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Human Papilloma Virus-related risk factors for adolescent and young women. I PhD in Nursing. Nurse at the Ministry of Health. Rio de Janeiro, Brazil. E-mail: mcrismelo4 hotmail. Associate Professor. E-mail: abaqueiroz hotmail. E-mail: maparecidavas yahoo. E-mail: sergiocmarques uol. E-mail: biadargam gmail.

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Rio de janeiro Brazil. E-mail: denniscf gmail. Objective : to identify risk factors for human papillomavirus HPV infection associated with behaviors and attitudes of adolescents and young people at an upper secondary school in Rio de Janeiro. Method : in this quantitative, descriptive study conducted from May to Novemberdata were collected by questionnaire from women from 15 to 24 years old, and received descriptive statistical treatment, which highlighted demographic, economic and behavioral variables.

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: the data indicated resistance to condom use in sexual relations: Another of the participants' characteristics highlighted by the study was the use of a condom in the first relation only. Female condoms were not used by the group studied. Conclusion : the study shows epidemiological data and important sociocultural issues that indicate the need for in-depth research, as well as the nurses' playing a role in new educational strategies deed to be effective in changing behavior and attitudes in these population segments.

Human Papillomavirus HPV infection has been described as the most frequent sexually transmitted disease worldwide. This infection affects preferentially the genital organs such as the vulva, vagina, cervix, penis, perianal areas and also the oropharynx. If left untreated, it may progress to cancer 1. HPV is grouped into genotypes considered of low and high oncogenic risk, in an attempt to establish a relationship between the persistence of the infection, viral types and cervical cancer 2.

HPV is recognized as the main risk factor for cervical cancer, but it cannot be considered the necessary cause for the development of this type of malignant neoplasm 3. HPV infection is one of the most frequent sexually transmitted diseases in the female population 4. Thus, HPV infection is an important public health problem in this population segment 4.

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Several factors may contribute to HPV infection, including those related to the viral nature such as subtypes and viral load; and those related to the host such as onset of early sexual activity, multiparity, use of oral contraceptives, precarious hygiene habits, smoking, inadequate feeding, infections by other sexually transmitted pathogens such as Human Immunodeficiency Virus HIVClamydia Trachomatis and Type 2 Herpesvirus 3.

The of sexual partners that the individual has had during life stands out as the most important factor associated with the acquisition of virus 5. Women under the age of 25 are vulnerable to HPV infection, but persistent infection occurs in women over 50 years of age with immunological deficits and concomitant risk factors 6. Young women experience a of changes that occur not only in their bodies, but also in the social and psychological spheres.

Depending on their experiences, as for example with HPV infection, these changes can generate a lack of identity, disrupt sexuality and affectivity, and hinder the maturation process 8. Adolescent sexuality is considered a dimension of the social context and is also understood as a public health problem because of the risks arising from unprotected sex. The precocity of menarche, the growing exploitation of the topic sexuality by the media, greater sexual freedom and precarious socioeconomic conditions 9 are also pointed out.

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The lack of information and the false idea of not being vulnerable to the situation also prevent young people from adopting preventive measures against risk factors Given this scenario of vulnerability to HPV, it is of fundamental importance that health professionals know the profile and differences of behaviors and attitudes among these individuals, in order to build proposals and strategies with the purpose of reducing morbidity and mortality due to precursor lesions and cervical cancer.

Based on these arguments, this article aimed to identify the risk factors for HPV infection associated with the behaviors and attitudes of adolescents and young people of a high school unit in Rio de Janeiro. HPV infection is considered the most common sexually transmitted disease in the world. More than types of viruses have been described and are distinguished from each other based on the sequence of Deoxyribonucleic Acid DNA It is an epitheliotropic virus, considered a causal agent of cervical cancer and produces oncoproteins that modify cellular behavior The relationship between persistent HPV infection and some viral types and cervical cancer has been established with aid of molecular biology techniques.

These viral types preferentially infect the genital organs vulva, vagina, cervix, penis and perianal areas as well as the oropharynx. However, although HPV is recognized as a fundamental risk factor for cervical cancer, it cannot be considered as the single cause for the development of this type of malignant neoplasm Viruses that infect the genital area are classified into HPV types of low and high oncogenic risk, which are identified by s. The highest risk are those classified as 16, 18, 45, 31, 33, 35, 52, 58, 59, 56, 51, 39, 68, 73 and 82, and the viral types 16 and 18 are the most frequent in adolescents and young women.

HPV types 16 and 18 are associated with High-Grade Intraepithelial Lesion, epidermoid carcinoma and adenocarcinoma of the uterine cervix, as well as anal carcinoma. It is noteworthy that In this context, understanding the relationship between HPV infection and the risk factors associated with this type of infection is essential for the practice of the health professionals, whose role is to establish strategies, such as educational actions among adolescents and young people, to prevent cervical cancer and the acquisition of HPV.

This is a descriptive study with a quantitative approach carried out in a state secondary school of the Municipality of Rio de Janeiro, Brazil, between May and November The population was composed of women selected from group of women aged 15 to 24 years. The participants were in the age group defined by the World Health Organization as youth - from 15 to 24 years - and were enrolled and attending the study scenario 4. We decided to divide the participants into two groups, also based on the Brazilian Institute of Geography and Statistics, which defines young people as individuals aged years The first Barra mansa cock Barra mansa was composed of 64 adolescents belonging to the second phase of adolescence, which is from 15 to 19 years of age; and the second group was composed of 64 young people and in the age group of 20 to 24 years of age This division is justified on the premise that the subjects' behaviors and attitudes emerge from the different life stages Participants were invited to the study and the interviews were scheduled and carried out in a private room in the school itself.

The information collected was stored in a computerized database in the Excel software the Microsoft Office package Subsequently, data were tabulated and submitted to descriptive statistics. The analysis considered the absolute and percentage frequencies, confronted with the scientific literature on the subject. A total of volunteer young women participated in this study, among 64 adolescents and 64 youngsters. The age group between years prevailed among the adolescents, corresponding to As for the educational level, the first year of high school prevailed in in both groupswith Regarding the marital situation, See Table 1.

Rio de Janeiro Brazil. Half of the adolescents had from three to four minimum wages as family income, a fact that was different among youngsters, among whom the income of up to two minimum wages prevailed. At the time Barra mansa cock Barra mansa data collection, In the young segment, See Table 2. TABLE 2: Characteristics related to risk behaviors and attitudes of adolescent and young women towards the human papillomavirus.

Regarding the use of condoms, It is worth noting that In the variable "Use of oral contraceptives", Regarding parity, 3. Regarding the characteristics related to risk behaviors and attitudes, the predominant age of onset of sexual activity was between 14 and 17 years in both groups It should be noted that the profile of the sample indicates the predominance of the age group from 20 to 22 years, brown skinned, enrolled in the first year of high school, single, and with a family income of 3 to 4 minimum wages, as shown in Table 2.

The prevalent age between the two study groups was 17 to 22 years, being this age group the most likely to be infected by HPV. In fact, age is among the most important risk factors for HPV infection, with a higher prevalence among adolescents and young people aged up to 24 years 7.

It is emphasized that the peak of prevalence in this segment can be explained by the greater alternation of partners and early onset of sexual activity. In this context, HPV infection can affect adolescents and youngsters at the onset of sexual activity, a phenomenon that may be transient and that most of the time regresses spontaneously Research has indicated that black and brown races are more susceptible to the prevalence of carcinogenic HPV infection The present study indicates that the white race predominated among the adolescents, and among the young women, the brown color was the one that was more prominent, although there was no statistically ificant difference between groups.

The insertion of in the school environment is a determining factor for the construction of knowledge about certain health problems. The relationship between schooling and vulnerability to HPV is considered a predisposing factor to HPV infection: the lower the Barra mansa cock Barra mansa, the greater is the prevalence of the infection Little information or even lack of information are still considered one of the main barriers to the control of sexually transmitted diseases.

The lack of education influences the perception of risk 21, Another aspect that deserves to be highlighted, in terms of risk factors for HPV, is family income. It was noticed that in both groups, participants with a low income, or between two and four minimum wages, predominated. The of the present study show that half of the adolescents had a slightly higher income, corresponding to three or four minimum wages. As for the young women, we observed that there was a prevalence of lower income among them, equivalent to two minimum wages, since in their case, many reside with their partners and children, and only the partner is the provider of the household.

It should be noted that a low-income population with social and gender inequalities faces obstacles to adopt attitudes favorable to health care Regarding the marital status and sexual partners, although In contrast, In view of these data, it is evident that stable union was more prominent among the young women, due to the age factor, than among the adolescents.

Stability in a relationship is now considered a risk factor for HPV infection. The fact of having a fixed partner le to sexual deprivation because the use of condoms is despised after the relationship becomes stable 8. This usually happens when the relationship is no longer eventual but becomes more permanent, which implies a decrease or even absent use of condoms.

This can occur because of trust or even submission to the partner when it comes to negotiating the continuity of condom use in the relationship. A permanent partnership is defined as a single partner for a longer period of time However, occasional partners, as expressed by the adolescents and youngsters, are also considered risk factors for HPV, both for multiplicity of partners and for non-use of condoms.

Multiplicity of partners was another risk factor found in this study. Thus, the two groups studied are subject to vulnerability due to the frequent exchange of partners, which brings a greater chance of acquiring HPV, especially when the condom is not used in all relations.

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The increased of sexual partners allows for different sexual practices, increasing the possibility of acquiring the infection and the degree of vulnerability In this same direction, it is important to mention the portion of participants who did not use condoms, incurring greater exposure to HPV.

Most women reported never having used condoms. The use of condoms among women is a subject that can be attributed to the affective-sexual relationship, contributing to the decision to use the condom or not 8.

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This is reinforced by the fact that only It is noticeable that the use of condoms can be linked to the intimacy and trust between partners Moreover, the use of refractory condom was also mentioned in the data, by This discontinuous use may be explained by factors such as not liking to use condoms because of the belief that it implies loss of sexual pleasure, because of the belief that the person is not in a situation of Barra mansa cock Barra mansa, forgetfulness, difficulties to acquire condoms, and difficulty to control the sexual impetus typical of adolescents and young people As for the type of condom used by the participants, only the male condom was mentioned.

This reinforces that the female condom is little known, and it is still being disseminated, a fact that also corroborates the submission of women, for they need to negotiate the use of male condoms The age of sexual initiation is an important factor when studying the vulnerability of HPV, since the early onset of sexual activity is one of the factors for the acquisition of HPV. Furthermore, the time of exposure to the virus in this part of the population is enhances the risk situation In the case of oral contraceptives, the majority of participants did not use this contraceptive method.

However, comparing the two segments studied, the young women were the ones that stood out the most with regard to the use of the pill with In view Barra mansa cock Barra mansa the use of contraceptives, and in the case of the condition of stable union that a large part of the young women It is worth mentioning that the prolonged use of oral contraceptives increases the risk of developing cervical carcinoma in women with HPV, since they contain hormones such as dexamethasone, progesterone and estrogens that intensify the genetic expression of HPV With regard to the of births, a small of young women 9.

Multiparity is considered a risk factor for HPV infection, which may result from vaginal trauma during delivery and effects of hormonal changes in the cervix 3. Studies have highlighted the increased prevalence of HPV in women with three to four deliveries and that multiparity can increase by two- or thre-fold the risk of cervical cancer precursor lesions and cervical cancer itself in women infected with oncogenic HPV types 25, In the case of smoking, most participants did not present this habit, a fact that is very positive.

Smoking is considered as an important risk factor for the development of cervical cancer in women who are carriers of oncogenic HPV. This is due to the presence of carcinogenic metabolites of tobacco in cervical secretions, which may lead to the persistence of the virus 26, The objective of the study was fully achieved, as it was possible to survey the socioeconomic characteristics and behaviors of the adolescents and young women that contribute to the vulnerability of these groups to HPV. It was possible to identify that the study participants presented behavioral characteristics of susceptibility to HPV, such as low adherence to the use of male condom and early onset of sexual activity.

However, when comparing the two study groups - adolescents and young women - we concluded that there are differences in relation to risk factors, such as multiplicity of partners, use of oral contraceptives and multiparity, which were more prevalent among young women. Considering the behaviors of adolescent and young women reported in this study, it can be inferred that there is a fragility of educational actions regarding the valuation of the social and cultural context of individuals in relation to protective measures against sexually transmitted infections such as HPV.

More research is needed targeting young women and the possibility of being infected with HPV and development of cervical cancer. Emphasis should be placed on the participation of nurses as health professionals in the search for new strategies for preventive and educational actions, aiming at effective change in the behavior and attitudes of these population segments, recognizing not only statistical data but also biopsychosocial issues.

The study contributes to innovations and to the need to implement strategies for preventive practices, valuing knowledge and making it possible to meet the needs of adolescents and young women regarding protection against sexually transmitted infections. As a limitation of the study, only adolescent and young women participated in the study, not allowing the comparison between male and female individuals regarding socioeconomic issues and behavioral attitudes towards HPV infection.

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