Youth social dynamics in low-income urban communities in Brazil: spaces, leisure, and vulnerabilities to HIVAbstract
Given the incidence of HIV among youth in Brazil and the dismantling of educational policies on sexual and reproductive health (SRH) by the federal government (2019-2022), the lack of current national studies with heterosexual youth on these topics is worrisome. To expand this knowledge, we conducted a socioanthropological study in spaces of sociability and leisure for heterosexual youth in low-income communities in five Brazilian cities. According to our collected field observations and reports, leisure and sociability take place in the communities (dances, parties), given that economic and symbolic barriers limit circulation to other places in the city. In these spaces, most young people establish meetings, have affective and sexual interactions, and use alcohol and other drugs, generally with people from the territory, while digital interactions take on a secondary role. In the five communities, no campaigns and educational actions were identified on access to means of protection against STI/HIV, HIV testing, and AIDS care. The findings, together with data on the views and practices of these young people regarding STI/HIV, can contribute to the formulation of interventions aimed at SRH, within and outside the contexts of sociability, adapted to the sociocultural and economic reality of the youth segments.
Key words:
Youth; Poverty; Leisure activities; HIV; Prevention
Resumo
Frente à incidência de HIV entre segmentos juvenis no Brasil e ao desmonte de políticas educativas sobre saúde sexual e reprodutiva (SSR) no governo federal (2019-2022), preocupa a carência de estudos nacionais atuais com jovens heterossexuais acerca desses temas. Para ampliar esse conhecimento, realizamos pesquisa socioantropológica em espaços de sociabilidade e lazer juvenil, heterossexual, de comunidades de baixa renda de cinco cidades brasileiras. Segundo as observações de campo e relatos colhidos, o lazer e a sociabilidade acontecem nas comunidades (bailes, festas), dado que as barreiras econômicas e simbólicas limitam a circulação para outros lugares da cidade. Nesses espaços, a maioria dos/as jovens estabelece encontros e interações afetivas e sexuais e usa álcool e outras drogas, em geral, com pessoas do território; as interações digitais assumem papel secundário. Nas cinco comunidades não foram identificadas campanhas e ações educativas sobre acesso aos meios de proteção das IST/HIV, ao teste do HIV e cuidado sobre aids. Os achados, somados aos dados das visões e práticas desses jovens sobre IST/HIV, podem contribuir para a formulação de intervenções voltadas para SSR, dentro e fora dos contextos de sociabilidade, adequadas à realidade sociocultural e econômica dos segmentos juvenis.
Palavras-chave:
Juventude; Pobreza; Atividades de lazer; HIV; Prevenção
Resumen
Dada la incidencia del VIH entre los jóvenes en Brasil y el desmantelamiento de las políticas educativas sobre salud sexual y reproductiva (SSR) en el gobierno federal (2019-2022), la falta de estudios nacionales actualizados con jóvenes heterosexuales sobre estos temas es preocupante. Para ampliar este conocimiento, realizamos una investigación socioantropológica en espacios de sociabilidad y ocio para jóvenes heterosexuales en comunidades de bajos ingresos en cinco ciudades brasileñas. Según las observaciones de campo y los informes recopilados, el ocio y la sociabilidad tienen lugar en las comunidades (bailes, fiestas), dado que las barreras económicas y simbólicas limitan la circulación a otros lugares de la ciudad. En estos espacios, la mayoría de los jóvenes establecen reuniones e interacciones afectivas y sexuales, y consumen alcohol y otras drogas, generalmente con personas del territorio; las interacciones digitales asumen un papel secundario. En las cinco comunidades, no se identificaron campañas ni acciones educativas sobre el acceso a medios de protección contra las ITS/VIH, las pruebas del VIH y la atención del SIDA. Los hallazgos, combinados con datos sobre las perspectivas y prácticas de estos jóvenes respecto a las ITS/VIH, pueden contribuir a la formulación de intervenciones orientadas a la salud sexual y reproductiva, dentro y fuera de los contextos de sociabilidad, adaptadas a la realidad sociocultural y económica de estos segmentos.
Palabras clave:
Juventud; Pobreza; Actividades de ocio; VIH; Prevención
Introduction
A retrospective look at the emergence of AIDS in the early 1980s reveals significant advances in the diagnosis, prevention, and care of people living with HIV/AIDS (PLWHA). However, the epidemic has not yet been globally nor nationally controlled. One of the current challenges in Brazil concerns the vulnerability of youth, as evidenced by the increase in the HIV incidence rate among men aged 15 to 241,2. Although most cases are reported among young people with homosexual and bisexual practices, heterosexual practices in this population group also pose a risk of HIV infection and have been less commonly investigated in recent literature.
The lack of current national studies on HIV/AIDS among heterosexual youth, compared to studies with homosexual and transgender youth, is worrisome, given the criticism and lack of investment in educational policies in the field of sexual and reproductive health for youth, especially by the federal government from 2019 to 2022. In recent years, the few AIDS prevention actions have prioritized biomedical technologies, such as treatment for prevention and the provision of pre-exposure and post-exposure prophylaxis for HIV. Despite the importance of these strategies, their reach among heterosexual youth has been limited and dissociated from other historically successful preventive actions that sought to encompass the political, sociocultural, and economic dimensions of AIDS responses3-6.
To contribute to this discussion, this paper analyzes leisure and sociability contexts involving affective and heterosexual interactions between young women and men from low-income communities. The focus on lower-income segments aims to address young people’s vulnerability to HIV and other sexually transmitted infections (STIs) resulting from structural and social inequalities linked to individual and programmatic factors7. The term ‘community’ is defined here as a territory characterized as a geographic, social, and cultural space where individuals share values and social practices, as well as exposure to vulnerable social and health situations8-10.
The term ‘sociability’ refers to a playful form of autonomous sociability, taking on a life of its own, freeing itself from ties to concrete reality; that is, it is a game in which people perform and create society. As such, it plays a symbolic role that fulfills and gives meaning to people’s lives11. According to Pais12, the interactions, experiences, and use of time in “youth cultures” enable the emergence of specific forms of sociability, influenced by a shared historical moment across generations. However, they take on a wide range of configurations due to the impact of social markers of difference related to class, gender, color/race, sexuality, and territory of the young people’s trajectories and sociability. This perspective aligns with the need to study the youth population from their economic and sociocultural contexts.
This work assumes that the affective and sexual exchange networks of heterosexual and cisgender adolescents and young adults from low-income urban areas develop primarily in the social spaces of their residential community, given that precarious socioeconomic conditions tend to limit movement to other neighborhoods. Thus, the present study hypothesizes that these youth segments tend to pursue their leisure and cultural activities, consume alcoholic beverages and other drugs, and engage in affective and sexual interactions close to home.
To analyze the conditions of vulnerability to STIs/HIV in the leisure and sociability contexts, a socioanthropological study was conducted with adolescents and young people from low-income communities in the cities of Porto Alegre-RS, São Paulo-SP, Rio de Janeiro-RJ, Manaus-AM, and Salvador-BA. The concept of community was used, but other native categories exist to define these territories, such as favela or neighborhood. This study sought to identify the places in which youth sociability and leisure occur, the young residents’ justifications for frequenting these places, whether affective and sexual encounters and drug use occur in these spaces that may be associated with vulnerability to STIs/HIV, and whether social networks are used to find affective and sexual partners.
It is understood that reflection on the conditions of vulnerability to HIV in spaces where mostly heterosexual young people socialize could contribute to the formulation and implementation of STI/HIV prevention policies that are more appropriate to the socioeconomic and cultural reality of these population segments.
Method
This is a qualitative study, informed by the contribution of social sciences to the health field, characterized by an understanding of the cultural significance of health and disease processes. By giving importance to the subjective and interpretative nature of aspects of social life, social research makes it possible to analyze the connections between cultural systems, social hierarchies, and access to material and symbolic assets in shaping social practices and the processes of social vulnerability as they relate to the health of individuals and social groups13,14.
It is important to emphasize that this is part of a broader multicenter study on the contexts of HIV vulnerability among low-income youth in five communities, located in the cities of Porto Alegre, São Paulo, Rio de Janeiro, Manaus, and Salvador, respectively. The same strategies were implemented in each community: ethnographic observations of social spaces, informal conversations during fieldwork, interviews, and focus groups with young men and women aged 15 to 24.
The proposed research was approved by the Ethics Committees of all institutions involved in the study (CAEE No. 36495120.7.0000.5327). Participants were informed about the objectives of the study. Those participants aged 18 or over signed a Consent Form while those aged between 15 and 17 signed an Assent Form. There was a favorable opinion from the Ethics Committee to waive the need for an additional Consent Form signed by legal guardians.
Fieldwork was conducted during the pre-emergence of COVID-19 (2019), the pre-vaccination pandemic period (2020), and the vaccination phase of the majority of the population (2021). Therefore, it involved document analysis, virtual contacts, and in-person visits to the five communities. The field teams consisted of researchers with training and/or experience in developing studies in the Social Sciences and Humanities in health. Other publications15,16 have discussed the receptiveness, difficulties, and alternatives used during fieldwork, given the restrictions imposed by COVID-19, the topics covered (such as sexuality and violence), and the tensions arising from the presence of drug trafficking, police violence, and militia groups in the communities.
Field diaries were prepared with observations and descriptions of social spaces, formal and informal business dynamics, public institutions, community and cultural centers, churches, streets, alleys, and lanes. Informal conversations during the visits made it easier to approach adolescents and young people, who, in turn, suggested new interviewees. Residents, community leaders, and members of civil society organizations also contributed to contact with the youth population and facilitated the researchers’ movement within the communities, aiming for better safety and identification of local codes.
Data from the 137 interviews and 11 focus groups conducted in the five communities have been discussed in another article17. However, it is important to include a brief profile of the interviewees, given that some of the young people were contacted in social settings, and their testimonies complement the findings discussed here. There were 137 interviewees, the majority between the ages of 15 and 19 years (N=107), female (79), who reported heterosexual practices (126), and self-identified as Black or Brown. Most were born in these communities and are enrolled in the public school system; some combine study and work, while others have dropped out of school and perform informal and irregular work or are unemployed. In the older age groups, some are pursuing technical or higher education; a smaller group does not study and has no occupation.
Field diary notes and testimonies were categorized based on the stages of thematic content analysis. Thus, based on an exhaustive reading of the data, the core meanings associated with the study themes were identified, organized, and coded, such as sociodemographic profile; sociability; social networks; relationships with health services; exposure to and prevention of HIV, STIs, and pregnancy; and local characteristics. The thematic categories and subcategories were derived from the topics in the interview guide, and others were derived from reading the testimonies and records. The category framework guided the indexing of the data in the N-VIVO software, generating a single database. In this work, the thematic categories related to sociability that were similar across the five communities were prioritized and organized along the following axes: contexts of sociability in free circulation spaces; local parties, spontaneous gatherings, and dances; money spent on leisure; movement outside the community; and use of social media.
The statements present the fictitious name of the interviewee, his/her age, and the abbreviation of the city: RJ=Rio de Janeiro; MA=Manaus; SSA=Salvador; POA=Porto Alegre, and SP=São Paulo.
Results and discussion
The investigated communities revealed heterogeneity both within the territory itself and across the five locations. However, some similarities were identified, such as the socioeconomic profile of the population, characterized by a majority of low-income and less educated individuals. Another common element referred to the limitations of local public health and education services, including the lack of STI/HIV prevention and treatment for the young population19, coupled with precarious housing and the lack of or low coverage of basic sanitation services.
Furthermore, residents of the five locations lived with the presence of drug trafficking, which involves the sale of marijuana and cocaine, the presence of people carrying firearms, and the imposition of rules and barriers, both concrete and symbolic, that define circulation zones20. Armed conflicts between drug traffickers, militia groups, and police forces frequently generate violence, resulting in the closure of schools and health facilities and the deaths of residents not directly involved in these conflicts.
Local resistance movements in the five communities were identified, led by community leaders and social, governmental, and nongovernmental organizations. These initiatives offer children and youth activities pertaining to sports, recreation, education, culture, health, and rights. Some reports suggested that young people with experience in these community interventions had a greater capacity for expression and knowledge of the topics addressed in the study. However, field data indicated that these projects have a limited reach, given that few interviewees had this type of experience. Although this aspect was not explored in depth in this study, the positive impact of community social interventions related to sexual and reproductive health has been documented in the literature21.
The communities comprise extensive business activities, reflecting a vibrant local economy characterized by fairs, shops, markets, restaurants, and street vendors, as well as street and doorstep stalls. This creates small business centers scattered throughout the community, managed by residents and used by the local population. Public health and education facilities, churches, religious temples, religious centers, and the headquarters of social organizations are also present. Some public recreational facilities were observed, such as multi-sports courts, soccer fields, public squares, swimming pools, theaters, and cultural centers, mainly in São Paulo, Porto Alegre, and Rio de Janeiro. However, these facilities are less frequently found in Salvador and Manaus.
There are also similarities in the spaces for youth social interaction. By analyzing these contexts, this study sought to characterize the places where young residents gather for recreation and entertainment and what occurs in terms of affective and sexual interactions and the consumption of alcohol and other drugs, which are related to the risk of exposure to STIs/HIV.
Youth sociability in open spaces
Field observations, interviews, and conversations indicate that young people in these communities meet for fun, dating, sports, prayer, and fellowship. One of these activities involves roaming around the streets, alleys, and lanes; stopping at corners and sidewalks to talk with friends; having romantic encounters; catching up on community events; and “taking their minds off things,” as one interviewee put it. Strolling through the streets and alleys is not aimed at finding a fixed place, but rather at seeing what is going on, finding a place to “hang out,” and then heading to more secluded spots where they can smoke marijuana, date, and do things their parents would not allow.
Other social situations result from the informal occupation of public areas, free from bureaucratic and governmental oversight. The areas surrounding schools, public squares, sports courts, soccer fields, alleys, streets, cafes, and bars form appropriate spaces for social interaction where young men and women can listen to music, engage in religious worship, watch and play soccer, dance, chat, drink alcoholic beverages and use recreational drugs, barbecue, flirt, and partake in affective and sexual interactions. When asked about the types of activities that take place in the community, one young woman stated:
The kids do a little bit of everything! They drink, have snacks, dance, play volleyball, soccer, party, hang out, use drugs, prostitute themselves, rob people - it depends on what you want (Larissa, 21, MA).
Other reports confirmed that these activities were among the most significant aspects for young people22, as a way to connect, forming “youth collective groups”23 of all kinds based on their musical and religious affinities, tastes in sports, cultural and artistic events, alcohol and other drug use, and illegal practices. Cultural circles and “rap battles”, in which rappers compose lyrics about daily life in their communities, also form youth groups, and are prominent in São Paulo and Rio de Janeiro. These battles have been posted online and can lead to successful careers in the cultural industry, as is the case of rapper, singer, and songwriter Leandro Roque de Oliveira, known by his stage name Emicida, born in São Paulo in 1985.
In terms of social markers related to gender and sexuality, most of the social spaces involved heterosexual interactions, marked by young women and men, mostly Brown and Black, and low-income from the same communities. However, specific spaces were recorded that focused on LGBT youth
In short, sociability in spaces where young people freely circulate favors the formation of collective groups, which come together based on different affinities and social markers. The creative use of streets for leisure activities converges with studies on the forms of sociability of young people living on the outskirts of large cities24. These studies observed that it is on the streets, its corners, and meeting points that friendships, flirtation, and leisure moments are developed25,26.
Informed by Simmel’s reflections11, the contexts of youth sociability observed in these places occur for the sake of being together. According to the author’s definition, this sociability, regardless of concrete purposes and valued for its own sake, is characterized as a “playful association.” Put another way, young people create associations, i.e., different forms of social interactions, to satisfy their interests, dissociated from practical content and shaped by the material conditions of their existence12.
Parties, dances, and gossip in the community
Dances and parties can also be defined as expressions of “playful social interaction.” For most of the interviewers covered by this study, these events are places for fun, music, dancing, sex, and flirting, with the sale and consumption of alcohol and other drugs, such as marijuana. According to one interviewee, “the boys can’t see you or they’ll be all over you right away” (Natália, 16, RJ). These events can take place within the community (e.g., streets, blocks, public squares), with no age restrictions and with cars equipped with loudspeakers blaring loud music. They are known by various names, such as “baile” (RJ and POA), “paredão” (MA, SSA), “pancadão” (SP), or “fluxo” (SP). Here is one account:
Because when you’re at one of these outdoor parties, it’s not that you go there to have sex, you go there to listen to the music, to have fun, to drink. Sure, some people go there to use drugs, [...] to prostitute themselves, [...] they go there to have sex. That’s not the context of the party; the context is you go out to drink, listen to music, like you’re at a club, only a club in your neighborhood, and then everything is allowed. Drugs are allowed. Legal and illegal, you know? (Gabriel, 18, SP).
Regarding sexual interactions, some interviewees stated that after the party, people head to other locations for more intimate encounters, whether on nearby streets and alleys, in their own homes, in motels, or in remote locations (for example, abandoned houses and/or unfinished buildings). In POA, it was reported that drug traffickers rent out local party venues, commonly used for birthdays and graduations; they also use the samba school’s court or close off the street or “alley” under their control for parties. According to Natália (18, POA), these events feature free music and drinks, a lot of drug use, and places set aside for young women to have sex with drug traffickers, known as ‘hooking up’.
During a fieldwork observation at a Rio funk dance, the permitted age for entry was 16 or older, but according to reports, proof of age was not required; security guards determined age based on appearance. At this dance, young people were even seen carrying weapons. Other witnesses attested to the fact that tensions sometimes arose at the dances when security forces showed up, invading these events in a repressive and aggressive manner, as the following report indicates:
They go there to spoil the fun. They show up and start shooting, throwing tear gas, and people start running, and things get really messy [...] Everyone is there having a good time, and then the police cars come. As soon as the kids see them, they start running away because they know what they’re like (Katelyn,18, SP).
The violent actions by the police, whose job it is to protect the population, affect many young people who are not involved in illegal activities while enjoying themselves. Conversely, drug lords, despite generating violence and making money through illicit activities - as opposed to hardworking people who earn an honest living - are the ones who fund the parties and dances, distribute food, and promote recreational activities in the communities, which residents enjoy27. This situation fosters a paradox between the repressive legal power of the State and the welfare actions of organized crime, expressed in the testimony of a Rio de Janeiro interviewee:
They put up this giant inflatable castle [...] It’s really cool. I think the local kingpins do a good job here in the favela, even though I think what they do is wrong, but for us residents, we’d still prefer to have soccer shoes, food baskets, gas, and everything else. We’d prefer them to someone who breaks into our house, ransacks everything, and treats us like we’re the criminals, you know? They’d rather kill than be someone who’s throwing a party... I know it’s wrong to throw a party in the middle of quarantine or to sell drugs, but if you think about it, they really help us here (Bruno, 15, RJ).
Cultural industry entrepreneurs generally sponsor private dances and include shows with MCs (acronym for Master of Ceremonies, who sing and/or lead the events) and may be supported by drug traffickers. These events attract audiences of all sizes and can also bring together people from other neighborhoods. As reported by an informant from Rio de Janeiro, community dances benefit not only drug trafficking, but also local businesses in the beauty industry (e.g., girls get their hair and nails done and rent clothes) and in the sale of beverages and food.
Regarding the various actors involved in the production and hosting of the dances, it is important to note the comment of a young person from Rio de Janeiro who frequently attends these events. According to his account, groups of evangelicals are permitted to distribute pamphlets and offer prayers; in his words: “For more than 15 minutes, you don’t hear the sound of funk music, only the testimonies of men of God who are not there to ruin your fun, as they themselves make clear”. As indicated in other research studies28,29, evangelical churches play an important role in low-income communities, and future studies should explore how this phenomenon impacts youth sociability and their vulnerability to STIs/HIV.
Funk and pagode dominate the musical styles at dances and parties. However, there are other venues dedicated to forró, samba, rock, and pop music. Some of these events even attract adults and children.
The homes of residents (friends and acquaintances) are also used for fun, leisure, flirting, and affective and sexual interactions, known as “resenhas”. These gatherings are generally more intimate and private, attended by groups of friends, couples in stable relationships, or pregnant girls. Furthermore, they are an alternative for teenagers and young adults who do not like, or do not have parental permission, to attend dances.
Leisure economy and movement outside the community
Leisure activities primarily take place in public spaces without charging an entrance fee; however, this does not mean they are free of expenses for food, beverages, or transportation. The gathering cited above described it as an inexpensive program, with food and beverages purchased from markets, based on the participants’ monetary contributions, eliminating the need for transportation expenses.
Most of the participants had no income, either because they were studying or unemployed. However, they took odd jobs (e.g., doing nails), selling drugs, asking their parents for money, or crowdfunding friends, which made it possible to raise money for leisure activities.
Oh, some worked by doing odd jobs, others begged their parents, but most of those who are still around today end up turning to drug trafficking, they end up becoming what we call ‘radinhos’ (Guilherme, 21, SP).
Among the young girls, it was reported that friends, dates, hookups, or boyfriends pay their bills, indicating the renewal of hierarchical gender relations. The situation of subordination tends to be greater in the case of girls who have relationships with drug traffickers, given the impression of virility and economic power associated with these groups.
Field research and interviews corroborated the assortment of leisure options and the range of available activities within the communities. However, when they have the money, the young people reported trips to shopping malls and movies, visits to friends or relatives in other neighborhoods, and outings to rented farms near the city. Traveling to other municipalities was seen as a luxury for the few and a dream for some. The communities in Manaus and Rio de Janeiro are geographically closer to the city center, which facilitated access to bars and parties in these neighborhoods; however, the communities in São Paulo, Salvador, and Porto Alegre are farther away, making travel more difficult.
Discrimination based on race/ethnicity and social class also inhibited movement outside the territory, with meetings between equals without discrimination being valued. Michel (19, RJ) is described as white by the researcher and wears clothing characteristic of hip-hop. In addition to being the target of police stops, he said people in middle- and upper-class neighborhoods appear to be afraid of him. Thus, despite the possibility of armed conflict and the socioeconomic deficiencies of their neighborhoods, young people clearly prefer local leisure spaces, as expressed in the following accounts.
I think it’s wonderful here. I swear, I wouldn’t leave. I think it’s a really cool place because there’s everything at any time, you know? It has its downsides, because you can expect anything at any time, but it also has its upsides. Parque União has some great places, both for eating and having fun. I like drinking, going out with my friends, and enjoying the local attractions (Gisele, 18, RJ).
In our neighborhood, there are several singers, several artists. We go there to have fun, because this hang-out is our only leisure, the only place where we meet people from our own neighborhood, where we aren’t discriminated against for being from the favela (Analu, 18, SSA).
Other studies reported how economic and symbolic barriers, perceived by residents and/or imposed by places outside the community, impact and limit the movement of low-income young people through various parts of the city30.
The “digital age” in working-class neighborhoods
The majority of adolescents and young people in the study were familiar with and use apps and social media for various purposes. However, not everyone had regular access to these resources, either because they do not own a cell phone or have limited access to quality internet. Sometimes, they shared their devices with family members and had to delete and reinstall apps so their parents would not see them, as one young woman describes:
But my mom won’t let me either. Messages come in, Facebook comes in, I delete everything, and then reinstall it. One time, I left my Facebook open, and she saw it. [...]. Then when I went out, she hit me (Francine, 15, MA).
According to the interviewees, WhatsApp and Instagram were used for conversations between friends and family, flirting, group chats, organizing informal get-togethers, promoting parties, and sometimes exchanging nude photographs, especially among teenage boys. TikTok was used for recording dances and watching videos of famous influencers. The social network Twitter, now called X, was cited as a source for pornographic videos. Online dating apps and geosocial networks, such as Tinder, were rarely mentioned; virtual flirting tended to involve people they met in the community, as the following account illustrates:
I used Tinder once, but I didn’t like it. [...] I don’t know, I didn’t use it much, and then I’d get matches, but I always forgot to open the app, so I never actually set up a date through it. [...] I usually try to connect with people I already know, but it takes a long time to connect with people I don’t know. I try to figure out where I’m going (Leonardo, 20, POA).
In short, flirting strategies were constructed primarily in everyday community relationships and face-to-face encounters, in transit spaces, and within the neighborhood. Thus, digital interactions play a secondary or complementary role. These findings contrast with Santos’s findings31 regarding the ubiquitous role of digital social media platforms in the daily lives of urban middle-class Brazilian youth and reiterate the differences in youth experiences resulting from the diversity of social, economic, and cultural contexts12.
Sociability and vulnerability to STIs/HIV: final remarks
Based on socioanthropological research in social spaces for youth in low-income communities in five Brazilian cities, this study aimed to expand current knowledge on the vulnerability to HIV among young people with heterosexual practices.
Field observations and reports revealed that “playful social interaction” was intensely evident in community recreational spaces: dances, parties, and social gatherings. Young people in these settings established affective and sexual interactions, often with locals, and consumed alcohol and other drugs. Digital interactions were secondary. This intense social activity - described by Simmel as an autonomous “game,” where the form of the interaction is more important than its immediate content - may be linked to situations where young people are vulnerable to STIs/HIV exposure. These casual encounters, often involving the use of psychoactive substances, can lead to unprotected sexual relations, amplifying the risk of contracting a sexually transmitted disease.
The association between situations of vulnerability to STIs and social contexts does not occur only among low-income, heterosexually active youth. Research on urban youth sociability indicates that the varied dynamics of social interaction were permeated by markers of gender, sexuality, class, and race, as well as by constant and changing patterns in the way young people experience their affective and sexual exchanges32,33.
Thus, the main finding of this study has confirmed the hypothesis that the young people surveyed from the five communities mostly have affective and sexual relationships with people from their own neighborhood, given that economic and symbolic barriers limit their movement to other parts of the city. These forms of sociability expressed “playful associations”, characterized by entertainment, enjoying the camaraderie, and interactions for their own sake; in contrast to formal and regulated interactions11.
Furthermore, no campaigns and/or actions to prevent STIs/HIV were identified in social spaces in the five communities, whether in terms of access to means of protection, such as condoms and pre-exposure and post-exposure prophylaxis for HIV, providing information about the transmission routes of STIs/HIV, HIV testing and care for PLWHA, or local services focused on the sexual and reproductive health of young people.
This evidence is even more relevant when complemented by data from interviews and focus groups, analyzed in another publication17, regarding the lack of knowledge among adolescents and young people from these five communities about diagnosis, new technologies for HIV prevention and treatment, and low self-perception of HIV risk18.
This information could be useful in formulating and developing interventions focused on sexual and reproductive health, tailored to the sociocultural and economic realities of youth populations. Given the accumulated experience on this topic and the dismantling of SRH-focused policies in recent years3-6, it is not only important but also essential that young people themselves become involved and participate in the education and health units in their neighborhoods, as well as seek local support networks, such as leadership and governmental and nongovernmental social projects. The creation of participatory, ongoing educational programs integrated into the residents’ daily lives, in which young people are the protagonists and multipliers of health promotion actions through cultural circles, rap battles, and sex education workshops, could transform their recreational activities and culture into health education initiatives.
However, it is important to emphasize that addressing conditions of vulnerability to STIs/HIV requires proposing policies capable of encompassing the individual, programmatic, and social dimensions of vulnerability. That is to say, policies need to go beyond prevention and care actions and community mobilization. These initiatives must be accompanied by a commitment from government agencies to reduce social, racial, and gender inequalities, and address the stigma associated with AIDS and sexual diversity.
Finally, it is important to recognize the limitations of this study. By emphasizing commonalities among young people from the five communities, it did not explore the diversity of profiles regarding educational attainment, lifestyles, musical preferences, religious affiliations, and gender identities, nor the particularities of each neighborhood. These aspects could be further explored in future studies and shed new light on the field of sexual and reproductive health among Brazil’s youth.
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Acknowledgments
The study was supported by CNPq/MS-DCCI (process 442618/2019-0) and the Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM) Grant No. 01.02.016301.001618/2022-44.
The data sources adopted in the research are indicated in the article’s body.
