Background: Sexual and reproductive rights include access to accurate and appropriate information in order to make informed decisions. In the current age of media globalization and Internet, adolescents are exposed to information about sexual health and sexuality from a myriad of sources. The objective of this study was to explore sources of information and adolescent learning about sexual health and sexuality in Santiago, Chile. Methods: Data collection included four focus group discussions with a total of 24 adolescents 18–19 years old, 20 semi-structured interviews with adolescents 16–19 years old, and seven interviews with key informants working with adolescents. Audio recordings were transcribed verbatim and analysed using content analysis. Results: The primary sources of sexual health and sexuality information were parents, teachers and friends, whilst secondary sources included health professionals for females and Internet for males. Information provided by the trusted sources of parents, teachers and health professionals tended to focus on biological aspects of sexuality, particularly pregnancy and sexually transmitted infections. Limited emphasis was placed on topics such as love, attraction, pleasure, relationships, abstinence and sexual violence. Information focused primarily on heterosexual relations and reproduction. Adolescents learnt about relationships and sexual acts through friends, partners and, for many males, pornography. Findings indicate a lack of available information on partner communication, setting personal limits, and contraception, including morally neutral and medically correct information about emergency contraception. Conclusions: This study highlights numerous gaps between adolescent information needs and information provided by parents, teachers and health professionals. The priority these trusted sources place on providing biological information overshadows learning about emotional and relational aspects of sexuality. This biological rationalization of adolescent sexual behaviour neglects the way gender inequality, peer-pressure, coercion, media eroticization and religion influence adolescent sexual decision-making. The heteronormativity of information excludes other sexual orientations and disregards the diverse spectrum of human sexual behaviours. Finally, the limited provision of practical information hinders development of skills necessary for ensuring safe, consensual and pleasurable sexual relations. Trusted adults are encouraged to engage adolescents in critical reflection on a broad range of sexuality topics, dispelling myths, and building knowledge and skills necessary to make informed decisions.

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From disease to desire, pleasure to the pill: A qualitative study of adolescent learning about sexual health and sexuality in Chile.

The article reports Chilean college students’ implicit attitudes toward homosexual men (N = 117), measured through the Implicit Association Test (IAT). The study compared young men and women implicit assessments with those obtained with an explicit measure, the Attitude toward Gay Men (ATG) Scale. Men showed more unfavorable implicit attitudes toward homosexuals than women. However, these differences were not observed when measuring implicit attitudes, showing that both men and women had negative implicit attitude toward homosexual men. These results suggest that the apparent decrease in prejudice revealed in self-reports measures, or associated with certain demographic groups, could conceal the fact that automatic attitudes might not have changed.

/pdf/actitudes-explicitas-e-implicitas-hacia-los-hombres-50vt8weeoy.pdf

Actitudes Explícitas e Implícitas hacia los Hombres Homosexuales en una Muestra de Estudiantes Universitarios en Chile

Objetivo: mostrar el diseno y resultados de la implantacion de una estrategia educativa extracurricular, de tipo participativa, dirigida a mejorar la salud sexual y reproductiva de adolescentes y jovenes en instituciones universitarias cubanas. Metodos: se realizo un estudio de desarrollo con la aplicacion de tecnicas cuantitativas y cualitativas. Se identificaron las necesidades de aprendizaje sobre el tema mediante el modelo de Leiva Gonzalez. Se aplico un cuestionario estructurado en 592 estudiantes de dos instituciones universitarias en La Habana, se realizaron ademas, grupos focales y entrevistas en profundidad a expertos. Resultados: se diseno una estrategia educativa extracurricular conformada por el componente capacitacion y comunicacion articulados entre si y que se desagregan en un conjunto de acciones. Se encontraron deficiencias en la educacion sexual, baja percepcion del riesgo de un embarazo o de contraer alguna infeccion de trasmision sexual, practicas de cambio frecuente de parejas, tanto en sexo masculino, como el femenino; comienzo temprano de las relaciones sexuales y bajo uso del condon, unido a poca comunicacion entre padres e hijos. Conclusiones: el diseno de la estrategia educativa conduce a fomentar un pensamiento responsable sobre salud sexual y reproductiva en los estudiantes. Su implantacion ha sido factible y ha brindado buenos resultados en los adolescentes y jovenes y ademas, hace que los mismos una vez egresados de sus respectivos perfiles de formacion puedan realizar correctamente actividades de promocion, prevencion y educacion para la salud en la poblacion donde trabajen.

/pdf/estrategia-educativa-sobre-promocion-en-salud-sexual-y-47a3rf365d.pdf

Estrategia educativa sobre promoción en salud sexual y reproductiva para adolescentes y jóvenes universitarios

Cervical cancer mortality in Chile is four times higher than in developed countries. We compared the accuracy of human papillomavirus (HPV) DNA testing and conventional Papanicolaou (Pap) testing to detect prevalent precancerous and cancerous lesions in the routine clinical practice of the public health system. Women aged 25 years and older residing in the area covered by three primary care centers of Santiago, Chile, were invited to participate. Eligible women received both HPV DNA (Hybrid Capture 2) and Pap testing. Women positive by either test (Pap: ASCUS+, HC2: RLU/CO ≥ 1.0) underwent colposcopy and biopsy, as did a sample of double-negative women with an abnormal cervix at visual inspection or with risk factors for cervical lesions. Crude and verification bias-corrected sensitivities and specificities were estimated. In total, 8,265 women (98.8% of eligible) had complete screening results. Of these, 10.7% were HPV positive, 1.7% were Pap positive and 1.1% were positive by both tests. In all, 931 (11.3%) women were screen-positive, of whom 94.3% attended colposcopy. Additionally, 295 control women were invited for colposcopy, of whom 78% attended. In all, 42 CIN2, 45 CIN3 and 9 cancers were identified. Verification bias-corrected sensitivity for CIN2+ (95% confidence interval) was 92.7% (84.4-96.8) for HPV and 22.1% (16.4-29.2) for Pap; corresponding specificities were 92.0% (91.4-92.6) and 98.9% (98.7-99.0). In conclusion, in routine clinical practice in a developing country, HPV testing was four times more sensitive for CIN2+ than Pap testing, identifying three times more CIN2+ lesions; HPV testing was easily implemented in our established cervical cancer prevention program.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/ijc.27662

Screening trial of human papillomavirus for early detection of cervical cancer in Santiago, Chile

Evidence on the prevalence of sexual aggression among college students is primarily based on studies from Western countries. In Chile, a South American country strongly influenced by the Catholic Church, little research on sexual aggression among college students is available. Therefore, the purpose of the present study was to examine the prevalence of sexual aggression victimization and perpetration since the age of 14 (the legal age of consent) in a sample of male and female students aged between 18 and 29 years from five Chilean universities (N = 1135), to consider possible gender differences, and to study the extent to which alcohol was involved in the reported incidents of perpetration and victimization. Sexual aggression victimization and perpetration was measured with a Chilean Spanish version of the Sexual Aggression and Victimization Scale (SAV-S), which includes three coercive strategies (use or threat of physical force, exploitation of an incapacitated state, and verbal pressure), three victim-perpetrator constellations (current or former partners, friends/acquaintances, and strangers), and four sexual acts (sexual touch, attempted sexual intercourse, completed sexual intercourse, and other sexual acts, such as oral sex). Overall, 51.9% of women and 48.0% of men reported at least one incident of sexual victimization, and 26.8% of men and 16.5% of women reported at least one incident of sexual aggression perpetration since the age of 14. For victimization, only few gender differences were found, but significantly more men than women reported sexual aggression perpetration. A large proportion of perpetrators also reported victimization experiences. Regarding victim-perpetrator relationship, sexual aggression victimization and perpetration were more common between persons who knew each other than between strangers. Alcohol use by the perpetrator, victim, or both was involved in many incidents of sexual aggression victimization and perpetration, particularly among strangers. The present data are the first to provide a systematic and detailed picture of sexual aggression among college students in Chile, including victimization and perpetration reports by both men and women and confirming the critical role of alcohol established in past research from Western countries.

/pdf/sexual-aggression-victimization-and-perpetration-among-male-589n39f1ml.pdf

Sexual Aggression Victimization and Perpetration among Male and Female College Students in Chile

We studied 4,971adolescents of both sexes aged between 12 and 19 years, who consulted in a clinic for adolescentsbetween the years 1990 and 2005. Several variables related to adolescent sexuality were considered.Uni and bivariate analysis were carried out and a model of stratified lineal regression per sex wasfixed to explain the following variables: age at which sexual activity is initiated, number of sexualpartners, time period between start of dating and the start of sexual activity along time.

/pdf/comportamientos-sexuales-y-diferencias-de-genero-en-2igese04pn.pdf

Comportamientos sexuales y diferencias de género en adolescentes usuarios de un sistema público de salud universitario

Antecedentes: La agresion sexual es un evento traumatico y doloroso que afecta de manera transversal, a las victimas de ambos sexos, de todos los niveles socioeconomicos con graves consecuencias para la salud fisica, psicologica y social para quienes la sufren. Objetivo: Determinar las caracteristicas de las agresiones sexuales y sus consecuencias en adolescentes consultantes en un centro de atencion en Salud Sexual y Reproductiva. Metodo: Estudio analitico de corte transversal de 573 adolescentes atendidas en un centro de medicina reproductiva (CEMERA) en el periodo 2003-2010 y que reportaron antecedente de abuso sexual. Se estudiaron tanto las caracteristicas como las consecuencias del abuso, datos que se obtuvieron desde las fichas clinicas. Resultados: En el 86,5 % de los casos se reporto abuso sexual y en un 13,5% violacion. El 48,5% de los agresores son familiares. La edad mas vulnerable fue entre 5-9 anos con un 41,2%. En el 39,2% el abuso sexual fue reiterado. En un 43,4% el lugar fue el propio hogar de la victima. Un 70% revelo y de estos el 45,9% lo hizo en forma tardia. Solo en un 19% se hizo la denuncia legal. De las adolescentes que iniciaron actividad sexual voluntaria (83,3%), un 35,4% tenia menos de 15 anos. Un 11,8% reporto 3 y mas parejas sexuales. Conclusion: El antecedente de abuso sexual debe ser considerado en la atencion de adolescentes que consultan por salud sexual y reproductiva. El equipo de salud debe estar preparado para atender sus multiples necesidades.

/pdf/caracteristicas-y-consecuencias-de-las-agresiones-sexuales-1o5xoekhxp.pdf

Características y consecuencias de las agresiones sexuales en adolescentes consultantes en un centro de salud sexual y reproductiva

Background: Teenage pregnancy is a psychosocial and multifactorial problem described as a lack of exercise of rights in sexual and reproductive health. There are important aspects in the doctor-patient relationship and confidentiality that directly affect the continuity and quality of care. There are controversies in the laws relating to the provision of contraception and confidentiality, and those that protect the sexual indemnity, especially in adolescents under 14 years. Aim: To describe the implications of the legal framework for professional midwives in the care of adolescents younger than 14 years in sexual and reproductive health. Material and methods: In-depth interviews were conducted to 13 female and 2 male midwives working at Primary Health Care Centers in the Metropolitan Region. Results: The attention of adolescents younger than 14 years in sexual and reproductive health involves medical-legal issues for health professionals. All professionals recognize that mandatory reporting sexual activity is a complex situation. All professionals notify pregnancies. In relation to the delivery of contraception, clinical care is problematic since professionals should take shelter from a legal standpoint. Conclusions: The medical-legal context of pregnant women under 14 years of age care generates a context of uncertainty and fear for professionals and becomes a source of conflict and insecurity in the exercise of the profession.

https://scielo.conicyt.cl/pdf/rmc/v144n10/art04.pdf

Implicancias del marco legal chileno en la prevención del embarazo adolescente: conflicto e inseguridad en los profesionales de la salud

Objetivo: Conocer la frecuencia y describir las caracteristicas de las agresiones sexuales infantiles en adolescentes mujeres ingresadas a la unidad de salud mental de un Centro de Salud Sexual y Reproductiva Adolescente. Metodo: Estudio de diseno transversal y analitico, se revisaron las fichas clinicas entre enero de 2006 y diciembre de 2009. Las variables estudiadas fueron: edad de la agresion, tipo y frecuencia de esta; sexo, edad y tipo de relacion con el agresor; revelacion y persona a la que se le informa de la agresion sexual y denuncia de la agresion. Resultados: La mayor frecuencia de agresion sexual se presenta en la edad pre-escolar (28,1%) y la mas comun es el abuso sexual (73,8%), tipo de agresion que es la mas comun en todas las edades. La mayoria de las agresiones fue un episodio unico (59,3%). La totalidad de los agresores eran conocidos o familiares de la victima, todos varones, el 29,1% eran menores de 18 anos. El 36% nunca revelo la agresion sufrida. El 31,8% de las agresiones sin revelar ocurrieron en la edad pre-escolar. Solo un 14,1% realizo denuncia. Conclusion: La mayoria de las agresiones sexuales ocurridas durante la infancia y adolescencia no son reveladas, ni denunciadas legalmente, manteniendo un alto nivel de silenciamiento y dificultades por parte de los equipos de salud para apoyar y tratar a las victimas.

/pdf/perfil-epidemiologico-de-adolescentes-mujeres-con-1f0szr23xr.pdf

Perfil epidemiológico de adolescentes mujeres con antecedentes de agresión sexual consultantes en el área de salud mental de un centro de salud sexual y reproductiva

Carolina Leyton M

Papers

Comportamientos sexuales y diferencias de género en adolescentes usuarios de un sistema público de salud universitario

Características y consecuencias de las agresiones sexuales en adolescentes consultantes en un centro de salud sexual y reproductiva

Implicancias del marco legal chileno en la prevención del embarazo adolescente: conflicto e inseguridad en los profesionales de la salud

Perfil epidemiológico de adolescentes mujeres con antecedentes de agresión sexual consultantes en el área de salud mental de un centro de salud sexual y reproductiva