Prevención de los comportamientos sexuales de riesgo en los adolescentes: SIDA, otras enfermedades de transmisión sexual y embarazos no deseados

Resumen

En la actualidad, los adolescentes son uno de los grupos que por sus características conductuales, cognitivas y sociales, se encuentran en mayor riesgo frente al posible contagio con el VIH. Esta amenaza para la salud y el bienestar de los adolescentes, se ha venido a sumar a otros problemas ya existentes en este colectivo: los embarazos no deseados y las enfermedades de transmisión sexual (ETS), que también se derivan de la no utilization de precauciones en las relaciones sexuales

En este trabajo se exponen diversos factores biológicos, psicológicos (conductuales y cognitivos) y sociales que pueden facilitar, dificultar o impedir los comportamientos sexuales de prevención de los adolescentes, y se revisan y valoran algunas de las intervenciones preventivas realizadas. A partir de esta revisión se argumenta sobre la conveniencia de unificar los programas para la prevención simultánea de los tres trastornos, maximizando de esta forma los recursos disponibles

Abstract

At present, adolescents are a group which due to their behavioural, cognitive, and social characteristics, run the greatest risk of possible contagion. This threat to the health and well-being of adolescents is added to other problems already facing them, such as unwanted pregnacies and sexually transmitted diseases (STD), which are due to the non-use of preventive methods in sexual relations. The paper deals with biological, psychological (behavioural and cognitive), and social factors that may facilitate, interfere with or impede preventive sexual behaviours in adolescents. Some preventive intervention programmes are also reviewed and assessed. The discussion supports the advisability of unifying programmes aimed at the simultaneous prevention of all three risk areas to optimize available resources

Extended Summary

Adolescents are, today, one of the groups which due to their behavioural, cognitive and social characeristics, run the greatest risk of possible HIV contagion. This threat to the health and well-being of adolescents is added to other problems already facing this group: unwanted pregnancies, sexually transmitted diseases (STD), which also derive from the lack of prevention in sexual relations.

The article presents different biological, psychological (behavioural and cognitive), and social factors that can facilitate, interfere with or impede preventive social behaviour in adolescents. It also reviews and evaluates some preventive intervention programmes that have been carried out.

Among biological factors, drug use (both legal and illegal, stimulants and depressors) negatively influences preventive sexual behaviours. With respect to Psycho-behavioural factors, it seems that an increase in the use of oral contraceptives by adolescent females is in detriment to the use of other methods of contraception, such as condoms. This means that the triple effectiveness of the latter (in terms of preventing pregnancies, STD, and AIDS), benefitial to both members of the couple, is wasted. In addition, male adolescents are frequently hostile to using contraceptives as they reduce pleasurable sensations. In terms of Psychocognitive factors, information is a necessary but insufficient factor for initiating and/or mantaining preventive behaviours which are also influenced by other factors, such as: risk perception, belief in one's own invulnerability, and expectations both towards results and effectiveness of the preventive method adopted (together with their ability of putting them into practice correctly). Other factors that also negatively affect preventive sexual behaviours are: low self-esteem, poor assertiveness and communication abilities. Finally, in relation to social factors, peer-pressure—both in favour and against prevention—exerts a decisive influence on whether an adolescent decides to adopt preventive methods or not. Likewise, belonging to economically and culturally disfavoured social groups makes prevention more difficult due to poor material (price of male contraceptives) and educational resources.

From this review, the discussion supports the advisability of unifying current intervention programmes so that it may be possible to simultaneously prevent sexual risk behaviours and their corollaries, thus maximizing available resources. Such programmes should take into account the following aspects:

—	The need to approach adolescents through education centres, youth clubs, etc., for in general they are unaware of the dangers they are exposed to, they may also be afraid or embarrassed to talk about their worries, and/or they may simply not know where and how they may get help.
—	Intervention programmes should not be restricted to distributing information, they should also facilitate the acquisition of preventive behaviours and make resourses available.
—	Intervention programmes should cover all possible levels of prevention: primary, secondary, and tertiary.
—	Finally, the success of intervention programmes should be evaluated through assessment of behavioural changes that have taken place; either through the use of adolescents' self-reports, or through the knowledge of the incidence of pregnancies and STD among adolescents in the programme.

Palabras clave:

• Adolescentes
• SIDA
• comportamientos sexuales de riesgo

Keywords:

• Adolescents
• AIDS
• sexual-risk behaviour