Sexually transmitted diseases (STDs) are frequent in adolescence and contribute to the increase in the number of AIDS cases. Early sexual initiation, multiple sex partners, and lack of condom use are considered risk factors and are influenced by a male-dominated gender system. We interviewed 356 adolescent patients at the Adolescent Health Research Center in Rio de Janeiro State University to identify possible STD risk factors in adolescence. Young men reported more partners and early sexual initiation. Females used condoms less frequently and were more subject to sexual abuse. The results confirm a model sustained by traditional gender values that demarcate the male and female spheres, with male supremacy. We conclude that to achieve more effective STD control, it is necessary to expand the discussion on culturally constructed patterns of masculinity and femininity.

The goal of this research was to identify ethically conflicting situations experienced by health professionals during health appointments with adolescents in order to create a protocol for action to help professionals make decisions and to protect the clients. The study used an observational cross-sectional method through interviews with health professionals at the Center for Studies on Adolescent Health, Rio de Janeiro State University, to obtain data from cases involving bioethical, ethical, and legal conflicts. Seventy-four professionals reported 149 cases, in which there were 250 conflicts identified through posterior qualitative analysis. The conflicts were interconnected, but for didactic reasons they were mentioned here separately. They included: secrecy and confidentiality, illicit activities, violence, contraception in girls less than 15 years of age, negligence, autonomy, and recording of confidential information on patient medical records. We conclude that there are constant ethical conflicts during health appointments with adolescents, and that bioethics is a useful instrument for solving them. It is also essential to be familiar with the prevailing legislation, to consult pertinent organizations, and to evaluate situations individually.

RESUMO As doenças sexualmente transmissíveis são prevalentes na adolescência e facilitadoras da contaminação pelo HIV. A baixa idade das primeiras relações sexuais, a variabilidade de parceiros, o não uso de preservativo e o uso de drogas

Results indicate that there are multiple STD risk factors in both groups. We believe that intervention of the health services for the purpose of reducing incidence of STD in adolescents should be concentrated on the continued encouragement for the use of a condom at each sexual intercourse, as the decrease of other risk factors seems to rest upon actions that are beyond the health ambit.

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