RESUMO
INTRODUCTION: Access to comprehensive abortion care could prevent the death of between 13 865 and 38 940 women and the associated morbidity of 5 million women worldwide. There have been some important improvements in Latin America in terms of laws and policies on abortion. However, the predominant environment is still restrictive, and many women, adolescents and girls still face multiple barriers to exercise their reproductive rights. This research will systematically assess comprehensive abortion policies in five Latin American countries (Argentina, Colombia, Honduras, Mexico and Uruguay). The aim is to identify barriers, facilitators and strategies to the implementation of abortion policies, looking at four key dimensions-regulatory framework, abortion policy dynamics, abortion service delivery and health system and health outcomes indicators-to draw cross-cutting lessons learnt to improve current implementation and inform future safe abortion policy development. METHODS AND ANALYSIS: A mixed-method design will be used in the five countries to address the four dimensions through the Availability, Accessibility, Acceptability and Quality of Care model. The data collection tools include desk reviews and semi-structured interviews with key actors. Analysis will be performed using thematic analysis and stakeholder analysis. A regional synthesis exercise will be conducted to draw lessons on barriers, facilitators and the strategies. ETHICS AND DISSEMINATION: The project has been approved by the WHO Research Ethics Review Committee (ID: A66023) and by the local research ethics committees. Informed consent will be obtained from participants. Data will be treated with careful attention to protecting privacy and confidentiality. Findings from the study will be disseminated through a multipurpose strategy to target diverse audiences to foster the use of the study findings to inform the public debate agenda and policy implementation at national level. The strategy will include academic, advocacy and policy arenas and actors, including peer-reviewed publication and national and regional dissemination workshops.
Assuntos
Aborto Induzido , Gravidez , Adolescente , Feminino , Humanos , América Latina , México , Formulação de Políticas , PolíticasRESUMO
Background: Erectile dysfunction (ED) is a multifactorial medical disorder often neglected in clinical practice between elderly men, defined as the inability to achieve and/or maintain a penile erection sufficient for satisfactory sexual intercourse and a common clinical entity among men and associated with impaired quality of life and cardiovascular diseases in elderly men. The aim of this study is to evaluate the association between ED and clinical, demographic and behavioral parameters in elderly men. Methods: A total of 2436 males aged 60 years and over who participated in the health screening between January 2008 and December 2018 were included in this study. Laboratory exams, clinical and behavior profiles were analyzed. Logistic regression models were used. Results: Men with ED were older (65.87±5.49 vs. 63.85±4.05 years old. p<0.001), higher prevalence of physical inactivity (23.8 vs. 19%, p = 0.039) and had a higher body mass index (BMI; 28.36±4.06 vs. 27.72±3.89 kg/m2. p<0.001) than men without ED. The multivariate model shown that hypertension (p = 0.001), diabetes mellitus (p<0.001), lower urinary tract symptoms (LUTS), depressive symptoms (p<0.001) and age (p<0.001), were strongly associated with ED. Conclusion: The main risk factors associated with ED in elderly men were hypertension, diabetes mellitus, LUTS, depressive symptoms and age.
Assuntos
Disfunção Erétil , Hipertensão , Idoso , Masculino , Humanos , Pessoa de Meia-Idade , Disfunção Erétil/epidemiologia , Disfunção Erétil/etiologia , Estudos Transversais , Qualidade de Vida , Brasil/epidemiologia , Fatores de Risco , Hipertensão/complicaçõesRESUMO
INTRODUCTION: The prevalence of sexually transmitted infections in imprisoned women is high. In the prison school context, education in health is one of the best strategies to achieve positive indicators in terms of health promotion and disease prevention. The use of educational technologies, such as board games, can aid in the process of knowledge acquisition on a given subject matter. This article describes the protocol of a health educational intervention that addresses content about sexually transmitted infections directed to imprisoned women in a prison school. METHODS AND ANALYSIS: A quasi-experimental study to test the effect of a board game on 64 imprisoned women's level of knowledge about sexually transmitted infections. The Previna board game was specifically created and validated for these women. The primary outcome will be the level of knowledge on sexually transmitted infections, measured using a score obtained after the assessment conducted during the initial interview, immediately after the intervention and after 15 days. ETHICS AND DISCLOSURE: This study was approved by the Research Ethics Committee of the Federal University of Pernambuco (Opinion No. 3 986 050 and CAAE: 30035520.7.0000.5208). The results will be presented to the school and to the Federal University of Pernambuco, as part of the activities of a PhD Thesis in Nursing, and will be disclosed in peer-reviewed journals and scientific events. TRIAL REGISTRATION NUMBER: RBR-2JWS7DV.
Assuntos
Infecções Sexualmente Transmissíveis , Humanos , Feminino , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções Sexualmente Transmissíveis/epidemiologia , EscolaridadeRESUMO
INTRODUCTION: Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve. These changes have consequences: vaginal dryness, dyspareunia, discomfort, burning and irritation, vulvovaginal pruritus, dysuria and increased frequency of genitourinary infections. The therapy more suitable for vaginal symptoms in postmenopause yet is the use of a topical hormone. However, the prescription of topical oestrogens should also be avoided in women with a history of breast cancer, oestrogen-sensitive tumours and thromboembolism, emphasising the necessity of alternative treatments. Recently, physical methods, such as laser and radiofrequency (RF), in their non-ablative, ablative and microablative forms have been used in the vaginal mucosa to promote neocolagenesis and neoelastogenesis. This randomised study aims to compare the efficiency of microablative fractional RF (MAFRF) treatment with vaginal oestrogens and no treatment. METHODS AND ANALYSES: This randomised, controlled clinical intervention trial with an open label design comparing the treatment of MAFRF with vaginal oestrogens and no treatment. Four important moments were considered to evaluate treatment results (T0, T1, T2 and T3). The primary outcome includes vulvovaginal atrophy (vaginal pain, burning, itching, dryness, dyspareunia and dysuria), and the secondary outcomes will be sexual function, vaginal health (epithelial integrity, vaginal elasticity, moisture, fluid volume and vaginal pH) and quality of life. ETHICS AND DISSEMINATION: Due to the nature of the study, we obtained approval from the ethics committee. All participants must sign an informed consent form before randomisation. The results of this study will be published in peer-reviewed journals. The data collected will also be available in a public repository of data. TRIAL REGISTRATION NUMBER: RBR-94DX93.
Assuntos
Dispareunia , Lasers de Gás , Doenças Vaginais , Atrofia , Dispareunia/etiologia , Dispareunia/terapia , Feminino , Humanos , Menopausa , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Vagina/patologia , Doenças Vaginais/terapiaRESUMO
INTRODUCTION: The COVID-19 pandemic and its control measures have impacted health and healthcare provision in various levels. Physical distancing measures, for instance, may affect sexual health, impacting access to HIV prevention supplies and changing sexual behaviour, as well as mental health, increasing feelings of unsafety and weakening community support ties. These effects can be worsened among socially marginalised groups, such as men who have sex with men (MSM) and transgender women (TGW). Brazil is among the countries most affected by COVID-19 in the world, where control measures have been inconsistently implemented. We aim to investigate the effects of the COVID-19 pandemic on the sexual and mental health of adolescent and adult MSM and TGW in Brazil. METHODS: Convergent mixed-method prospective cohort study, nested in two ongoing HIV pre-exposure prophylaxis (PrEP) cohorts in Brazil, named PrEP1519 and Combina. Participants will be invited to answer, at baseline and after 6 months, a questionnaire about the effects of the COVID-19 pandemic on sexual behaviour, HIV prevention and mental health. Data on HIV infection and sexually transmitted infections (STI) will be collected as part of routine follow-up from the cohorts. Main outcome measures (HIV infection, STI and depression symptoms) will be observed within 12 months after baseline. Sample size is estimated at 426 participants. Complementarily, 50 participants will be invited to in-depth interviews through video calls or interactive voice response, and 20 will be invited to chronicle their lives during the pandemic through digital diaries. Triangulation will be done across qualitative methods and with the quantitative data. ETHICS AND DISSEMINATION: The study was approved by Research Ethics Committees from the Brazilian Universities coordinating the study. Findings will be published in scientific journals and presented at meetings. Informative flyers will be elaborated to communicate study findings to participants and key stakeholders.
Assuntos
COVID-19 , Infecções por HIV/prevenção & controle , Saúde Mental , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero/psicologia , Pessoas Transgênero/psicologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Estudos de Coortes , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Adulto JovemRESUMO
INTRODUCTION: Prisons are places with high vulnerability and high risk for the development of sexually transmitted infections. World Health Agencies recommend establishing intervention measures, such as information and education, on the prevention of diseases. Thus, technologies as tools for health education have been used to reduce sexually transmitted infections. However, no systematic review has investigated the effectiveness of these interventions. Therefore, this review's objective is to examine the effect of educational technologies used for preventing sexually transmitted infections in incarcerated women. METHODS AND ANALYSIS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be strictly followed. The following electronic databases will be searched: Scopus; Cumulative Index of Nursing and Allied Health, Education Resources Information Center, Embase, PsycINFO, PubMed/Medline, Web of Science and Google Scholar. Randomised clinical trials of interventions that used educational technologies to prevent sexually transmitted infections in incarcerated women will be searched in the databases from the beginning of 2020 until December by two researchers independently. A narrative synthesis will be constructed for all included studies, and if there are sufficient data, a meta-analysis will be performed using the Review Manager software (V.5.3). Continuous results will be presented as the weighted mean difference or the standardised mean difference with 95% CIs. Under the heterogeneity of the included studies, a random-effects or fixed-effects model will be used. The studies' heterogeneity will be assessed by the I2 method. The sensitivity analysis will be carried out to examine the magnitude of each study's influence on the general results. A significance level of p≤0.05 will be adopted. ETHICS AND DISCLOSURE: Ethical approval is not required because no primary data will be collected. The results will be published in journals reviewed by peers. PROSPERO REGISTRATION NUMBER: CRD42020163820.
Assuntos
Prisioneiros , Infecções Sexualmente Transmissíveis , Tecnologia Educacional , Feminino , Educação em Saúde , Humanos , Metanálise como Assunto , Projetos de Pesquisa , Infecções Sexualmente Transmissíveis/prevenção & controle , Revisões Sistemáticas como AssuntoRESUMO
OBJECTIVE: To describe and compare trends in prevalence, sexual behaviour and HIV transmission knowledge data related to sexually transmitted infections (STI) and HIV in patients attending three STI clinics over an 8-year period in Escuintla Department, Guatemala. METHODS: STI clinic attendees were classified into transmission groups as follows: female sex workers (FSW), men who have sex with men (MSM) and 'high-risk heterosexuals' (HRH). Annual cross-sectional analysis and multivariable Poisson regression adjusted for sociodemographic variables were used for prevalence comparisons and adjusted prevalence trends for HIV/STI outcomes and used for adjusted trends in proportions in sexual behaviour and HIV transmission knowledge outcomes. Endocervical swabs were obtained to detect trichomonas, chlamydia and neisseria infections. Serologies for syphilis and HIV were performed using rapid tests. For reactive HIV samples, positivity was confirmed by an ELISA. All reactive syphilis samples were further confirmed for diagnosis of active syphilis disease. RESULTS: From a total of 4027 clinic attendees, 3213 (79.78%) were FSW, 229 (5.69%) were MSM and 585 (14.53%) were HRH. The proportion of FSW, MSM and HRH who had a single visit was 56.42%, 57.23% and 91.10%, respectively. Overall, HIV prevalence was 2.10% in FSW, 8.17% in MSM and 4.12% in HRH. Prevalence trends in HIV and syphilis decreased in FSW. Prevalence trends in gonorrhoea did not decrease over time neither in FSW nor in HRH. Chlamydia and trichomonas infections in HRH showed an increase prevalence trend. In FSW, trends in condom use in last sexual intercourse with regular and occasional clients were above 93%. CONCLUSIONS: FSW show a decreasing trend in HIV, syphilis and chlamydia prevalence. Gonorrhoea prevalence in FSW and HRH did not decrease over time. HRH is a hard to engage population with low follow-up rates and high potential to act as a bridge population.
Assuntos
Infecções por HIV , Profissionais do Sexo/estatística & dados numéricos , Comportamento Sexual , Minorias Sexuais e de Gênero/estatística & dados numéricos , Infecções Sexualmente Transmissíveis , Adulto , Estudos Transversais , Feminino , Guatemala/epidemiologia , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Infecções por HIV/transmissão , Humanos , Masculino , Técnicas Microbiológicas/métodos , Prevalência , Saúde Pública/tendências , Fatores de Risco , Infecções Sexualmente Transmissíveis/classificação , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/psicologiaRESUMO
OBJECTIVES: The objectives of this study were to estimate the point prevalence of sexually transmitted infection (STI) and to investigate the sexual practices and behaviours associated with STIs in a group of gay men, other men who have sex with men and transgender women (GMT) in the province of La Romana, Dominican Republic. DESIGN: A cross-sectional study of a convenience sample of GMT persons. SETTING: The study was conducted in the province of La Romana, Dominican Republic, in June-July 2013. PARTICIPANTS: Out of 117 GMT persons screened, a total of 100 completed the study. Participants had to be at least 18â years of age, reside in La Romana and have had sex with another man in the preceding 12â months. All participants were interviewed and tested for STI. PRIMARY OUTCOME MEASURE: The main outcome of interest was the detection of any STI (HIV, herpes simplex virus type 2 (HSV-2), syphilis, hepatitis B or C) by serology. RESULTS: Among 100 participants, the median age was 22â years (range 18-65). One-third had consumed illicit drugs the preceding year and only 43% consistently used condoms. Prevalence was 38% for HSV-2, 5% for HIV and 13% for syphilis. There were no cases of hepatitis B or C. Factors associated with the odds of a STI were age >22â years (OR=11.1, 95% CI 3.6 to 34.5), receptive anal intercourse (OR=4.2, 95% CI 1.3 to 13.6) and having ≥2 male sexual partners during the preceding month (OR=4, 95% CI 1.3 to 12.5). CONCLUSIONS: In this group of GMT persons, seroprevalence of STI was high, and a number of risk behaviours were associated with STI. These preliminary data will help inform policy and programmes to prevent HIV/STI in GMT persons in the region.
Assuntos
Homossexualidade Masculina , Assunção de Riscos , Infecções Sexualmente Transmissíveis/epidemiologia , Pessoas Transgênero , Sexo sem Proteção/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , República Dominicana/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Infecções Sexualmente Transmissíveis/transmissão , Adulto JovemRESUMO
OBJECTIVES: This study intends to evaluate whether the belief that condoms are 100% effective in protecting against HIV infection is associated with sexual risk behaviours among youth. METHODS: A cross-sectional study was performed in representative samples of high-school students in the Philippines, El Salvador and Peru. Participants completed a self-administered questionnaire. Students were asked about the risk of HIV transmission if one has sex using condoms. They were also asked to indicate whether they had ever had sexual relations and whether they used a condom in their first sexual relation. The sample was composed of 8994 students, aged 13-18. RESULTS: One out of seven adolescents believed condoms are 100% effective (safe-sex believers). Those adolescents were 82% more likely to have had sex than those without such belief, after adjusting for confounders (OR=1.82; 95% CI 1.51 to 2.21). On the contrary, no association was found between risk perception and condom use. Subgroup and sensitivity analyses produced similar results. CONCLUSIONS: This is, to the best of our knowledge, the first study conducted specifically to evaluate this phenomenon and that has used the same questionnaire and the same data collection protocol in three different developing countries from Asia, Central and South America. These results reasonably suggest that there could be an association between safe sex beliefs and sexual initiation. Longitudinal studies are needed to better understand this possible association as it could influence how to better promote sexual health.
Assuntos
Comportamento do Adolescente/psicologia , Preservativos/estatística & dados numéricos , Países em Desenvolvimento , Infecções por HIV/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Assunção de Riscos , Sexo Seguro/psicologia , Adolescente , Estudos Transversais , El Salvador , Feminino , Infecções por HIV/transmissão , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Peru , Filipinas , Sexo Seguro/estatística & dados numéricos , Inquéritos e Questionários , Sexo sem Proteção/psicologia , Sexo sem Proteção/estatística & dados numéricosRESUMO
OBJECTIVES: To evaluate whether dyspareunia is associated with HIV status in menopausal women and also to assess which factors are associated with dyspareunia in a group of HIV-positive menopausal women. METHODS: A cross-sectional study was conducted with 178 HIV-negative and 128 HIV-positive women aged 40-60â years. The Short Personal Experiences Questionnaire (SPEQ) was used to collect data. Sociodemographic, clinical, behavioural and reproductive factors were evaluated, as well as factors related to the HIV infection. Dyspareunia was defined as pain during intercourse. A bivariate analysis and Poisson multiple regression analysis were performed. RESULTS: Overall, 41.4% of the HIV-positive women reported dyspareunia compared with 34.8% of the HIV-negative women (p=0.242). In the HIV-positive women, bivariate analysis revealed an association between dyspareunia and having a steady partner (p=0.047); the woman's partner having undergone HIV testing (p=0.020); vaginal dryness (p<0.001); muscle/joint pain (p=0.021); physical/emotional violence (p=0.049); urinary incontinence (p=0.004); and the use of lamivudine/zidovudine (p=0.048). The Poisson multiple regression analysis found an association between dyspareunia and vaginal dryness (prevalence ratio (PR)=1.96, 95% CI 1.10 to 3.50, p=0.023) and urinary incontinence (PR=1.86, 95% CI 1.06 to 3.27, p=0.031). CONCLUSIONS: Dyspareunia was common in this group of HIV-positive women and was associated principally with vaginal dryness and urinary incontinence. The importance of treating dyspareunia within the context of sexual health in this group of women should be emphasised and appropriate management of this issue may reduce the likelihood of lesions on the vaginal wall, which may act as a portal of entry for other infections.
Assuntos
Dispareunia/complicações , Dispareunia/epidemiologia , Soronegatividade para HIV , Soropositividade para HIV/complicações , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Este artigo busca refletir sobre o desinteresse pela área que congrega estudos e intervenções clínicas sobre a sexualidade por parte dos estudiosos críticos da sexualidade como campo político na América Latina. Iniciamos com um panorama sobre as sexualidades e as políticas na América Latina e, em seguida, apresentamos um panorama histórico do campo da sexologia e da medicina sexual na região. Procuramos argumentar que considerar a medicalização da sexualidade apenas como uma forma da sua despolitização deixa de lado aspectos importantes do processo, em especial no que diz respeito à produção de novos sujeitos na esfera do consumo. Em nossas conclusões realizamos uma reflexão crítica acerca do crescente consumo de biotecnologias na esfera da sexualidade e das concepções que lhes são subjacentes, buscando ressaltar seu aspecto eminentemente político.
This essay deals with the lack of interest in the studies and clinical interventions on sexuality on the part of those who have a critical view of sexuality as a political field in Latin America. We begin with an overview on the field of sexualities and politics in Latin America and then go on to present a historical overview of the field of sexology and Sexual Medicine in the same region. We argue that to consider the medicalization of sexuality merely as a part of its depoliticization leaves out important aspects of the process, especially regarding the production of new subjects in the sphere of consumption. In our conclusions we conduct a critical analysis of the growing use of biotechnology in the field of sexuality, as well as the concepts that underlie this use, seeking to highlight their eminently political aspect.
Este artículo reflexiona sobre el desinterés por estudios e invervenciones clínicas en sexualidad por parte de aquellos estudiosos que tienen una visión crítica de la sexualidad como campo político en América Latina. Comienza con un panorama sobre las sexualidades y las políticas en América Latina y, a continuación, se presenta un panorama histórico del campo de la sexología y de la medicina sexual en la región. Se argumenta que considerar la medicalización de la sexualidad sólo como una forma de su despolitización deja de lado aspectos importantes de ese proceso, en especial los relativos a la producción de nuevos sujetos en la esfera del consumo. En las conclusiones, se realiza una reflexión crítica sobre el creciente consumo de biotecnología en la esfera de la sexualidad y de las concepciones subyacentes a éste, buscando descatar su aspecto eminentemente político.
Assuntos
Humanos , Masculino , Feminino , América Latina , Políticas , Sexologia/história , Sexualidade/etnologia , Direitos Humanos/tendências , Terapêutica/tendênciasRESUMO
Este artigo pretende discutir a passagem da "segunda onda sexológica", que surge em meados do século XX, para uma terceira fase representada pela Medicina Sexual, cujo surgimento data da última década do século. Analisa-se o surgimento da Medicina Sexual como parte de um processo mais amplo de "biologização" das concepções acerca do humano ao qual se concatena uma transformação importante do modo de atuação e produção da indústria farmacêutica. Dois pontos cruciais na passagem da segunda sexologia para a Medicina Sexual serão abordados: a reconfiguração médica da impotência através da construção e da difusão do diagnóstico de "disfunção erétil" e os efeitos disto para a sexualidade masculina; a mudança de foco da sexualidade feminina ou do casal para a sexualidade masculina e suas consequências. O objetivo mais amplo do artigo é apresentar e discutir a medicalização da sexualidade masculina e seu significado no que diz respeito às relações de gênero.
Este artículo se propone discutir el paso de la "segunda ola sexológica", que surge a mediados del siglo XX, a una tercera fase representada por la Medicina Sexual, cuyo surgimiento data de la última década del siglo. Se analiza el surgimiento de la Medicina Sexual como parte de un proceso más amplio de "biologización" de las concepciones acerca de lo humano, ligado a una transformación importante del modo de acción y producción de la industria farmacéutica. Se abordarán dos puntos cruciales del paso de la "segunda sexología" a la Medicina sexual: la reconfiguración médica de la impotencia, a través de la construcción y difusión del diagnóstico de "disfunción eréctil", con sus efectos en la sexualidad masculina; y el cambio de foco, de la sexualidad femenina o de la pareja a la sexualidad masculina y sus consecuencias. El objetivo más amplio del artículo es presentar y discutir la medicalización de la sexualidad masculina y su significado, en lo que respecta a las relaciones de género.
This article discusses the passage of the "second sexological wave", which emerged in the middle of the 20th century, to a third phase represented by Sexual Medicine, which came to light in the last decade of the 20th century. I analyze the emergence of Sexual Medicine as part of a broader process of "biologization" of the human, which was parallel to an important transformation in the mode of operation and production of the pharmaceutical industry. Two crucial points in the transition from the second sexology to Sexual Medicine will be addressed: the medical reconfiguration of impotence through the construction and dissemination of the diagnosis of "erectile dysfunction" and its effects on male sexuality; the changing of focus from female (or couple) sexuality to male sexuality and its consequences. The broader goal of the article is to present and discuss the medicalization of male sexuality and its significance regarding gender relations.
Assuntos
Humanos , Masculino , Sexualidade , Sexologia , Indústria Farmacêutica , Medicalização , Disfunção ErétilRESUMO
Neste artigo apresentamos e discutimos os resultados parciais da investigação sobre a constituição do campo da sexologia contemporânea no Brasil, parte da pesquisa comparativa "Sexualidade, ciência e profissão na América Latina". Uma segunda onda sexológica surgiu no Brasil em finais dos anos 1970 no Rio de Janeiro, com um viés essencialmente clínico, e em São Paulo, com um viés educacional. A década seguinte marcou um período de institucionalização no qual são criadas as duas associações que hoje polarizam o campo em torno de uma sexologia mais eclética e multiprofissional e da chamada "medicina sexual", em geral dominada pelos urologistas. Discutimos os significados dessa polarização em termos das disputas profissionais subjacentes e das concepções de gênero implicadas em tais disputas.
In this paper we present and discuss the preliminary results of an investigation on the constitution of the contemporary field of sexology in Brazil, which is part of the comparative research "Sexuality, science and profession in Latin America". A second sexology arose in Brazil in the late 70's in Rio de Janeiro, with an essentially clinical approach, and in São Paulo, with an educational approach. The following decade brought a period of institutionalization in which the two associations that nowadays dominate the sexological field were created. They represent the two main trends in modern sexology; a more eclectic and multiprofessional approach and the so-called "sexual medicine", dominated by urologists. We discuss the meanings of this polarization in terms of its underlying professional disputes and the gender assumptions implied in such disputes.
Assuntos
Humanos , Comportamento Sexual/história , Sexologia/tendências , Sexualidade/história , Controles Informais da Sociedade/história , Identidade de GêneroRESUMO
Numerosas mudanças surgiram no domínio da pesquisa em sexologia, notadamente no que concerne à função e disfunções sexuais e seus tratamentos. A disfunção erétil foi reconceitualizada como uma disfunção com origem orgânica, uma transformação em relação às abordagens anteriores acerca da impotência psicogênica, desenvolvidas nos anos 1960 e 1970. Essa mudança se baseia em muitas descobertas científicas e no avanço farmacológico realizado sob influência de urologistas norte-americanos. A disponibilização no mercado do sildenafil, em 1998, acionou novos tipos de tratamentos, centrados na atividade peniana. Os mesmos grupos de urologistas passaram recentemente a repensar as "disfunções sexuais femininas" segundo o mesmo modelo orgânico da função sexual. Novos produtos farmacêuticos estão em testagem clínica, tendo em vista a proposta de tratamentos da nova categoria de transtornos sexuais. A colocação no mercado do sildenafil não provocou reações contrárias às novas abordagens dos transtornos sexuais masculinos. Inversamente, o surgimento de novos conceitos da função sexual feminina suscita importantes debates. O British Medical Journal veiculou uma discussão, estabelecendo que a função sexual feminina não possuía origem orgânica, mas fundava-se em fatores psicológicos e relacionais da atividade sexual das mulheres. O debate centrou-se na "simplicidade" da sexualidade masculina, em oposição à "complexidade" da sexualidade feminina. Este artigo apresenta a analisa as novas concepções da função sexual masculina e feminina, e evidencia a permanência de estereótipos tradicionais da sexualidade masculina e feminina, e sua influência sobre as pesquisas científicas mais avançadas nessa esfera1.
Major changes have occurred in male and female sexual function/dysfunction research and treatments. Male erectile dysfunction has been re-conceptualized as an organic dysfunction, which marks a dramatic shift from previous conceptions of psychogenic impotence developed during the 60' and the 70's. This shift is based on major scientific discoveries, and pharmacological advances that took place since the early 80's under the influence of North American urologists. The release of sildenafil in 1998 was the corner stone of a new paradigm of treatments focusing on male penile activity, far remote from any psychological approaches. More recently, the same group of urologists started to reconsider Female Sexual Dysfunction using the same organic/biological model of sexual function. New pharmaceutical products are currently under trial for the treatment of this new category of female sexual disorder. But as opposed to the absence of public adverse reaction to the development of this approach of male function, many voices raised to oppose this new conception of female function. A major discussion took place in the British Medical Journal stating that female sexual function was not organically driven, but rather determined by the social, psychological and interpersonal context of female sexual activity and relations. One of the major dimensions of this discussion opposed the so-called "simplicity" of male sexual function to the "complexity" of female sexual function. This paper demonstrates the permanence of traditional social scripts of male and female sexuality and their influence in the most advanced scientific research in this field.