Frequency of adolescent girls in the SUS is 2.5 times that of boys

The gap that separates men and women from health care starts in adolescence. The frequency of girls between 12 and 19 years old in the public health system is two and a half times that of boys in the same age group.

According to data from the SIA (Outpatient Information System), of the Ministry of Health, in 2020, 10 million girls underwent general care in the SUS against 4 million boys.

The difference in care is also seen in the coverage of the HPV vaccine.

Just over a third (36%) of eligible boys received both doses of the vaccine, while girls account for 56%, according to the National Immunization Program (PNI). Immunization is offered free of charge in the SUS to girls between 9 and 14 years old, since 2014, and boys between 11 and 14 years old, since 2017.

These disparities became the motto of a campaign launched by the SBU (Sociedade Brasileira de Urologia), with the objective of drawing the attention of adolescents and their families so that, in the same way that girls start to visit the gynecologist after the onset of menstruation, the Boys also need a doctor to call their own when they stop going to the pediatrician.

For the entity, this male distance from health care has repercussions in adult life and is one of the reasons why women live, on average, 80 years, and men, 73. In addition to hormonal factors, they are also less prone to unhealthy habits, such as drinking and smoking, and have less heart disease, cancer and diabetes, among others.

“The boy suddenly falls into a limbo of medical care, often because he thinks it’s not necessary, but other times simply because he has no idea what it can bring in terms of benefit. And then a culture is sustained that men only go to the doctor when he is sick. This is the mindset that must change”, explains urologist Karin Anzolch, communication director at the SBU.

The idea of ​​the campaign is not to direct the boy to a urologist, reinforces Daniel Suslik Zylbersztejn, coordinator of the campaign — although the movement is called #Vemprouro.

He claims that general practitioners or family doctors, for example, can perfectly take care of men’s health and advise boys on health promotion and disease prevention.

“It’s not a corporate campaign. It’s for the boy to go to the doctor. The family doctor, for example, is much more suited to these guidelines than the urologist. The urologist, sometimes, doesn’t even know what to do with that boy in your office.”

The campaign reinforces the importance of the boy taking care of his genital and reproductive health and preventing himself against HPV (Human Papillomavirus), which has a predilection for infecting the skin and mucous membranes and is related to various types of cancer such as cervical, anus, penis and oropharynx.

According to Inca (National Cancer Institute), international studies suggest that between 25% and 50% of the female population and 50% of the male population worldwide are infected with HPV. Many of these infections start in adolescence as soon as young people start having sex. Vaccination is the best form of protection.

Not that this is the subject that most worries the boys. “In general, the drama of teenagers is the size of the penis. Today they have easy access to pornography and there is comparison, which creates anxiety in this process. curve”, says urologist Zylbersztejn.

Reinforcing the importance of condom use is another goal of the campaign. A survey conducted by the SBU in 2020 with adolescents found that 44% of respondents did not use a condom at the first sexual intercourse and 35% do not use or rarely use a condom. Already 38.57% of boys said they do not even know how to put condoms.

Another survey with data from the IBGE, released last July, also shows that the sex education of young people in the country is deficient. Between 2009 and 2019, the percentage of students 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%, while among boys, from 74.1% to 62.8%.

A year-old high school student at a school in the west of São Paulo says that his classmates even have an idea that STIs (Sexually Transmitted Infections) exist and that you need to use condoms to protect yourself against them. But, he says, there is still a lot of misinformation.

He claims that he never learned anything about STIs in school and what he knows today was taught by his parents or looked up on the internet. He says that he took a single class on sex education in seventh grade, and that it was useless.

Among the most common STIs are syphilis, herpes simplex, chancroid, HPV, lymphogranuloma venereum (chronic infection caused by the bacterium Chlamydia trachomatis), gonorrhea, trichomoniasis (infection caused by the protozoan Trichomonas Vaginalis), hepatitis B and C and HIV. They are the main focus of the SBU campaign.

“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”, says José Murillo Bastos Netto, coordinator of the department of adolescent urology at the SBU.

For Zylbersztejn, in general, doctors also need to get rid of prejudices about sexual issues in adolescents if they want to approach them. “Especially when it comes to homosexuals or transgender people. The trans girl continues with the male organs, she has the hormones, all of this needs to be looked at carefully.”