Revista Adolescência e Saúde

Revista Oficial do Núcleo de Estudos da Saúde do Adolescente / UERJ

NESA Publicação oficial
ISSN: 2177-5281 (Online)

Vol. 15 nº 2 - Apr/Jun - 2018

Original Article Imprimir 

Páginas 72 a 80


Sexual violence among Brazilian adolescent students

Violencia Sexual entre Adolescentes Escolares Brasileños

Violência Sexual entre Adolescentes Escolares Brasileiros

Autores: Felipe Barbosa de Sousa Costa1; Cássio Eduardo Soares Miranda2; Malvina Thais Pacheco Rodrigues3; Márcio Dênis Medeiros Mascarenhas4

1. Graduated in Physiotherapy by the Sciences and Technology College of Maranhão (FACEMA). Caxias, MA, Brazil. Mastering of the Post-graduation Program in Health and Community – Health Sciences Center of the Federal University of Piauí (UFPI). Teresina, PI, Brazil
2. Doctor in Psycology by the Rio de Janeiro Federal University (UFRJ). Rio de Janeiro, RJ, Brazil. Permanent Professor of the Post-Graduation Program in Health and Community - Health Sciences Center of the UFPI. Teresina, PI, Brazil
3. Doctora in Collective Health by the Ceará State University (UECE). Fortaleza, CE, Brazil. Permanent Professor of the Post-Graduation Program in Health and Community - Health Sciences Center of the UFPI. Teresina, PI, Brazil
4. Doctor in Medical Sciences by the Campinas State University (Unicamp). Campinas, SP, Brazil. Permanent Professor of the Post-Graduation Program in Health and Community - Health Sciences Center of the UFPI. Teresina, PI, Brazil

Felipe Barbosa de Sousa Costa
Rua Castelo Branco, n° 815, Campo de Belém
Caxias, MA, Brasil. CEP: 65609-130
(felipe_barbosama@hotmail.com)

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Keywords: Sexual violence, adolescent, students.
Palabra Clave: Violencia sexual, adolescente, estudiantes.
Descritores: Violência sexual, adolescente, estudantes.

Abstract:
OBJECTIVE: Describe the prevalence of sexual violence against Brazilian adolescent students and identify the main perpetrators of this type of violence.
METHODS: Descriptive study based on micro-data from the National Survey of School Health (PeNSE) of the year 2015 made with students from the 9th year of elementary education in public and private schools in Brazil. It was estimated the prevalence and respective confidence intervals (IC95%) of sexual violence according to sex, administrative dependency of the school by regions and federative units, besides estimated the prevalence and IC according to the author of the aggression by geographic regions.
RESULTS: 48,3% of students were male and 51,7% female. The results showed that 4,0% (IC: 3,8-4,3) of Brazilian students were forced to have sexual intercourse at any time of their lives, being more prevalent in females (4,3%, IC: 4,0-4,7), in students of the public school system (4,4%, IC: 4,1-4,7) and in the Northern Region of the Country (5,3% IC: 4,8-5,9). There were high prevalence of family aggressors and / or with affective and loving relationships with the victim, mainly violence perpetrated by the victim's boyfriend/girlfriend/ex-boyfriend/ex-girlfriend (26,6%; IC: 24,3-28,9).
CONCLUSION: Violence through forced sexual intercourse is a serious social and public health problem, presenting significant rates among Brazilian students. The perpetrator of the aggression often has some connection with the victim, drawing attention to the high prevalence of violence observed in affective-loving relationships.

Resumen:
OBJETIVO: Describir la prevalencia de violencia sexual contra adolescentes escolares brasileños e identificar a los principales perpetradores de este tipo de violencia.
MÉTODOS: Estudio descriptivo a partir de micro datos de la Encuesta Nacional de Salud del Escolar (PeNSE) del año 2015, efectuado con estudiantes del 9º año de la enseñanza básica (fundamental) de escuelas públicas y privadas de Brasil. Se estimaron las prevalencias y respectivos intervalos de confianza (IC95%) de violencia sexual según el sexo, dependencia administrativa de la escuela por regiones y unidades federativas, además de estimadas las prevalencias e IC según el autor de la agresión por regiones geográficas.
RESULTADOS: El 48,3% de los estudiantes eran del sexo masculino y el 51,7% del sexo femenino. Los resultados mostraron que el 4,0% (IC: 3,8-4,3) de los adolescentes escolares brasileños fueron forzados a tener relación sexual alguna vez en la vida, siendo más prevalente en el sexo femenino (4,3%, IC: 4, (0,47), en los estudiantes de la red pública de enseñanza (4,4%, IC: 4,1-4,7) y de la Región Norte del país (5,3%, IC: 4,8-5, 9). Se observaron altas prevalencias de agresores familiares y / o con relaciones afectivas y amorosas con la víctima, principalmente de violencia perpetrada por el novio (a) / ex novio (a) de la víctima (26,6%: IC: 24,3-28 9).
CONCLUSIÓN: La violencia por relación sexual forzada es un grave problema social y de Salud pública, presentando tasas significativas entre escolares brasileños. El autor de la agresión frecuentemente tiene algún vínculo con la víctima, despertando atención a la alta prevalencia de violencia observada en las relaciones afectivas-amorosas.

Resumo:
OBJETIVO: Descrever a prevalência de violência sexual contra adolescentes escolares brasileiros e identificar os principais perpetradores deste tipo de violência.
MÉTODOS: Estudo descritivo a partir de microdados da Pesquisa Nacional de Saúde do Escolar (PeNSE) do ano 2015 feito com estudantes do 9º ano do ensino fundamental de escolas públicas e privadas do Brasil. Estimou-se as prevalências e respectivos intervalos de confiança (IC95%) de violência sexual segundo o sexo, dependência administrativa da escola por regiões e unidades federativas, além de estimadas as prevalências e IC segundo o autor da agressão por regiões geográficas.
RESULTADOS: 48,3% dos estudantes eram do sexo masculino e 51,7% do sexo feminino. Os resultados mostraram que 4,0% (IC: 3,8-4,3) dos adolescentes escolares brasileiros foram forçados a ter relação sexual alguma vez na vida, sendo mais prevalente no sexo feminino (4,3%; IC: 4,0-4,7), em estudantes da rede pública de ensino (4,4%; IC: 4,1-4,7) e da Região Norte do País (5,3%; IC: 4,8-5,9). Foram observadas altas prevalências de agressores familiares e/ou com relacionamentos afetivos e amorosos com a vítima, principalmente de violência perpetrada pelo namorado(a)/ex-namorado(a) da vítima (26,6%: IC: 24,3-28,9).
CONCLUSÃO: A violência por relação sexual forçada é um grave problema social e de saúde pública, apresentando taxas significativas entre escolares brasileiros. O autor da agressão frequentemente possui algum vínculo com a vítima, despertando atenção a alta prevalência de violência observada nos relacionamento afetivos-amorosos.

INTRODUCTION

Submitting to children and adolescents the situation of sexual violence breaks with the socio-family rules of adult accountability to individuals in formation and development, transgressing rights and seriously undermining the dignity of others1. In Brazilian reality, the latest official data provided by the National Secretariat for Human Rights shows that in the year 2015 more than 80 thousand reports of violations of the rights of children and adolescents were carried out, of which more than 25% corresponded to the crime of rape2.

In view of the problem of sexual violence perpetrated against children and adolescents, important measures were taken, such as Law 8.069 of July 13, 1990, which establishes the Statute of the Child and Adolescent (ECA), which in its article 5 states that: no child or adolescent shall be subjected to any form of neglect, discrimination, exploitation, violence, cruelty and oppression, punished in the manner prescribed by law for any act or omission to violate their fundamental rights"3.

Forms of violence against children and adolescents include physical, psychological and sexual violence. The latter, the object of this study, is divided into intra-family sexual abuse, extra-familial sexual abuse and commercial sexual exploitation1,4.

Currently, the World Health Organization (WHO) considers sexual violence as one of the greatest public health problems in the world, as it causes physical, psychological and social harm5. Several international studies indicate that the family member is the main sexual aggressor of children and adolescents. However, there are several situations of sexual violence involving adolescents, including affective-sexual relationships6.

This study aims to describe the prevalence and main perpetrators of sexual violence against Brazilian schoolchildren.


METHODOLOGY

The present study is a descriptive study that was carried out from the microdata of a cross-sectional study, developed by the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics, entitled "National School Health Survey" (PeNSE) in the year 20157 The data were collected on the IBGE website and are in the public domain7.

PeNSE 2015 acquired innovations after the 2009 and 2012 editions. One of the main ones was the provision of two sample plans, one with schoolchildren who are attending the 9th year of elementary education in public and private schools in Brazil, and the second sample plan covering schoolchildren from 13 to 17 years of age from the 6th to the 9th year of primary and secondary education7. In this study, data available from sample plan 1 were used. PeNSE 2015 sample 1 was representative of the Brazilian population, it included the 26 municipalities of the capitals and the Federal District, the 26 Federal Units (UF), the five large regions, and Brazil n = 102,072), totaling 53 geographic strata7.

A sample of schools from each stratum was dimensioned and selected in each geographic stratum. Then, a sample of classes was selected in each school, followed by an invitation to the students to participate in the study. Thus, an independent sample was obtained in each stratum formed. Allocation strata were created in the geographic strata where schools were identified according to the cross-strata of geographic strata, administrative dependency (public or private) and size of schools according to the number of classes enrolled in grade 9 fundamental. For the strata of the municipalities of the capitals and the Federal District the schools were selected in the allocation strata in a manner proportional to the size of the schools according to the number of classes7.

The answers were obtained through a self-administered questionnaire, with more than 120 questions, inserted in the smartphones of the research participants. In the 2015 version of the questionnaire there was an increase of questions and exclusion of others, besides the possibility of "jumping" the question, in the perspective of reducing its time of application and minimizing inconsistent answers. The detailed PeNSE methodology is described in specific publication7.

For this article, sexual violence involving school adolescents was analyzed through the following questions contained in the "SECURITY" item of the questionnaire:

"Have you ever been forced to have sex?" (Yes/No);

"Who forced you to have sex?" (boyfriend/ex-boyfriend, friend, father/mother/step-father/stepmother, other family members, unknown, others.

The prevalence of sexual violence with a 95% confidence interval (CI) according to sex (female or male) and administrative dependency (public or private) by large region and UF, and the prevalence of sexual violence according to the aggressor for large region of the country. The data were analyzed in the statistical software Statistical Package for the Social Sciences, SPSS, version 20.0 using procedures of the Module of Complex Samples, suitable to analyze data obtained by complex sampling plan.

The PeNSE 2015 was approved in the National Commission of Ethics in Research - Conep, of the National Health Council, through Opinion No. 1,006,467, dated 03.33.2015. Because it is secondary data available in the public domain on the IBGE website and does not allow the identification of the research participants, the study complies with Resolution 510/2016 of the National Health Council and doesn´t require appreciation and approval by the Ethics Committee.


RESULTS

Among the students interviewed, 48.3% were male and 51.7% female. Regarding age, approximately 87.4% of the adolescents were in the age range of 11 to 15 years and 12.1% of the interviewees were aged 16 years or older. Regarding administrative dependence, 79.5% of the students were from public schools and 20.5% from private schools.

In Table 1, the results showed that 4.0% (CI: 3.8-4.3) of Brazilian schoolchildren were forced to have sexual intercourse at any time in their lives, being more prevalent in females (4.3%; CI: 4.0-4.7), and among students in the public network (4.4%) (CI: 4.1-4.7). The prevalence of forced sexual intercourse (5.3%; CI: 4.8-5.9) was higher in the northern region of the country, with a significantly higher prevalence among women (6.3%; CI: 5,6 -7,1) in relation to males (4.3%; CI: 3.6-5.0).




In general, the prevalence of violence due to forced sexual intercourse was lower in the private school system. Table 1 shows that significant differences in victimization due to forced sexual intercourse were observed between public and private schools in the Northeast, Southeast and South regions. In the Northeast region, for example, the prevalence was 4.2% in the public network (IC: 3 , 8-4.6), whereas in the private network the prevalence was 2.5% (CI: 2.1-2.9).

Figure 1 shows the prevalence of schoolchildren who had sexual intercourse forced by units of the federation. The highest prevalences were observed in the states of Roraima (7.3%, CI: 95% 6.4-8.2), Mato Grosso (6.2%, CI: 5.0-7.4), Amazonas (6 (CI: 4.7-6.6), Tocantins (5.3%, CI: 4.4-6.2) , Amapá (5.1% CI: 4.5-5.8), Pará (4.9% CI: 3.9-6.0), Rondonia (4.8% CI: 5,6), Ceará (4,5%; CI: 3,6-5,4) and Acre (4,5%; CI: 3,6-5,5). It is noteworthy that among the ten states with the highest prevalence, seven of them make up the Northern Region of the country, the same region where this type of violence was most prevalent (Table 1). The lowest prevalence in Brazil was observed in the State of Alagoas (2.8%; CI: 2.2-3.4).


Figure 1. Prevalence (%) and respective confidence intervals of 95% of schoolchildren in the 9th year of elementary school who were forced to have sexual intercourse at any time in their lives, according to the Federation Units, 2015.



Regarding the author of the violence, there was a higher prevalence in affective-loving relationships, where the boyfriend/ex-boyfriend was identified as the main perpetrator of sexual violence among Brazilian schoolchildren (26.6%; CI: 24.3-28.9), followed by friends (21.9% CI: 19.4-24.1) and other relatives (19.7%; CI: 17.5-21.9). The less prevalent aggressor in the Brazilian students' responses was the father/mother/stepfather/stepmother, with a prevalence of 11.9% (CI: 10.2-13.6). There was a statistically significant (p <0.05) difference between the prevalence of sexual violence perpetrated by boyfriend/ex-boyfriend or friends in relation to violence perpetrated by the father/mother/stepfather/stepmother.

The Central-West region recorded the highest prevalence of violence perpetrated by boyfriend/ex-boyfriend (31.7%, IC: 27.5-35.8) and by father/mother/step-parent/stepmother (15.3%, CI: 12.0-18.5). When the aggressor is a friend, the highest prevalence was measured in the Northeast (24.8%; CI: 21.4-28.2). The South region recorded the highest prevalence for other relatives (22.9%, CI: 17.5-28.4) and unknown persons (16.2%; CI: 11.4-21.1) (Table 2).




DISCUSSION

The PeNSE 2015 showed that violence due to forced sexual intercourse was more prevalent in the female sex, in the Northern region of the country and among students of public schools.

Understood as a complex and non-homogeneous phenomenon in the world, violence, in general, is a serious social and public health problem. This phenomenon is influenced by economic, social, political and cultural factors in which more than 95% of acts of violence against children and adolescents occur in countries with the lowest indicators of economic and social development8.

Violence is a phenomenon that materializes in unequal relationships, with victims often in a situation of social and / or physical disadvantage, with a higher incidence in the popular classes, residents of urban peripheries and regions of low socioeconomic development9.

Situations of violence perpetrated against children and adolescents violate the social rules of accountability of adults by minors and are contrary to what is stated in the Statute of the Child and Adolescent (ECA). It is estimated that five reports of violence against children and adolescents in Brazil are recorded every hour through the telephone service Dique 100, and this number may be even greater considering that many cases remain in secrecy10.

American studies with adolescent students indicate that 18% of girls and 12% of boys have experienced sexual violence11. According to the Centers for Disease Control and Prevention of the United States Department of Health, it is estimated that one in four girls and one in six boys have experienced an experience of sexual violence perpetrated by an older adult or adolescenty12.

In this study, the highest prevalence of sexual violence victimization was observed in females. In general, studies on the subject of sexual violence against adolescents report a higher prevalence in females, but emphasize the underreporting in the country's information systems, where violence against boys is often neglected13. Added to this is the fact that the construction of our society is based on a macho culture with patterns of masculinity in which men and boys are individuals endowed with force, and therefore invulnerable, incompatible with the position of victim, and this doesn´t often reveal the experiences of sexual violence14.

The WHO points out that violence against children is a significant problem, with prevalence observed in developed countries between 5 and 10% and in developing countries prevalences ranging from 3.6 to 20%15 are observed, corroborating with the findings of this study where they were observed prevalence of 3.7 (CI: 3.3-4.1).

Although this study didn´t verify the relationship between socioeconomic variables and the experience of violence through forced sexual intercourse, it is important to highlight that the North region, where the highest prevalences were observed, is one of the regions of the country with the lowest economic and with higher unemployment rates, lower income levels, higher rates of illiteracy, among other indicators constantly reported in the literature as factors related to the greater possibility of victimization due to violence16.

The North region represents almost half of the whole national territory, which becomes a great challenge for the development of public policies. Added to this are the difficulties of access to their states - with several isolated cities, the scarcity of information and data on the living conditions of children and adolescents, especially in rural communities10. These factors allow inferring that the numbers of this type of violence in the region can be much larger than the numbers verified in this study.

Research indicates that individuals who are more exposed to violent events in the community are more likely to suffer violence16. According to the Atlas of Violence 2017, four of the ten states with the highest prevalence rates of sexual violence are among the ten states with the highest prevalence rates of sexual violence. Of these, three belong to the Region North, where violence due to forced sexual intercourse was more reported, including the state of Roraima presented the highest prevalence17.

The high prevalence observed among schoolchildren in the public school system is justified by the fact that most of them belong to the lower socioeconomic classes and thus are more vulnerable to exposure to violent events.

In analyzing the experience of forced sexual intercourse according to the author of the aggression, the PeNSE 2015 showed that in most cases, the perpetrator is known to the victim and often someone with whom the same maintains some type of relationship, with a higher prevalence reported for the boyfriend ( a) / ex-boyfriend and friend. Violence in the relational spheres of adolescents and young people has drawn the attention of the scientific community to the high prevalence of this phenomenon in the world. During adolescence the first experiences of love and sex are experienced, being then a stage of high vulnerability to violent relationships18.

It is estimated that 2/3 to 3/4 of all experiences of sexual violence against adolescents are perpetrated by a family member or known to the victim, increasing the damage caused. Sexual violence perpetrated against children and adolescents impacts the lives of victims with physical, psychological, emotional and social damages, including fear, social phobia, depression, suicidal ideation, alcohol and other drug abuse, sexually transmitted infections transmission and pregnancy8,11.

Data from a national multicenter study with public and private school teaching adolescents showed that 10.1% of schoolchildren already suffered sexual violence in at least one relational sphere. In this study, the highest prevalence of violence was also observed in affective-loving relationships, with the victim's partner being the main aggressor6.

Another study carried out with Brazilian adolescents and youngsters showed that the partner or ex-partner was the main agent of coercion (53.6%) for girls, followed by friend (18.1%). For the boys, the main agent was the friend (44.5%), followed by a partner or ex-partner (33.3%)19.

Although it has not been verified as the main aggressor in this study, it is important to reflect on the sexual violence committed by parents and / or persons occupying this position, since this practice is surrounded by myths and taboos. The family is considered a safe, caring and protective space, where these relatives are unable to perform any violent act against theirs, especially the rape. However, these cases occur and there is often secrecy in the violence practiced by the parents or guardians, which may explain the lower prevalence observed in relation to other aggressors in this study10,13.

The data presented showed that the school adolescents are exposed to situations of sexual violence. The PeNSE is an extensive research, but may not correspond to the reality found in the whole country, especially in the cities of the interior, besides the sample analyzed in this study is only the 9th year of elementary school, which doesn´t include adolescents who are in other education series.


CONCLUSION

The growing manifestation of violence in the country significantly affects adolescents and young people. Violence through forced sexual intercourse is a serious social and public health problem, presenting significant rates among Brazilian schoolchildren, despite neglect and potential underreporting.

The experience of forced sexual intercourse analyzed by the PeNSE was more prevalent in the female sex, among students of the public school system and in the regions with the lowest indicators of economic and social development, like the North Region where all their states appeared among the ten states with the highest prevalence of this type of sexual violence.

The main perpetrators of aggression belonged to some relational sphere of adolescents, with higher prevalences in affective-loving relationships.

The findings of this study described the prevalence of forced sexual violence against Brazilian schoolchildren and allowed the identification of the main perpetrators of this violence. In order to better understand this complex and dynamic phenomenon, it is necessary to carry out other studies that deepen this discussion, relating socioeconomic characteristics of schoolchildren and their places of residence, for example, to infer the factors associated with the higher prevalence observed in female students, the public network and the poorest regions of the country. It is important to highlight the need to understand the dynamics of intra-family sexual abuse and the affective and loving relationships of adolescents, since the practice of forced sexual intercourse was more prevalent in this relational sphere.


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