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Comportamento sexual de risco, promotor da gravidez e VIH na adolescência: um estudo na província de Maputo, Moçambique
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Abstract(s)
O trabalho de tese tem por objetivo investigar os comportamentos sexuais de risco, promotores da gravidez precoce e infeção pelo Vírus da Imunodeficiência Humana na adolescência, utilizando o modelo socioecológico de Bronfenbrenner (1979) para uma análise multinível que abrange as dimensões individual, relacional e comunitária. A abordagem multinível, que integra a Teoria do Comportamento Planeado (TCP) e o Modelo de Crenças em Saúde (MCS) fornece uma compreensão dos fatores que influenciam os comportamentos de saúde sexual dos/das adolescentes. Utilizou-se uma metodologia mista sequencial, onde a análise quantitativa focou no MCS em relação ao VIH e a TCP no uso de preservativos e/ou contracetivos, e no adiamento da iniciação sexual. Com a metodologia qualitativa explorou-se o envolvimento dos/das adolescentes à escola com o objetivo de explorar a sua perceção em relação à ligação a escola e o impacto desta no comportamento sexual de risco.
Os resultados revelam uma correlação positiva entre o desempenho académico, conhecimentos sobre VIH/SIDA e práticas sexuais seguras, e a influência positiva das perceções ao VIH/SIDA na adoção de comportamentos sexuais preventivos. O estudo destaca o papel das atitudes, normas sociais, autoeficácia e vínculos familiares na formação das intenções e comportamentos sexuais dos/das adolescentes.
A análise qualitativa destaca a ligação dos/das adolescentes à escola e o seu impacto nas atitudes, escolhas sexuais e o bem-estar, ressaltando a importância de um ambiente escolar acolhedor e inclusivo.
Os resultados apontam para a necessidade de acesso a educação sexual e serviços de saúde.
This thesis uses Bronfenbrenner’s socio-ecological model to examine adolescent sexual risk behaviours leading to early pregnancy and HIV infection and a multilevel framework covering individual, relational, and community aspects shows how adolescents' choices are influenced by their environments. The Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) further detail this: TPB focuses on intentions and perceived control over condom or contraceptive use, while HBM addresses perceived susceptibility, severity, benefits, and barriers in HIV prevention. It was implemented in a sequential mixed-methods design, in which the quantitative method evaluated HBM constructs related to HIV and TPB constructs associated with consistent contraceptive use and postponing sexual initiation. The qualitative method was employed to examine the impact of belonging and engagement on the risk-sexual behaviour of adolescents within the context of their school connectedness. Results indicate a relationship between knowledge of HIV/AIDS, academic success, and safe sexual behaviour. In other words, the likelihood of using a condom or contraceptive increases as one's knowledge and school grades got better. Furthermore, HBM perceptions, which encompass the perceived severity of infection and susceptibility to HIV, significantly predict preventive actions while attitudes, subjective norms, perceived self-efficacy, and family relationships are all significant factors that influence sexual intention and behaviour. The adolescents underscored that a school environment that is inclusive and friendly fosters healthier decision-making, as strong relationships between students and teachers often result in a greater intention to postpone having sex, conversely, feelings of disconnection may impede protective behaviours.
This thesis uses Bronfenbrenner’s socio-ecological model to examine adolescent sexual risk behaviours leading to early pregnancy and HIV infection and a multilevel framework covering individual, relational, and community aspects shows how adolescents' choices are influenced by their environments. The Health Belief Model (HBM) and the Theory of Planned Behaviour (TPB) further detail this: TPB focuses on intentions and perceived control over condom or contraceptive use, while HBM addresses perceived susceptibility, severity, benefits, and barriers in HIV prevention. It was implemented in a sequential mixed-methods design, in which the quantitative method evaluated HBM constructs related to HIV and TPB constructs associated with consistent contraceptive use and postponing sexual initiation. The qualitative method was employed to examine the impact of belonging and engagement on the risk-sexual behaviour of adolescents within the context of their school connectedness. Results indicate a relationship between knowledge of HIV/AIDS, academic success, and safe sexual behaviour. In other words, the likelihood of using a condom or contraceptive increases as one's knowledge and school grades got better. Furthermore, HBM perceptions, which encompass the perceived severity of infection and susceptibility to HIV, significantly predict preventive actions while attitudes, subjective norms, perceived self-efficacy, and family relationships are all significant factors that influence sexual intention and behaviour. The adolescents underscored that a school environment that is inclusive and friendly fosters healthier decision-making, as strong relationships between students and teachers often result in a greater intention to postpone having sex, conversely, feelings of disconnection may impede protective behaviours.
Description
Tese de Doutoramento em Sustentabilidade Social e Desenvolvimento, apresentada à Universidade Aberta
Keywords
Urie Bronfenbrenner, 1917-2005 SIDA Modelo de crença em saúde Teoria do Comportamento Planeado Ligação com a escola Moçambique HIV/AIDS Socioecological model Theory of Planned Behavior School connectedness