An unprecedented survey carried out by the Brazilian Society of Urology (SBU), with data from the Ambulatory Information System of the Ministry of Health points out that the number of visits of adolescent boys aged 12 to 18 years to the urologist is 18 times lower than the number of visits of girls to the gynecologist of the same age group.
In September, SBU carries out the #VemProUro campaign, which emphasizes the importance of boys also taking care of their genital and reproductive health, in addition to encouraging HPV vaccination in the fight against cancers caused by the virus.
“While the girls, after leaving the pediatrician, mostly continue to be connected with their health, especially through the gynecologist, caring for and being oriented about their general and genital health, the boy suddenly falls into a limbo of medical assistance, often for think it’s not necessary, but others simply because they have no idea what it can bring in terms of benefit”, says doctor Karin Anzolch, director of communication at the SBU.
The specialist says that the culture that men only go to the doctor when they are sick can harm their health in the long run.
“Perhaps the most important legacy of the entire campaign is really the early approach of the boy to health care, including genital health care, which is so important for quality of life, relationships and global health, whether through the urologist, the general practitioner, hebiatrician or family doctor”, he adds.
The data on general care provided to adolescents by the Unified Health System (SUS) are in line with the survey carried out by the SBU. Figures from 2020 from the Outpatient Information System (SIA), of the Ministry of Health, showed that girls aged between 12 and 19 had access to the SUS almost 2.5 times greater than that of boys: 10,096,778 for girls, against 4,066 .710 of boys.
Health promotion actions
Since 2018, the year of the first campaign of the Brazilian Society of Urology (SBU), the most varied aspects of boys’ health have been addressed, with an emphasis on a specific subject.
This year, Sexually Transmitted Infections (STIs) will be highlighted, with a special focus on HPV and the importance of vaccination in the early period of adolescence, before the first sexual intercourse. HPV is the leading cause of cervical cancer and is also associated with penile cancer.
Data from the Ministry of Health indicate that less than 40% of male adolescents were vaccinated with both doses of the HPV vaccine.
“Each year, there is a greater engagement of urologists and a greater reach of the population of male adolescents and their parents. I believe that, over time, this campaign will decisively contribute to a change in the culture of health care for boys, equating to what we see today in the health care of adolescent girls”, emphasizes urologist Daniel Suslik Zylbersztejn, coordinator of the campaign.
Data from the Ministry of Health, obtained exclusively by the SBU, show that in 2021 there were 189,943 female consultations by gynecologists aged between 12 and 18 years old, against 10,673 male consultations by urologists in the same age group, the equivalent to about 18 times less . In 2020, there were 165,925 female consultations by gynecologists and 7,358 male consultations by urologists.
“These numbers emphasize the discrepancy between health care between the sexes in adolescence. Going to the doctor on a regular basis is present in the lives of girls, while the visit to the urologist is, in general, limited to the presence of an acute disease of the genitourinary tract, which is uncommon at this stage of life”, says Zylbersztejn.
STIs among young people
Among the most common STIs are syphilis, herpes simplex, chancroid, HPV, lymphogranuloma venereum, gonorrhea, trichomoniasis, hepatitis B and C and HIV.
“It is increasingly common for us to assist adolescents with STIs, in the office or in the public health service, which worries us a lot. That’s why we thought about focusing this year’s campaign on STI prevention, including HPV vaccination”, says José Murillo Bastos Netto, coordinator of the Department of Adolescent Urology at SBU.
A survey by the Brazilian Institute of Geography and Statistics (IBGE), released in July, points to a drop in condom use by adolescents in Brazil.
From 2009 to 2019, the percentage of people between the ages of 13 and 17 who used a condom at their last sexual intercourse dropped from 72.5% to 59%. Among girls, the drop was from 69.1% to 53.5% and, among boys, from 74.1% to 62.8%.
The data are an excerpt from an experimental study of the National School Health Survey (PeNSE), which presents comparable indicators for students in the 9th year of elementary school.
“The current generation has not lived through the fear of AIDS like previous generations, when there were numerous campaigns for condom use. It is because of this reduction in educational campaigns that we are seeing alarming data like these”, comments Netto.
HPV vaccine
HPV is associated with cancer of the cervix, penis, anus and oropharynx. The virus has a worldwide prevalence estimated at 11.7% and the age group with the highest prevalence is among those under 25 years of age. Because it is a disease most of the time asymptomatic and with spontaneous resolution in up to two years, many people do not discover they have the problem and transmit the virus to their partners.
The HPV vaccine has been offered free of charge in the SUS to girls between 9 and 14 years of age, since 2014, and boys between 11 and 14 years of age, since 2017. Data from the National Immunization Program (PNI) reveal low HPV vaccine coverage with both doses for both sexes. While girls with two doses add up to 56.2%, boys, 36%.
“The population has little information about the vaccine and many are afraid of side effects and of encouraging the early initiation of sexual activity, so it is important to promote campaigns to demystify vaccination against HPV”, points out Netto.
Young people research sex education on the internet
Published in August, the ICT Kids Online 2021 survey on internet use by children and adolescents found that more than 22.3 million people aged 9 to 17 access the service in Brazil.
The study, carried out by the Brazilian Internet Steering Committee, indicates that young people use the internet to research health, including sex education.
The most searched for topics are: diet (55%), disease prevention and treatment (38%), exercise and ways to get in shape (36%), information about medicines (22%) and discussions about sexual health and sexual education ( 21%).
“We often observe that young people have incorrect notions about various issues involving sexuality. There is often some degree of difficulty in dialogue within the family nucleus, and the search for information on the internet does not always occur on reliable sites with adequate and above all reliable content”, says Alfredo Félix Canalini, president of the SBU.
According to the SBU, the consultation with the urologist allows the evaluation of several items, such as physical development and nutrition, general health conditions, notions about the correct hygiene of the body and genitals.
In addition, it is possible to identify and guide preventive measures for the development of future diseases such as hereditary and behavioral factors. Testicular examination information helps detect abnormalities such as varicocele (enlarged veins in the testicles that can lead to infertility), hernias, poorly descended testes, and tumors in the organ.
Source: CNN Brasil
