PROTAGONISM OF ADOLESCENTS IN PLANNING ACTIONS TO PREVENT SEXUAL VIOLENCE

PROTAGONISMO DE ADOLESCENTES EN LA PLANIFICACIÓN DE ACCIÓN PARA LA PREVENCIÓN DE LA VIOLENCIA SEXUAL VIOLENCE

ABSTRACT

Objective:

to investigate the knowledge and attitude of school adolescents regarding sexual violence.

Method:

a qualitative study with data gathering, based on Maurice Merleau-Ponty’s Phenomenology of Perception, conducted in April 2018 with 12 adolescents from a state school in Recife, using the focus group technique. For data systematization, thematic content analysis was used in the following steps: pre-analysis, material exploration, treatment of results and interpretation.

Results:

three thematic categories were established: adolescents’ perceptions of sexual violence; reflective construction of adolescents on the factors of exposure to sexual violence; and facilitating aspects for the prevention of adolescent sexual violence.

Conclusion:

the perception of adolescents regarding sexual violence is influenced by cultural, structural, social, economic, psychological and biological aspects, which should be considered in the planning of actions aimed at preventing sexual violence for this public.

DESCRIPTORS
Sexual violence; Adolescents; Health promotion; Health education; Nursing

RESUMEN

Objetivo:

investigar el conocimiento y la actitud de los adolescentes escolares con respecto a la violência sexual.

Método:

un estudio cualitativo con captura de datos, basado en la Fenomenología de la percepción de Maurice Merleau-Ponty, realizado en abril de 2018 con 12 adolescentes de una escuela estatal en Recife, utilizando la técnica de grupos focales. Para la sistematización de datos, el análisis de contenido temático se utilizó en los siguientes pasos: preanálisis, exploración de materiales, tratamiento de resultados e interpretación.

Resultados:

se establecieron tres categorías temáticas: percepción de los adolescentes de la violencia sexual; construcción reflexiva de adolescentes sobre los factores de exposición a la violencia sexual; y facilitando aspectos para la prevención de la violencia sexual adolescente.

Conclusión:

la percepción de los adolescentes con respecto a la violencia sexual está influenciada por aspectos culturales, estructurales, sociales, económicos, psicológicos y biológicos, que deben tenerse en cuenta al planificar acciones destinadas a prevenir la violencia sexual para este público.

DESCRIPTORES
Violencia sexual; Adolescentes Promoción de la salud; Educación en salud; Enfermería

RESUMO

Objetivo:

investigar o conhecimento e a atitude de adolescentes escolares a respeito da violência sexual.

Método:

estudo qualitativo, com apreensão dos dados, embasada na Fenomenologia da Percepção de Maurice Merleau-Ponty, realizada em abril de 2018 com 12 adolescentes de uma escola estadual do Recife, por meio da técnica de grupo focal. Para sistematização dos dados, utilizou-se a análise de conteúdo temática nas seguintes etapas: pré-análise, exploração do material, tratamento dos resultados e interpretação.

Resultados:

foram estabelecidas três categorias temáticas: percepções dos adolescentes sobre violência sexual; construção reflexiva de adolescentes sobre os fatores de exposição à violência sexual; e aspectos facilitadores para a prevenção da violência sexual dos adolescentes.

Conclusão:

a percepção dos adolescentes em relação a violência sexual é influenciada por aspectos culturais, estruturais, sociais, econômicos, psicológicos e biológicos, que devem ser considerados no planejamento de ações que visem a prevenção da violência sexual para esse público.

DESCRITORES:
Violência sexual; Adolescentes; Promoção da saúde; Educação em saúde; Enfermagem

INTRODUCTION

Sexual violence is understood as an act or attempt of a sexual act, as well as undesirable sexual comments against a person’s sexuality through coercion. It is considered a public health problem and is seen as a violation of human rights due to its negative impact on the life of the victim.1

In Brazil, the highest prevalence of sexual violence occurs against adolescents aged 10 to 14 years (66%) and predominantly female (91%).2 Factors associated with this violence are the victim’s low educational level, lack of professional training, having one or more intimate partners, drinking alcohol and witnessing alcoholism. All of these elements increase the chance of rape in the home environment by 18.9%.3

The negative impact of sexual violence is reflected in immediate and long-term harm, as it is a traumatic event with potentially devastating effects on the physical, mental, emotional and social well-being of adolescents. It also exposes this public to the risk of unplanned pregnancy, sexually transmitted infections and the human immunodeficiency virus (STI).4

In Brazil, the need for measures to deal with these situations led to the implementation of public policies and programs aimed at reducing the sexual and reproductive health problems of adolescents.5 In this setting, the Health at School Program (Programa Saúde na Escola) was instituted by the Ministry of Education. which has as one of its actions the promotion of youth sexual and reproductive health, integrating health and education.6

The school environment is one of the foundations involved in the educational process, being a means that integrates the adolescent with the social environment, building relationships that extend throughout life. It is understood that this space represents a strategic place to establish care for adolescents through projects that inform about sexual violence, contributing to the effectiveness of intersectoral policies, including health and education.7

It is noteworthy that, commonly, educational approaches to sexual violence are neglected and poorly carried out in schools. Adolescent-oriented education practices need to be mediated by innovative and creative strategies, with the effective participation of adolescents.8

Recognizing youth leadership in the creation of educational approaches to the prevention of sexual violence is to make them co-responsible for human development and the exercise of their citizenship. It enables you to broaden critical thinking, creativity, and involvement in causes that you consider relevant to yourself and your social group.9 The study of this phenomenon in the adolescent population finds, in the theoretical framework of Maurice Merlau-Ponty’s Perception Phenomenology. They are essential grounds for understanding the conception of the violated body as a direct fragmentation with the world, with immeasurable implications for physical and mental health.10

For Merleau-Ponty, the body is directly linked to consciousness, which depends on intentionality to perform actions. For this intentionality to emerge positively, it is necessary to recognize the body to understand an act of sexual violence. Awareness reveals understanding of the body as an essential element in attitudes and coping practices of this violation of rights.10

In view of the above, the objective was to investigate the knowledge and attitude of school adolescents regarding sexual violence.

METHOD

This is a qualitative study, whose gathering of information was based on Maurice Merleau-Ponty’s Phenomenology of Perception. Such reference is appropriate for the present study because it considers the body as an instrument of interrelation between the individual and the world. From this perception, it becomes possible to establish an awareness and intentionality for the situations experienced by adolescents, in addition to the dialogued information being a positive differential in decision making. In the case of this research, the adolescent’s experience builds a knowledge that strengthens the attitude of this being inserted in the world.10

The research, conducted in April 2018, used the focus group technique in order to capture the knowledge and attitude of adolescents about sexual violence. This study was conducted with 12 adolescents from a state school system in the city of Recife, state of Pernambuco.11 The criteria applied for the inclusion of the subjects were: being enrolled in the high school of that institution and being between 15 and 18 years old. The age range was established according to the age estimate for this school period. Adolescents with cognitive impairment were excluded, according to the evaluation of the educational institution itself.

For the selection of participants, the researcher, after authorization from the school board, went to the high school classrooms to make the formal invitation. On this occasion, the research objectives, the relevance of the participants’ adherence to this research were presented and the guarantee of anonymity aiming to soften the concern with any future exposure.

The adolescents granted formal consent to participate in the research through the Informed Consent Form. At the second meeting, they gave written informed consent, signed by their legal representative.

The sample composition was intentional, not probabilistic, because it strengthened the proposal of free and spontaneous participation of adolescents, as well as the dialogic process during group sessions. The adolescents, by accepting to participate in the research, showed interest in the discussions, being considered a valuable resource for the elucidation of little investigated questions or more sensitive topics.12

Two group sessions were held in a room provided by the school. The private environment allowed the adolescents to talk freely and without interference on the study questions. The adopted circle format promoted eye contact, strengthening discussions.11

In this study, the moderator was represented by the researcher in charge, assisted by two observers, nursing undergraduates, who received previous training through educational workshops. Two recorders were used to capture the participants’ speech.

The sessions were organized according to the following activities: preparation, presentation, development, closing and socialization.11 Each session lasted a maximum of two hours. The preparation consisted of the presentation of participants, introduction of the theme, presentation of objectives and explanation of the technique used for focus group. The development was guided by six guiding research questions: What is sexual violence to you? What situations expose the adolescent to sexual violence? What attitudes can you take to prevent sexual violence? What attitudes should a teenager have if he/she experiences sexual violence? What precautions do you take in your daily life to prevent sexual violence?

At the end of each group session, the moderator summarized the discussions with each group to validate the data by the participants. To systematize the data, we used the phenomenological trajectory composed of three moments: description of the phenomenon, reduction and phenomenological understanding. The description allows obtaining the discourses that must be analyzed and interpreted phenomenologically, glimpsing the scope of the essence and its transcendence. Reduction seeks to select the fragments considered essential, allowing a reflection on their possible concepts, originating the units of meanings. Understanding, on the other hand, comes with interpretation, revealing the subject’s awareness of the phenomenon.13

When finding the units of converging meanings in the subjects ‘discourses, each one was interpreted, using their own language and, subsequently, the synthesis of each one of them, emerging three thematic categories: adolescents’ perceptions of sexual violence; reflective construction of adolescents on the factors of exposure to sexual violence; and facilitating aspects for the prevention of adolescent sexual violence.

The anonymity of the subjects was respected, being identified by the letter “A” followed by the numeral referring to the order of participation, as well as by the gender with which they identified themselves.

RESULTS

The 12 adolescents who participated in the study were aged 15 to 18 years, four male and eight female, with family income between 1 and 3 minimum wages. For didactic purposes, the thematic categories will be presented and discussed separately.

Adolescents’ perceptions of sexual violence

The discourses on knowledge associated with sexual violence are related to rape, verbal violence, female fragility and gender domination:

Sexual violence to me is rape (A3 Male).

[...] There is also the verbal question, “right”? Which is when you’re on the street and the guy talks things to you, I think that’s pretty embarrassing. Like one time on the subway, a man said to me [referring to the buttocks] “if I had a couch kneader like this at home, I would do the maintenance every day,” that’s boring, hammering in my mind (A4 Female).

The man when fighting with the woman, she cannot even defend herself because she is afraid of being beaten (A5 Female).

The power of man over woman comes from the macho culture. Because, for example, a thousand years ago if someone said something to you, abused you, you had to take nonsense and that’s it [...] So much so that Brazilian culture is so rooted in the thought of sexuality that if you listen to a song that talks about ostentation it will talk about three or four things: car, money, drink and woman (A6 Male).

Regarding the definition of attitude, adolescents stated that they can be taken according to the level of information acquired on a given subject.

Having knowledge of a subject, I have attitude (A9 Female).

[...] Until you have the knowledge about something, it will make you have an attitude towards it (A7 Female).

[...] We know something and put it into practice (A5 Female).

The right thing is to execute, to apply. By understanding the information I received, I can have a basis on how to act (A3 Male).

Reflective construction of adolescents on the factors of exposure to sexual violence

The adolescents interviewed reported some factors of exposure to sexual violence linked to environmental and behavioral conditions. They were listed among the environmental constraints: lack of safety in public transport, lack of illumination on public roads and exposure to virtual environments:

[...] The person takes a crowded bus, and most of the time frustrated, because a guy may come after you [...] (A5 Female).

[...] If I pass a dark and narrow street, I turn my back, I avoid the front of the man, for fear (A2 Female).

[...] Like you have a boyfriend and send nudes, if the relationship ends he can share on the network, then everyone will be pointing at you and that’s very boring, you get marked [...] Even a bikini picture when you put on the internet guys are starting to think they are offering (A9 Female).

Parents themselves expose their children on social networks, I think this influences a lot (A1 Female).

Regarding behavioral conditions, adolescents had particular characteristics, since their personality is in the process of formation and is influenced by pre-established postures. It is socially imposed that men assume a promiscuous attitude and dissociated from affective feelings about sexual practice. Failure to adhere to this attitude results in the spread of a pre-judgment that questions sexual choice:

[...] the man has to be ready for sex all the time, he finds himself in a position of obligation to fulfill what people expect from him [...] if he does not look at woman the way society expects, it is said that he is gay (A2 Female).

[...] a man will find me coming back from the club because I’m drunk, he will find himself entitled to harass me and rape me (A9 Female).

[...] If the guy is more handsome than average, the girl will start to want him a lot (A6 Male).

Sometimes women let themselves be influenced [...] the lyrics of funk are very explicit [...] they grow up seeing it, so much so that music is a cultural expression that comes from a place (A8, Male).

[...] I can’t go out with certain clothes because I’m afraid (A1 Female).

Facilitating aspects for the prevention of adolescent sexual violence

Family and school were highlighted as facilitating elements for the prevention of sexual violence, as they allow the active construction of adolescent knowledge by continuously accompanying them in their daily routine, observing their anxieties, concerns and behaviors. The media was valued as an exposition factor of ideas that can influence the decision making of this adolescent, by promoting sexual violence prevention practices.

Guidance I think has to come from school. Observe the signs, the small details. And mainly educate this audience! (A2 Female).

Guidance starts from the parents (A10 Male).

There are a lot of advertisements on television on how to prevent and report sexual violence, the media is also very involved in it! (A8 Male).

[...] We are saying this because we are aware, we have information, but who doesn’t? (A9 Female).

DISCUSSION

In discussing what they recognize as sexual violence, adolescents of both sexes highlighted a greater vulnerability for women, who face a historical cultural process of social imposition of power and male domination.

Sexual violence is mostly practiced by men against women in all age groups.14 One in three women have experienced sexual violence at some point in their lives, and it is also clear that sexual violence behaves according to the cultural and social conditions of each region or country.15^-16The practices of sexual violence were mentioned by adolescents of both sexes, linked to a macho culture of male domination over the female population, with the practice of “taking nonsense” to avoid physical confrontation with the dominator.

A study conducted in the state of Santa Catarina, regarding the notifications of sexual violence, found that adolescents are the most affected age group when compared to adult women, as well as revealed that most cases occur with vaginal penetration, characterizing as rape.17 The rape evidenced in the speeches of adolescents is a criminal modality, which generates embarrassment for the violent practice of sexual intercourse, without consent, constituting a violation according to article 213 of the Penal Code.18

Rape can lead to serious consequences such as pregnancy, sexually transmitted infections, suicide attempts and death. The high rate of underreporting, the fear of family dissociation if the fact is discovered and the discredit in the assaulted speech, sometimes blamed for being abused, are aspects that contribute to the maintenance of this injury.17

Understanding sexual violence was broad in scope, not limited to sexual practice with non-consensual physical contact. But it was also evidenced sexual violence without physical contact, as reported in situations of exposure to insults and obscene words that dishonor the human being, with emotional damage of the most varied intensities. The embarrassment generated by the visualization of gestures and attitudes or listening to words, characterized as obscene, finds legal support in article 233 of the Penal Code, being characterized as offensive indecency to shame.18

Gender inequality is one of the factors that perpetuates social heterogeneities. Thus, gender issues strengthen the domination of men over women, as well as the overlap of violence, including sexual ones, whose main aggressors are represented by parents, stepparents, friends and partners of women.19

Another cultural factor raised by the adolescents was the use of music made only with commercial interests, which do not undertake to safeguard respect for the population and treat women as an object to fulfill male desires. A study carried out in Fortaleza, with male adolescents from 14 to 18 years old, showed the character of songs with misogynist lyrics in affirming the social role of women in satisfying male pleasure and in allowing them to punish those who occupy the outer space.20

The attitudes and practices developed by an individual are often related to the degree of knowledge about the subject in question. Subsidized an awareness capable of instrumentalizing their attitude and decision-making power, by choosing paths of greater possibility for their achievements and even their collectivity. Affinity with adolescents’ knowledge demands can support care improvement strategies that provide knowledge domains, to adopt safe behaviors and attitudes that strengthen the search for a support network to denounce this injury, if it occurs, preserving their rights and freedom.21

Family, school and society play important roles in the lives of young people, as they have the mission of developing educational activities. The school, therefore, plays an important role in the formation of the individual and represents a conducive space for working skills, knowledge and behavioral changes, since it is the place where the teenager stays the longest of his day.22

The dialogic relations in the production of health knowledge that involve participatory methodologies are the strategies that best meet the expectations of adolescents, as they contribute to increase the degree of awareness of the issues surrounding sexual violence today, as a historical process.23 For Merleau-Ponty, consciousness reveals the understanding of the body in an expressive space, capable of developing actions according to its experiences.10

The statements reveal the adolescents’ concern about public transportation and street lighting. This consideration refers to the violence experienced by these young people in their daily lives, presenting itself as a public health problem.

Insecurity inside the bus, with acts of sexual violence, compromises the freedom of individuals to come and go through exposure to public environments of vulnerability due to the fragility of public safety.24 The profile of the perpetrators involved in the crime of sexual violence on public transportation by bus in Salvador is young, unemployed men with no criminal record.23 It is required to break the banalization of sexual violence situations that adolescents are exposed to in their daily lives. demanding protective actions that safeguard security environments for citizens, as well as the fight against these crimes with appropriate punishments.

As mentioned by the adolescent, the lack of lighting and precariousness in paving conditions may constitute predisposing elements for criminality, as they expose individuals in their daily journey. The invisibility and accommodation of the representations of the public power in the face of situations of victimization by activities of the most varied types of violence, causes situations of embarrassment in adolescents and even the execution of acts that can impact as drastic consequences throughout the life of this individual.24

Adherence and accessibility of adolescents to the virtual environment promoted numerous advances, however it provided cyberbullying that, due to its greater dissemination of information and images, can cause embarrassment with permanent repercussions.

This reference to the social network as a determining factor in the process of exposure of adolescents to acts of sexual violence, may possibly be related to technological advances that broadened the modes of interaction used by adolescents and their parents, identifying the virtual environment as a form of communication with the world.24

Showing the family’s routine in the virtual environment proved to be a risky environment for sexual violence, leaving young people in vulnerable situations by using the internet as a strategy for self-affirmation.25^-26It is noticeable the importance of parents in maintaining a healthy and close relationship with their children, including education and supervision in the use of social networks and exposure of images that may compromise the lives of these adolescents.

Behavior carries with it a meaning, expressed through the emotion one feels in the totality of one’s being. The mechanical relationship of stimulus-response does not grasp the meaning of human behavior. In this relation, the phenomenology of perception contrasts the relationship between the sign and the symbol. The sign makes up the physical world and the symbol is an integral part of the human world of meaning. Recognition of the distinction between them is essential for understanding behavior.10

In the speeches of adolescents, it was evidenced that boys, to assume a position of power over women, are influenced by the stigma of the macho cultural and social pattern. Clothing has been used as a justification for crime, as a mechanism for blaming the victim for sexual violence. These findings strengthen men’s power over women and their lack of information about their rights and social issues surrounding their daily lives.27

Another important aspect evidenced in the opinion of adolescents concerns the use of alcohol, which consumed abusively can lead individuals to behavioral changes, increasing the risks for exposure to violence. The high use of alcohol alters the perception of the adolescent’s world, besides showing that it is susceptible to aggression due to the fragility caused by the drink.24 A research conducted throughout Brazil reveals particular behavioral, family and socioeconomic characteristics of victims of sexual violence, highlighting alcohol as a factor of great magnitude for the occurrence of this type of violence.28

It is important to understand the context of sexual violence against adolescents, which requires knowledge of cultural, structural, social, economic, psychological and physical aspects in view of the exposure of this population to the most prevalent risk factors.

The adolescents identified the responsibility of the microsystems in which they are interacting, which should constitute a support network in the confrontation and prevention of sexual violence, with interaction of family, school and media. However, the weaknesses of these contexts may enhance situations of vulnerability to sexual violence. Vulnerabilities are the health problems of adolescents when exposed to the influence of reality associated with the subjective and objective needs of the subjects.29

In the last decades, there have been public policies focused on adolescent health, the implementation of human rights, especially of children and adolescents, promulgated by the Magna Carta, the constitution of statutes and governmental entities for the protection of adolescent health and the implementation of laws. Thus, other protective instances are protected by reporting and reporting cases of sexual violence.30

In order to address the vulnerabilities and accessibility of this population to public health promotion policies, the Health at School Program is instituted. The objectives were intersectoral actions of primary care in the educational environment and contribute to the integral formation and emancipation of the school community, constituting a fertile arena for the debate on the theme of sexual violence.4

The school represents a space where teens get together and share most of their day. It is, therefore, a promising environment for educational practices in addressing young people’s daily issues, causing the active participation of students, the emancipation of their members and the community, as well as the protagonism of these adolescents in actions aimed at ensuring healthy habits and behaviors.31^-32In the phenomenology of perception, consciousness is intertwined in the relationship with the lived. The individual is immersed in the world, yet maintains a distance according to his process of formation.10

With regard to family, its social function is the protection of its members, providing affection and security, contributing to the development of subjectivity and learning of ways of interacting in the social environment, in its process of formation and socialization.33 The occurrence of sexual violence with adolescents can be evidenced in an extrafamilial context, but also within the family, breaking the idealization of the ideal of family life as a protective environment.34

Intra-family sexual violence is characterized by its onset in childhood and persisted through adolescence, which as a result of threats and embarrassment the victim contributes to the lack of complaint, perpetuating the aggression.34 To break the invisibility of sexual violence in the family context, notification is central to the restoration of the rights of children and adolescents, enabling the interruption of this injury and promoting protection and assistance to the victim and family.35 The media play an important role in the dissemination of information, however their media content can both encourage the exposure of adolescents to situations of sexual violence, as well as contribute to curb its occurrence.

A study36 appreciating media campaigns as a vehicle to prevent sexual violence in adolescents reveals that they should be based on robust research to meet the demands and circumstances surrounding the occurrence of this injury. It is worth appreciating the protagonism of adolescents in the creative construction and critical perception of what is exposed, in order to safeguard their rights with social responsibility.

The healthy development and growth of adolescents, faced with the prevention of sexual violence, requires the accountability of all actors involved in the family, school and community context. The theme of sexual violence needs to be addressed by breaking neutral positions and trivialization of situations of vulnerability, to which adolescents are exposed, ensuring conditions conducive to recognizing and denouncing the occurrence of this injury.

The limitation of the study is the cross-sectional approach, which did not allow the analysis of the practice of adolescents in the prevention of sexual violence. It is suggested to conduct new studies that contemplate the practice of adolescents facing the prevention of sexual violence in the face of different world realities.

CONCLUSION

Sexual violence was related to sexual practice without consent, as well as offensive indecency to shame. This type of violence was exemplified by obscene gestures or words directed by men at women. Adolescents of both sexes correlated this practice to a chauvinistic culture, which presents a historical construction of Brazilian society, imposing on women a posture of submission and fear in the face of male domination. The exercise of this gender domination contributes to the intentionality of maintaining situations of violence, when the victim experiences intense suffering in isolation, without feeling safe to ask for help in the face of the lack of information on how to cope and protect themselves from this situation.

The knowledge and attitudes of adolescents regarding violence, seized here, are important information that should be considered by nurses in the planning of educational health actions aimed at preventing sexual violence for this public. The interaction of nurses with the adolescent public makes it possible to recognize their experiences, providing greater proximity to objective and subjective aspects that involve sexual violence, broadening the perspectives of empowerment of this age group in the prevention of sexual violence.

The study, by presenting a specific reality, is not intended to generalize the results, but to deepen intersubjective questions that involve the studied subject, reinforcing the need for further research in different populations.

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NOTES

• ORIGIN OF ARTICLE

  Article extracted from the thesis - Effect of an educational technology to prevent sexual violence in adolescents, which will be presented to the Programa de Pós-Graduação, Universidade Federal de Pernambuco, in 2020.

• APPROVAL OF RESEARCH ETHICS COMMITTEE

  Approved by the Research Ethics Committee of Universidade Federal de Pernambuco, under Opinion 2,911,067 and Certificate of Presentation for Ethical Consideration: 78753417.9.0000.5208.

Publication Dates

• Publication in this collection
  17 Feb 2020
• Date of issue
  2020

History

• Received
  22 Dec 2018
• Accepted
  09 May 2019