Intervenções voltadas ao uso do preservativo por adolescentes em situação de rua: revisão sistemática e metánalise

Abstract

Health interventions aim to improve the living conditions of people, groups or populations. In this study, interventions aimed at condom use, within the scope of sexual health and the prevention of STI/HIV/Aids were the focus. In this perspective, this study aimed to analyze the scientific literature regarding the efficacy of health interventions for condom use by street adolescents. This is a systematic review of clinical trials and observational studies, based on the recommendations of the Cochrane Collaboration. The acronym PICOS was used in the construction of the guiding question, which is: Are educational and/or health care interventions effective in promoting condom use by street adolescents? Specific search strategies were applied to Medline, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, Scopus, EMBASE, Web of Science, CINAHL, LILLACS and BDENF electronic databases, without date or language restrictions. The search, eligibility assessment and data extraction from the studies were performed independently by two reviewers, for both Rayyan and ENDNOTEweb software were used in the blinding and management of references. The analysis of the feasibility and validity of the studies followed the Cochrane Handbook, with Review Manager 5.4.1 software used for statistical analysis and GRADEpro software to produce GRADE evidence profiles. The risk of bias assessment was performed using the instruments of Cochrane's Collaboration Tool for randomized clinical trials and the NEWCASTLE-OTTAWA SCALE for observational studies. The main categories of

interventions applied to homeless adolescents included: Counseling sessions, Multi- strategy programs (individual and family therapy - cognitive behavioral therapy,

motivational interviewing, family therapy, case management), and Community Reinforcement. Six studies were included in the meta-analysis. By means of the Cochran's Q, a significant difference was observed between the studies Q (5)=13.1; p=0.02; in addition, the analysis showed I2=62%, both indicative of heterogeneity. Thus, the random effects model was chosen. Thus, through the meta-analysis, it was shown that the interventions increased condom use by 28% (95%CI: 1.07 – 1.54; p<0.01). In this way, educational interventions increase/encourage condom use among street adolescents, with emphasis on counseling-based interventions as the most effective. The narrative findings highlight that: counseling is a psychoeducational strategy that must be carried out under an adolescent-centered, integral and integrated care model. Multistrategy programs are promising options when employing behavioral and generational

Fragilidades e rupturas nas redes de apoio dos adolescentes Conflitos na adolescência: um processo (des)construção da identidade

Conflitos na adolescência: um processo (des)construção da identidade

Conflitos na adolescência: um processo (des)construção da identidade

methodologies that have the potential to generate changes in behavior and lifestyle. Community Reinforcement is a comprehensive behavioral treatment package that helps people discover and adopt a pleasurable and healthy lifestyle. Finally, it is concluded that all strategies contribute, at the threshold of their scope and effectiveness, to improve safe sexual practices of street adolescents.