Abstract

The lack of a broader debate on HIV prevention and the resurgence of conservatism in recent years may have influenced the perceptions and practices of young people regarding HIV/AIDS. Semi-structured interviews conducted with 194 young individuals, aged 16 to 24, in four state capitals and two small municipalities in Brazil, revealed that they perceive AIDS as a “faceless disease,” making it impossible to identify who has HIV. Conceptions about HIV oscillate between fear and the perception that it is treatable. The risk was perceived as abstract, something that is not central to daily concerns, with the primary focus being in preventing pregnancy. Condom use is seen as a temporary prevention strategy, quickly replaced by trust in the sexual partnership. Available information technology appears unable to address the rise in conservatism and the lack of HIV prevention policies among young people. These policies should improve the provision of quality information tailored to the interest of young people, expand the availability of various prevention resources, and bring STIs and HIV back into the discussion arena.

Keywords:
Young Adult; Adolescent; HIV; AIDS; Condom

Introduction

AIDS and HIV prevention are topics that have not been frequently discussed in the mass media in recent years. These themes are remembered on rare occasions, such as on December 1st (World AIDS Day) and during Carnival (when there is a social expectation of a greater number of sexual relations with casual partners). On these dates, advertising pieces about prevention are launched by government institutions, at the municipal, state, and federal level, and epidemiological data are published. In 2023, for example, the Ministry of Health’s campaign slogan was Voltou o carnaval e com camisinha a alegria é geral (Carnival is back, and with condoms the fun is all around). However, outside of these dates, the topic is forgotten until the following year.

The silence about AIDS and its prevention is part of a broader context of crisis in the Brazilian response to HIV/AIDS. The accumulated experience in the sphere of prevention, which has historically relied on close collaboration with Non-Governmental Organizations (NGOs) and dialogue with the social movement, with actions based on peer-to-peer education methodologies, promotion of human rights, and combating stigma and discrimination (Ayres, 2002AYRES, J. R. C. M. Práticas educativas e prevenção de HIV/Aids: lições aprendidas e desafios atuais. Interface - Comunicação, Saúde, Educação, Botucatu, v. 6, n. 11, p. 11-24, 2002. DOI: 10.1590/S1414-32832002000200002
https://doi.org/10.1590/S1414-3283200200... ; Grangeiro; Silva; Teixeira, 2009GRANGEIRO, A.; SILVA, L. L. D.; TEIXEIRA, P. R. Resposta à aids no Brasil: contribuições dos movimentos sociais e da reforma sanitária. Revista Panamericana de Salud Pública, Washington, DC, v. 26, n. 1, p. 87-94, 2009.; Paiva, 2002PAIVA, V. Sem mágicas soluções: a prevenção e o cuidado em HIV/ AIDS e o processo de emancipação psicossocial. Interface - Comunicação, Saúde, Educação, Botucatu, v. 6, n. 11, p. 25-38, 2002. DOI: 10.1590/S1414-32832002000200003
https://doi.org/10.1590/S1414-3283200200... ), succumbed to the growth and resurgence of moral conservatism. Conservative movements, with political strength especially since the 2016 political coup and the 2018 presidential election, have begun to question the categories of gender, sexuality, sexual diversity, among others present in public policies, particularly affecting AIDS policy (Agostini et al., 2019AGOSTINI, R. et al. A resposta brasileira à epidemia de HIV/AIDS em tempos de crise. Ciência & Saúde Coletiva, Rio de Janeiro, v. 24, n. 12, p. 4599-4604, 2019. DOI: 10.1590/1413-812320182412.25542019
https://doi.org/10.1590/1413-81232018241... ).

When it comes to the young population, the topic of AIDS and HIV prevention is even less present, as, in general, it is not part of the topics discussed on the networks and social media that they follow or access. The subject is no longer treated systematically in schools, with the weakening of the Programa Saúde na Escola (PSE - School Health Program) in most municipalities and the growth of the Escola sem Partido movement and the fight against what has been called “Gender Ideology” (Miskolci; Campana, 2017MISKOLCI, R.; CAMPANA, M. “Ideologia de gênero”: notas para a genealogia de um pânico moral contemporâneo. Sociedade e Estado, Brasília, DF, v. 32, n. 3, p. 725-747, 2017. DOI: 10.1590/s0102-69922017.3203008
https://doi.org/10.1590/s0102-69922017.3... ). Studies on knowledge about HIV/AIDS have shown that young people whose main source of information about sexuality are parents, health professionals, or teachers have higher levels of knowledge (Fontes et al., 2017FONTES, M. B. et al. Fatores determinantes de conhecimentos, atitudes e práticas em DST/Aids e hepatites virais, entre jovens de 18 a 29 anos, no Brasil. Ciência & Saúde Coletiva, Rio de Janeiro, v. 22, n. 4, p. 1343-1352, 2017. DOI: 10.1590/1413-81232017224.12852015
https://doi.org/10.1590/1413-81232017224... ). Therefore, given the current learning context, we can assume that young people nowadays have less information on the topic.

The effects of this absence of the topic of AIDS and HIV prevention on young people’s conceptions and practices have been little investigated, especially because it is a relatively recent phenomenon. On the other hand, it is already possible to see an increase in this lack of information, as well as a decrease in condom use, a trend that was already being identified in recent years (Brasil, 2016BRASIL. Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira - PCAP 2013. Brasília, DF: Ministério da Saúde, 2016.; Vieira et al., 2021VIEIRA, G. N. et al. O HIV/AIDS entre os jovens no Brasil: revisão integrativa da literatura: HIV/AIDS among young people in Brazil: integrative literature review. Health and Biosciences, São Mateus, v. 2, n. 1, p. 16-30, 2021. DOI: 10.47456/hb.v2i1.32460
https://doi.org/10.47456/hb.v2i1.32460... ). Thus, recent data (2023) on HIV infection in the country show that 23.4% of new cases occurred in young people aged between 15 and 24. The progression of HIV to AIDS is also worrying in this age group, with 52,415 young people with HIV having progressed to AIDS in the last 10 years (2012-2022) (Brasil, 2023BRASIL. Boletim Epidemiológico HIV e Aids 2023. Brasília, DF: Ministério da Saúde, 2023. Disponível em: <Disponível em: https://www.gov.br/aids/pt-br/central-de-conteudo/boletins-epidemiologicos/2023/hiv-aids/boletim-epidemiologico-hiv-e-aids-2023.pdf/view >. Acesso em: 11 mar. 2024.
https://www.gov.br/aids/pt-br/central-de... ).

Given this context, this article aims to analyze the conceptions about AIDS and the risk of HIV infection, as well as the prevention strategies adopted by adolescents and young people.

Methods

The data analyzed comes from the research “Jovens da era digital: sexualidade, reprodução, redes sociais e prevenção às IST/Aids” (Young people in the digital era: sexuality, reproduction, social networks, and STI/AIDS prevention), carried out in six Brazilian municipalities with young people aged 16 and 24. The research adopted a socio-anthropological approach, that is, it sought to take into account both the social and structural contexts that are imposed on individuals, as well as their ability to intervene in these, through practices and the creation of meanings (Olivier de Sardan, 2008OLIVIER DE SARDAN, J.-P. La rigueur du qualitatif: les contraintes empiriques de l’interprétation socio-anthropologique. Louvain-la-Neuve: Academia-Bruylant, 2008.; Victora; Knauth; Hassen, 2000VICTORA, C. G.; KNAUTH, D. R.; HASSEN, M. N. A. Pesquisa qualitativa em saúde. [S.l.]: APGIQ, 2000.). This approach was adopted because it allows us to apprehend not only such important social determinants as gender, race, and social class, but also the biographical trajectories of the young people interviewed. A semi-structured interview was used for producing the data, based on a script that covered the family and residential context, study, and work issues, and the affective-sexual trajectories of the young people, with emphasis on the main sexual and reproductive events, such as sexual initiation, pregnancy/abortion, current partner, as well as conceptions and practices about HIV/AIDS and other sexually transmitted infections (STIs).

Participants were reached from the researchers’ personal and professional networks and through posts on WhatsApp groups and social media. We interviewed 194 young people living in four state capitals (37 in Porto Alegre, RS; 40 in Rio de Janeiro, RJ; 41 in Salvador, BA; and 43 in São Paulo, SP) and two smaller municipalities (17 young people from Conceição do Mato Dentro, MG; 16 from São Gabriel da Cachoeira, AM). The aim was to seek differences in gender, socioeconomic profiles, race/ethnicity, reproductive experiences, and sexual orientation. Thus, the universe was made up of 100 cisgender women and 3 transgender women; 87 cisgender men and 1 trans man; 1 person who defined themselves as genderfluid; and 2 who identified themselves as non-binary. In terms of age group, we interviewed 42 young people ranged from 16 and 17 years of age, 51 from 18 to 19 years of age, 45 from 20 to 21 years of age, and 56 from 22 to 24 years of age. In terms of race/color, 120 of the interviewees declared themselves Black, 55 White, 18 Indigenous, and 1 Yellow. Regarding sexual orientation, 136 interviewees declared themselves heterosexual and 58 fell into one of the LGBTQIAP+ categories.

The interviews were carried out at the location indicated by the interviewee, except for a few which, as requested by the participants themselves, were carried out remotely²2For a full description of the fieldwork, the characteristics of the interviewers, and the ways of contacting the interviewees, see the article “Juventudes, sexualidade e saúde: reflexões teóricas e metodológicas a partir de uma pesquisa multisituada sobre trajetórias afetivo-sexuais juvenis” in this Dossier.. All interviews were recorded and transcribed in full. The data were categorized based on the theoretical framework and research objectives and systematized in the Nvivo software.

It should be noted that, as this is a first analysis of the study’s findings, this article is more descriptive and prioritizes the recurring aspects across the different cities and characteristics of the young people, highlighting only the factors that showed significant differences, such as gender and, in some contexts, social class.

The research was approved by the National Commission of Ethics in Research (CONEP) and the Research Ethics Committees of the participating institutions. In the case of young people under the age of 18, the waiver of the informed consent form signed by the guardian was authorized, accepting only the informed assent form signed by the adolescent. Those over the age of 18 agreed to participate by signing the informed consent form.

Results and discussion

Conceptions about AIDS

The five decades of the AIDS epidemic and all the advances made in treatment, much more than just in the sphere of prevention, have impacted young people’s conceptions about the disease. While in the 1990s the prevailing conception was that AIDS was a distant disease, of the “other,” and that it had a “face”-characterized by homosexuality and weight loss- today, among the young people interviewed the idea prevails that the “disease has no face,” that is, it is not possible to identify “with the naked eye” who has HIV. The Comportamento, Atitudes e Práticas na População Brasileira (PCAP - Behavior, Attitudes, and Practices in the Brazilian Population) survey, carried out in 2013, which interviewed 12 thousand people aged from 15 to 64 years, already indicated that around 90% of those interviewed knew that an apparently healthy person may be living with HIV and almost 80% recognize that AIDS is a chronic disease that can be controlled (Brasil, 2016BRASIL. Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira - PCAP 2013. Brasília, DF: Ministério da Saúde, 2016.). In other words, the significant reduction in mortality, which meant that young people did not have the experience of seeing their idols and friends die of AIDS, produced changes in the way the disease is perceived by the new generation.

Conceptions of AIDS oscillate between a certain fear of the disease and the view that it is treatable. Although all the young people interviewed say they “do not want to get it” and believe they would be deeply affected if that happened, the possibility of treating the disease by using antiretrovirals produces a relativization of fear. AIDS is no longer perceived as a death sentence and young people say they have little knowledge about it.

Consistent with this conception that AIDS is a treatable disease, the possibility of HIV infection is often compared to the possibility of pregnancy. Pregnancy and AIDS are two things that young people do not want to deal with, but they admit that both are a possibility once they become sexually active.

It is interesting to note that having a sexually active life means, for young people, “being open” to the risk of both pregnancy and HIV infection or another STI. This equalization of risks may result from the perception that, in both cases, it is possible to deal with the consequences. In the case of HIV, they understand that there is the possibility of control with drug treatment, despite not considering the complexities implied in living under treatment for a chronic disease. In the case of an unexpected pregnancy, the reception provided by the family, especially after the birth of a child, can mitigate the “scare” (Joyce; Kaestner; Korenman, 2000JOYCE, T.; KAESTNER, R.; KORENMAN, S. The stability of pregnancy intentions and pregnancy-related maternal behaviors. Maternal and Child Health Journal, New York, v. 4, n. 3, p. 171-178, 2000. DOI: 10.1023/a:1009571313297
https://doi.org/10.1023/a:1009571313297... ; Bankole; Westoff, 1998BANKOLE, A.; WESTOFF, C. F. The consistency and validity of reproductive attitudes: evidence from Morocco. Journal of Biosocial Science, Cambridge, v. 30, n. 4, p. 439-455, 1998. DOI: 10.1017/s0021932098004398
https://doi.org/10.1017/s002193209800439... ; Sedgh; Singh; Hussain, 2014SEDGH, G.; SINGH, S.; HUSSAIN, R. Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning, Malden, v. 45, n. 3, p. 301-314, 2014. DOI: 10.1111/j.1728-4465.2014.00393.x
https://doi.org/10.1111/j.1728-4465.2014... ). In a few cases, induced abortion, even if illegal, can become a possibility for resolving this issue. Therefore, instead of managing risks preventively, young people often opt for harm reduction strategies (Bastos; Ventura; Brandão, 2018BASTOS, L. L.; VENTURA, M.; BRANDÃO, E. R. Entre a biomedicina, a saúde pública e os direitos: um estudo sobre os argumentos do Consórcio Internacional sobre Contracepção de Emergência para promover o acesso aos contraceptivos de emergência em “países em desenvolvimento”. Cadernos Pagu, Campinas, n. 53, p. e185309, 2018. DOI: 10.1590/18094449201800530009
https://doi.org/10.1590/1809444920180053... ; Brandão, 2017BRANDÃO, E. R. O atendimento farmacêutico às consumidoras da contracepção de emergência. Saúde e Sociedade, São Paulo, v. 26, n. 4, p. 1122-1135, 2017. DOI: 10.1590/S0104-12902017000003
https://doi.org/10.1590/S0104-1290201700... ; Cabral, 2017CABRAL, C. D. S. Articulações entre contracepção, sexualidade e relações de gênero. Saúde e Sociedade, São Paulo, v. 26, n. 4, p. 1093-1104, 2017. DOI: 10.1590/S0104-12902017000001
https://doi.org/10.1590/S0104-1290201700... ). In this sense, an unplanned pregnancy itself can serve as a warning about the risk of an STI, as exemplified in the statement below, from a young woman who, after pregnancy, started using condoms.

HIV/STI risk perception

For the majority of young people interviewed, risk is generally perceived as something quite abstract, that is, it exists, but is not part of their daily concerns. And, despite comparing the risk of contracting HIV to that of an unplanned pregnancy, in this hierarchy, their most pressing concern is with pregnancy, which according to them is reinforced by school.

The risk is widespread, including, in addition to sexual relations, kissing on the mouth, and even the possibility of someone intentionally injecting the virus, as one participant reported:

The lack of a hierarchy of risks, placing different sexual practices and situations on the same level, can be attributed to the lack of more qualified information by young people, which has been little discussed at school and other social spaces they frequent. On the other hand, we cannot ignore that the campaigns themselves and the hegemonic medical discourse tend to consider youth sexuality only from the perspective of risk.

In analyzing what he calls the “risk factory,” Gilbert (2003GILBERT, C. La fabrique des risques. Cahiers Internationaux de Sociologie, Paris, v. 1, n. 114, p. 55-72, 2003.), highlights that, from the perspective of the risk model managed by experts and public authorities, the public’s characteristic of irrationality appears precisely as the inability to correctly prioritize risks, overvaluing some that are unlikely at the expense of others that are more likely to occur (Gilbert, 2003GILBERT, C. La fabrique des risques. Cahiers Internationaux de Sociologie, Paris, v. 1, n. 114, p. 55-72, 2003.). At the beginning of the AIDS epidemic, authors such as Perlongher highlighted the extent to which the medical discourse ignored the pleasure dimension, treating sexuality only from the perspective of risk (Perlongher, 1987PERLONGHER, N. O que é aids. São Paulo: Brasiliense, 1987.; Valle, 2023VALLE, C. G. Entre o sexo como transgressão e a gestão dos riscos: Néstor Perlongher e o dispositivo da aids. Cadernos Pagu, Campinas, n. 66, e226604, 2023. DOI: 10.1590/18094449202200660004
https://doi.org/10.1590/1809444920220066... ). The absence of this hierarchy ends up having a kind of paralyzing effect, since there are no risks to prioritize or protective measures are always adopted in all situations or, on the contrary, the risk is left to chance.

The idea is that there is always some risk, but this is minimized by the protective measures adopted. This perception varies according to the gender of the interviewee. For women, the risk is most often attributed to the possibility of the condom “breaking” and the possibility of betrayal by the partner.

For men, in contrast, the risk seems to be related to not using condoms in situations considered risky. Failure to use a condom is seen as an inconsequential act, but justified by the emotions of the moment, such as horniness.

However, if on the one hand the fact of exposing oneself can generate “fear,” on the other it is proof of the sexual activity of those who exposed themselves. Therefore, there is a certain ambiguity in the risk perception among some of the men interviewed. It is interesting to note that, even when they identify a situation of exposure, men tend to wait and not immediately seek confirmation by testing. Women, in contrast, were more likely to seek testing when they realized they had been exposed.

The main protection strategy used by young people is “trust” in their sexual partners. For young women, this trust comes from the type of bond with their partner, while, for men, the fact of already “knowing” their partner generates a feeling of security to the point of abandoning the use of condoms.

Trust is given by “knowing” the person and the length of the relationship. Time is also relative, because if a condom is generally used during the first sexual intercourse with a new partner, this is soon dropped, as the partner has already become known and trusted.

Sexual encounters that occur via apps are also considered to be of greater risk, as they are generally a relationship with an unknown person.

Thus, “getting to know” one’s partner is the main strategy for identifying risk and using protection, whether at the start of a relationship or with someone who might be contacted via apps. The use of condoms is, therefore, almost exclusively reserved for the initial moment of the relationship or for relationships with unknown partners. It is interesting to note that, despite the new prevention technologies available, young people continue to use a feeling of trust in their partner as the main form of risk management. This leads us to reflect on the logic of affective-sexual relationships, in which the bond with the partner is prioritized over the rationality intended by preventive discourses. Béjin and Pollak (1977BÉJIN, A.; POLLAK, M. La rationalisation de la sexualité. Cahiers Internationaux de Sociologie, Paris, v. 62, p. 105-125, 1977.) already warned that the rationalization of sexuality, made possible by the autonomy of sexual interest, the creation of a body of experts and the emergence of sexual pleasure, creates more subtle mechanisms for controlling sexuality (Béjin; Pollak , 1977BÉJIN, A.; POLLAK, M. La rationalisation de la sexualité. Cahiers Internationaux de Sociologie, Paris, v. 62, p. 105-125, 1977.). Young people’s refusal to rationalize can also mean a refusal to accept forms of control imposed on youth sexuality.

Condom use

In general, there is no dialogue between the partners and no negotiation over the use of condoms. Among those who choose to use condoms, they leave their adoption implicit and the responsibility for bringing them falls on the man (Heilborn et al., 2006HEILBORN M. L. et al. (Org.). O aprendizado da sexualidade: reprodução e trajetórias sociais de jovens brasileiros. Rio de Janeiro: Editora Garamond: Editora Fiocruz; 2006. 536p.).

The main sources of information about HIV/STI and forms of protection against the disease are: school, almost always present in young people’s discourse, but identified as not providing sufficient information; and the internet, whether through search engines, social networks, or pornographic videos, which they describe as stigmatizing. For young people from middle classes, the family, especially the mother, also acts as a source of knowledge, although less frequently.

Condoms are acquired mainly through purchase in pharmacies or supermarkets. Few young people reported feeling comfortable withdrawing supplies from health services. The embarrassment of acquiring it and the fear of moral judgment, especially in contexts of familiarity (Cunha-Oliveira et al., 2009CUNHA-OLIVEIRA, A. et al. A aquisição do preservativo e o seu (não) uso pelos estudantes universitarios. Referência: revista de enfermagem, Coimbra, v. 2, n. 11, p. 7-21, 2009.), such as in favelas or rural cities, is evident in the speech of some interviewees.

On the other hand, purchasing a condom can serve, especially for men, as a way of reaffirming their virility and attesting to their sexual activity.

In the sexual trajectory of young people, condoms are used as a prevention method for STIs and HIV, in the context of casual relationships or at the start of a relationship, while there is not yet a bond of trust between partners, as already mentioned. As in the case analyzed by Perrusi and Franch (2012PERRUSI, A.; FRANCH, M. Carne com carne gestão do risco e HIV/Aids em casais sorodiscordantes no Estado da Paraíba. Revista de Ciências Sociais - Política & Trabalho, n. 37, p. 179-200, 2012.) concerning relationships between HIV-serodiscordant couples, young people also perceive condoms as a temporary method, which can-and even should-be quickly dropped in the case of relationships that aim to be stable. As the authors point out, condoms work as a “moral demarcator of the relationship” (Perrusi; Franch, 2012PERRUSI, A.; FRANCH, M. Carne com carne gestão do risco e HIV/Aids em casais sorodiscordantes no Estado da Paraíba. Revista de Ciências Sociais - Política & Trabalho, n. 37, p. 179-200, 2012.) which, in the context of young people’s affective-sexual life, can take priority over avoiding HIV and STIs.

In general, young people reported using condoms consistently with occasional partnerships. Some, however, report impulsiveness and lack of programming as reasons for not using condoms (Cunha-Oliveira et al., 2009CUNHA-OLIVEIRA, A. et al. A aquisição do preservativo e o seu (não) uso pelos estudantes universitarios. Referência: revista de enfermagem, Coimbra, v. 2, n. 11, p. 7-21, 2009.; Griep; Araújo; Batista, 2005GRIEP, R. H.; ARAÚJO, C. L. F.; BATISTA, S. M. Comportamento de risco para a infecção pelo HIV entre adolescentes atendidos em um Centro de Testagem e Aconselhamento em DST/aids no Município do Rio de Janeiro, Brasil. Epidemiologia & Serviços de Saúde, Brasília, DF, v. 14, n. 2, p. 119-126, 2005. DOI: 10.5123/S1679-49742005000200008
https://doi.org/10.5123/S1679-4974200500... ).

Corroborating the literature, which indicates that there is a gender distinction in the adoption of prevention strategies regarding the use of alcohol and other drugs, some young men justified not using condoms with occasional partnerships due to their use of substances (Bertoni et al., 2009BERTONI, N. et al. Uso de álcool e drogas e sua influência sobre as práticas sexuais de adolescentes de Minas Gerais, Brasil. Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 6, p. 1350-1360, 2009. DOI: 10.1590/S0102-311X2009000600017
https://doi.org/10.1590/S0102-311X200900... ; Cunha-Oliveira et al., 2009CUNHA-OLIVEIRA, A. et al. A aquisição do preservativo e o seu (não) uso pelos estudantes universitarios. Referência: revista de enfermagem, Coimbra, v. 2, n. 11, p. 7-21, 2009.). The same information did not appear in the speeches of the young women interviewed.

The traditional view that “using a condom is troublesome” remains among today’s generation. Many young people, especially working-class men, reported not using condoms because they do not like them or find them uncomfortable (Miranda-Ribeiro et al., 2008MIRANDA-RIBEIRO, P. et al. “É igual chupar bala com papel”: a vulnerabilidade feminina ao HIV/Aids e o uso de camisinha em Belo Horizonte e Recife. Qualificando os números: estudos sobre saúde sexual e reprodutiva no Brasil. In: MIRANDA-RIBEIRO, P.; SIMÃO, A. B. (Org.) Qualificando os números: estudos sobre saúde sexual e reprodutiva no Brasil Demografia em Debate. Belo Horizonte: ABEP, 2018. v. 2. p. 391-416.).

This discomfort sometimes involves the loss of sexual desire and inexperience with using the product. Pleasure is also one of the factors that motivates not using condoms, as one of the interviewees highlights:

Testing for HIV and other STIs is a strategy that was mentioned by some of the interviewees. The majority of young people reported having been tested at least once in their lives. As the literature indicates (Griep; Araújo; Batista, 2005GRIEP, R. H.; ARAÚJO, C. L. F.; BATISTA, S. M. Comportamento de risco para a infecção pelo HIV entre adolescentes atendidos em um Centro de Testagem e Aconselhamento em DST/aids no Município do Rio de Janeiro, Brasil. Epidemiologia & Serviços de Saúde, Brasília, DF, v. 14, n. 2, p. 119-126, 2005. DOI: 10.5123/S1679-49742005000200008
https://doi.org/10.5123/S1679-4974200500... ), the main testing strategies varied according to gender. For women, especially those with fewer partners, and some men (especially in state capitals), pregnancy was a privileged space for testing, since HIV testing is included in the list of tests requested during prenatal care to prevent mother-to-child transmission of HIV (Brasil, 2013BRASIL. Manual técnico para o diagnóstico da infecção pelo HIV. Brasília, DF: Ministério da Saúde, 2013. Disponível em: <Disponível em: https://bvsms.saude.gov.br/bvs/publicacoes/manual_tecnico_diagnostico_infeccao_hiv.pdf >. Acesso em: 11 mar. 2024.
https://bvsms.saude.gov.br/bvs/publicaco... ). For a significant proportion of men and also for some women, particularly those with a higher number of partners, testing took place because of a possible exposure, to make sure they had not been infected with an STI or HIV. A third group that appeared in our study was made up of young people, of both sexes, who were tested for routine exams. This group, unlike the previous ones, did not focus on being male or female, but rather on social class (the majority of which were middle-class young people) and sexual orientation (with a significant presence of LGBTQIAP+ people). Finally, one last group, much smaller than the previous ones, was made up of young people who, at the start of a relationship, were looking to find out their own and their partner’s serological status, to minimize the risk of contracting an STI/HIV and/or to abandon condom use. Only one young man reported having a family member living with HIV, which motivates him to get tested every three months.

Thus, the refusal to use condoms consistently may be signaling a kind of exhaustion of the preventative discourse centered on risk and, in the case of HIV, on condoms. New technologies (such as PreP and PEP) and prevention strategies (such as self-testing) can be an option in this scenario of youth sexuality, as the above statement indicates. However, there is a great deal of ignorance among the young people interviewed about these new technologies, as well as about where and how they can be accessed and used.

Final considerations

There have been many changes in recent years concerning young people, especially with the expansion of the internet, social networks, and the spread of smartphones (Palenzuela Fundora, 2018PALENZUELA FUNDORA, Y. Participación social, juventudes, y redes sociales virtuales: rutas transitadas, rutas posibles. Ultima década, Santiago, v. 26, n. 48, p. 3-34, 2018. DOI: 10.4067/S0718-22362018000100003
https://doi.org/10.4067/S0718-2236201800... ). The interaction of young people in social networks has been an important form of political mobilization and in the public space (Machado; Ribeiro; Meneses, 2023MACHADO, S. M.; RIBEIRO, V.; MENESES, R. A atividade das juventudes partidárias no Instagram em período eleitoral: Inovação ou normalização? Teknokultura. Revista de Cultura Digital y Movimientos Sociales, Madrid, v. 20, n. 1, p. 49-59, 2023. DOI: 10.5209/tekn.80991
https://doi.org/10.5209/tekn.80991... ; Santos, 2022SANTOS, R. O. A relação público/privada na juventude mediada pelas plataformas de redes sociais digitais. Cadernos Metrópole, São Paulo, v. 24, p. 871-890, 2022. DOI: 10.1590/2236-9996.2022-5501
https://doi.org/10.1590/2236-9996.2022-5... ; Simões; Campos, 2016SIMÕES, J. A.; CAMPOS, R. Juventude, movimentos sociais e redes digitais de protesto em época de crise. Comunicação Mídia e Consumo, São Paulo, v. 13, n. 38, p. 130-150, 2016. DOI: 10.18568/cmc.v13i38.1159
https://doi.org/10.18568/cmc.v13i38.1159... ), as well as establishing sexual partnerships with the use of specific apps and exchanging nudes (Acosta, 2019ACOSTA, T. Produções de verdade perante as vivências da sexualidade juvenil a partir da troca de fotos em aplicativos de celulares. Revista Periódicus, Salvador, v. 1, n. 12, p. 384-403, 2019. DOI: 10.9771/peri.v1i12.29169
https://doi.org/10.9771/peri.v1i12.29169... ; Facioli; Padilha, 2018FACIOLI, L.; PADILHA, F. O Desejo da Metrópole: gênero, sexualidade e mídias digitais em espaços urbanos brasileiros. Revista Periódicus, Salvador, v. 1, n. 9, p. 377-399, 2018. DOI: 10.9771/peri.v1i9.23955
https://doi.org/10.9771/peri.v1i9.23955... ; Maracci; Maurente; Pizzinato, 2019MARACCI, J. G.; MAURENTE, V. S.; PIZZINATO, A. Experiência e produção de si em perfis do aplicativo Grindr. Athenea Digital, Barcelona, v. 19, n. 3, p. e-2315, 2019.). However, when it comes to young people’s level of information and protection practices on sexual and reproductive health, the spread of the internet and social networks does not seem to have had the same impact. Our data indicates a significant lack of knowledge among young people about HIV/AIDS, about the different risks involved in each sexual practice or situation, and about the new HIV prevention technologies available.

The available information technology appears not to have been able to cope with the scenario of increasing conservatism and the lack of policies to prevent HIV among young people, especially heterosexuals. The use of condoms as a temporary prevention strategy, quickly replaced by trust in one’s partner, signals the limits of the preventive discourse centered on individual responsibility and condom use aimed at the young population.

Public policies aimed at preventing HIV in this group should include improving the provision of quality information, adapted to the interests of these young people, and expanding the supply of different HIV prevention materials, but they also should bring STIs and HIV back into the discussion arena. Young people need to take advantage of scientific information about the different risks involved in different sexual practices, as well as the technologies available to mitigate risks beyond the use of condoms. In other words, it is essential to guarantee a context of access to health services, qualified information, and necessary supplies, so that young people can manage their risks more effectively according to the situations and moments in their lives.

Acknowledgements

The research “Jovens da era digital” was coordinated by Cristiane S. Cabral (general and São Paulo/USP coordinator), Ana Paula dos Reis (Salvador/UFBA); Daniela Riva Knauth (Porto Alegre/UFRGS); Elaine Reis Brandão (Rio de Janeiro/UFRJ), Flávia Bulegon Pilecco (Conceição do Mato Dentro/UFMG); José Miguel Nieto Olivar (São Gabriel da Cachoeira/USP). The study received financial support from CNPq (Process 442878/2019-2; Process 431393/2018-4). Special thanks to the coordinators and fieldwork teams in each location, as well as to the young people who shared part of their life experiences with us.

References

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