and may postpone or neglect prenatal care.In 2006, approximately 49% of pregnancies were unplanned in the United States. Furthermore, in Tennessee, the percentage was even higher with 56% of pregnancies being unintended. Maternal Attention Deficit Hyperactive Disorder (ADHD) has been linked to decreased female contraceptive use and to increased risky sexual behavior. Failure to use contraception significantly increases the risk of unplanned pregnancy. This study examined inattention (a characteristic known to be elevated in individuals diagnosed with ADHD) and risk factors (i.e., marital status, education, depression) associated with unplanned pregnancy in Appalachian women. Information was collected from pregnant women recruited from Southern Appalachia as part of the Tennessee Intervention for Pregnant Smokers Program. As part of the larger study, women completed detailed research interviews upon entry into prenatal care. A total of 457 pregnant women had responses on the measures of interest in the current investigation. Logistic regression was performed to assess the ability of Inattention (determined by the Current Symptoms Scale) to predict the probability of a woman experiencing an unplanned pregnancy. The full logistic regression model containing all predictors was statistically significant Χ2 (7, N=457) = 92.35, p <.001 indicating that the predictors as a set reliably distinguished between those women who did, and did not, have an unplanned pregnancy. Inattention had an Adjusted Odds Ratio of 1.76, CI (1.09, 2.86) p =.02 indicating that controlling for the other variables in the model, those women who scored high on the Inattention measure were significantly more likely to experience an unplanned pregnancy. This model correctly classified 76.8% of participants. Additionally, consistent with previous research findings, women who were unmarried and had lower levels of education were also significantly more likely to have an unintended pregnancy. Furthermore, women who reported higher levels of depressive symptoms were significantly more likely toexperience an unplanned pregnancy. Ages and at-risk alcohol use (TACE) were also examined in this study but did not significantly contribute to the model. These results confirm that known risk factors were also found in this population. This study found that inattention predicted unplanned pregnancy. Because inattention is one aspect of ADHD, this could suggest that women diagnosed with ADHD would be more likely than others to experience an unplanned pregnancy. Identifying risk factors can assist health practitioners to target women who are at risk for unplanned pregnancy for purposeful discussion on contraceptive options.

A gestação, o parto e o puerpério são saberes especiais no universo da mulher, do parceiro, da família e de sua comunidade. A gestação pode gerar diversos sentimentos, tais como: o de surpresa, o de castigo, o de prêmio, o de motivação para continuar a viver, o de realização de um projeto antigo, o de competição em família, o de problema, o de estorvo, o de descuido ou de irresponsabilidade. Confirmada a gravidez, a mulher, o parceiro e os familiares podem vivenciar diferentes reações diante dessa novidade. A reação inicial depende do desejo e planejamento da gravidez (gestação), podendo ser desejada, planejada, ou acidental, não planejada e, até mesmo indesejada. Gravidez não planejada é toda a gestação que não foi programada pelo casal ou, pelo menos, pela mulher. A sua ocorrência tem impacto importante na oferta de cuidados de pré-natal, na orientação sobre aleitamento materno, no estado nutricional infantil e nas taxas de morbimortalidade materno-infantil. Embora pouco estudada, a gravidez não planejada representa risco aumentado de ansiedade e de depressão, sobretudo no período puerperal. Tendo em vista estes aspectos, o objetivo deste estudo foi compreender como as gestantes vivenciaram/experienciaram uma gravidez não planejada e suas consequências à vida familiar/conjugal. O estudo baseou-se na metodologia de análise de dados qualitativos, na análise destes dados, utilizou-se a abordagem metodológica do Discurso do Sujeito Coletivo (DSC), por meio do software Atlas.ti. A população em estudo foi constituída de gestantes em idade fértil, entre 18 e 49 anos de idade, pois essa faixa etária assegura maioridade às mulheres. Foi utilizada para organizar os dados verbais, entrevista semiestruturada, realizada com 11 gestantes. Partindo dos depoimentos das gestantes copiados no software, a análise dos discursos teve início com a identificação das expressões-chave, nas quais estão contidas as ideias centrais de cada discurso que foram escritas de forma breve e objetiva. Foi evidenciado que as gestantes apresentaram reações iniciais negativas com relação à descoberta da gravidez não planejada, vivenciaram conflitos, devido ao medo de enfrentar a família, o companheiro e os pais. Também ficou evidente que a gravidez não planejada tem como principal consequência a problemática nos níveis biopsicossociais. Evidenciaram altos níveis de ansiedade, estresse e depressão no decurso da gestação. Quanto aos métodos contraceptivos, a maioria estava em uso quando da descoberta da gravidez. Considera-se que este estudo ganha relevância pelo impacto que exerce sobre o bem-estar pessoal, familiar e socioeconômico das mulheres e seus companheiros, em virtude das possíveis gestações não planejadas / Pregnancy, childbirth and the postpartum period are special knowledge in the world of woman\'s partner, family and your community. Pregnancy can cause many feelings, such as: the surprise, the punishment, the premium, the motivation to continue living, the realization of an old design, the competition in the family, the problem of the hindrance, to carelessness or irresponsibility. Confirmed pregnancy, the woman, her partner and family members may experience different reactions to this news. The initial reaction depends on the planning and desire of pregnancy (gestation), and may be desired, planned or accidental, unplanned and even unwanted. Unplanned pregnancy is any pregnancy that was not planned by the couple, or at least the woman. Its occurrence has important impact on the provision of prenatal care, the guidance on breastfeeding, the nutritional status and rates of maternal and child morbidity and mortality. Although little studied, unplanned pregnancy is increased risk of anxiety and depression, especially in the postpartum period. Considering these aspects, the aim of this study was to understand how pregnant women experienced / experienced an unplanned pregnancy and its consequences for family life / marriage. The study was based on the methodology of qualitative data analysis, the analysis of these data, we used the methodological approach of the Collective Subject Discourse (CSD), using the software Atlas.ti. The study population consisted of pregnant women of childbearing age, between 18 and 49 years of age, because this age ensures age women. Was used to organize the verbal data, semi-structured interviews conducted with 11 pregnant women. Based on the testimonies of the women copied the software, discourse analysis began with the identification of key expressions, in which are contained the main ideas of a speech that was written briefly and objectively. It was shown that pregnant women had initial negative reactions regarding the discovery of unplanned pregnancy, experienced conflict due to fear of facing the family, spouse, and parents. It was also evident that unplanned pregnancy is mainly due to problematic levels biopsychosocial. Showed high levels of anxiety, stress and depression during pregnancy. As for contraception, the majority was in use when the discovery of the pregnancy. It is considered that this study becomes relevant for the impact it has on the well -being, family and socioeconomic status of women and their partners, because of possible unintended pregnancies

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Background: To date, little information exists about contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. Identifying existing curricula, including influences on whether and how curricula are delivered, is an essential starting point for evaluative processes. Purpose and Objectives: The purpose of this study was to explore contraception counselling, unplanned pregnancy counselling, and abortion services curricula in Ontario medical schools. The objectives were to 1) identify the existence of such curricula in undergraduate (preclinical, obstetrics and gynecology clerkship, and family medicine clerkship) and post-graduate (obstetrics and gynecology and family medicine) programs; and 2) explore factors influencing the existence and form of these curricula from the perspective of program directors. Design: An exploratory qualitative approach was used for this study whereby, Ontario program directors responsible for contraception counselling, unplanned pregnancy counselling, and abortion services curricula were interviewed. Results: Overall, the inclusion of routine curricula in contraception counselling, unplanned pregnancy counselling, and abortion services was limited and variable between schools, as well as within clerkship and post-graduate programs. Program directors were often uncertain about iii whether such routine curricula were present in their programs. Four factors were found to influence whether these curricula were included in a program: 1) program structure, 2) program resources, 3) the interests of residents/students, and 4) personal philosophy of the program director. A typology was developed to understand how program directors resolved uncertainty when asked about the existence of these curricula in their programs. The emergent sensemaking typology revealed strategies used by directors to either justify the current system of medical teaching (i.e., defending the status quo) or support change (i.e., responsive). Program directors were consistent across programs in terms of the factors they identified as influencing the curriculum offered. The perceived impact of these factors varied according to the sensemaking processes employed by each director. Conclusions: This study provides an outline of curriculum variability within and between medical school programs. Further, if offers a typology of the ways program directors explain their uncertainty regarding the inclusion of these curricula in their programs. In so doing, program director sensemaking as a key influence on the curriculum is revealed.

Made available in DSpace on 2015-05-14T13:16:21Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 2344571 bytes, checksum: a34cac467b290bb43b44cd146c6b32a7 (MD5) Previous issue date: 2013-03-07 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Questões socioculturais e econômicas aumentam a vulnerabilidade dos jovens à infecção pelas DSTs/HIV e ao risco de uma gravidez não planejada, devendo ser abordados nas estratégias de prevenção, tendo em vista que a educação se desenvolve em espaços formais e não formais desde que haja interação entre as pessoas e saberes. Partindo destes pressupostos, este estudo está fundamentado na teoria da Vulnerabilidade e na teoria do Comportamento Planejado, tendo como objetivo elaborar e verificar os efeitos da aplicação de uma estratégia de intervenção psicoeducativa para a prevenção das DSTs e gravidez não planejada para adolescentes jovens, enfocando de modo abrangente e integrado os aspectos da vulnerabilidade individual, social e programático. Trata-se de um estudo com delineamento quase-experimental com grupo de controle, que se divide em 03 estudos: (1) Construção e Validação de um instrumento de avaliação da percepção de vulnerabilidade adolescente jovem para uso no pré e pós-teste. (2) Construção de uma estratégia de intervenção psicoeducativa. (3) Aplicação e avaliação da intervenção psicoeducativa. A população do estudo é constituída por jovens de 14 a 24 anos, matriculados em escolas públicas e privada de ensino médio da cidade de João Pessoa. Para o primeiro estudo, a amostra foi constituída por 432 estudantes, no qual foi aplicada a escala de Percepção frente à Vulnerabilidade. A escala foi construída através das bases teóricas da teoria da Vulnerabilidade e os seus itens foram delineados a partir de estudo anterior. A partir da Análise Fatorial dos Componentes Principais e o alpha de Crombach, obteve-se um instrumento com 29 itens, dividido em três fatores de vulnerabilidade individual, social e programático -, confirmando os pressupostos teóricos e evidencias empíricas. No segundo estudo foi construída uma intervenção psicoeducativa nos moldes de oficinas, com base na Teoria da Vulnerabilidade e Teoria do comportamento Planejado. A intervenção resultou em três encontros em dias consecutivos no qual foram discutidas a iniciação sexual, as ideologias de gênero, negociação e uso do preservativo, DST e gravidez, crenças e normas sociais. Para análise dos resultados foram gravados os 15 minutos finais de cada dia, no qual foi discutida a percepção dos participantes sobre a intervenção, transcritos e analisados por categorização temática. Os dados demonstraram sua adequação ao publico alvo. O terceiro estudo ocorreu em quatro instituições escolares pública e privada, onde foram formados randomicamente dois grupos (experimental e controle), compostos em média por 10 alunos, equiparados em relação a sexo. Após a aplicação do pré-teste, o grupo experimental participou da oficina psicoeducativa, enquanto para o grupo controle foram realizadas palestras informativas. Os debates realizados no grupo experimental foram gravados (autorização dos participantes). Passados 4 meses da intervenção, foi aplicado o pós-teste, cuja eficácia foi verificada através do test t para amostras emparelhadas. Para os dados qualitativos referentes aos relatos dos participantes durante o processo de Intervenção Psicoeducativa, foi utilizada Análise Categorial Temática. Os resultados provenientes do grupo experimental e controle demonstraram que a intervenção psicoeducativa se mostrou eficaz na mudança da percepção de vulnerabilidade individual (p<0,05), decréscimo no primeiro e aumento no segundo grupo. No que tange os dados qualitativos emergiram quatro Classes Temáticas: Vulnerabilidade Social (Crenças Normativas); Vulnerabilidade Programática (Acesso ao Insumo); Vulnerabilidade Individual (Uso do Preservativo, Crenças de Gênero e Informação); e Ressignificação após Intervenção (Autopercepção e Autocuidado). Conclui-se, portanto, que a presente pesquisa alcançou o objetivo proposto, demonstrando a necessidade de intervenções que priorize as relações intersubjetivas, o que possibilita a construção de sujeito-cidadão.