Dating violence among adolescents from a region of high social vulnerability

Objective: to know and analyze the perceptions of adolescents with high social vulnerability regarding the establishment of dating violence. Method: a qualitative research study carried out with 19 adolescents from a central municipality São Paulo, Brazil. Data collection took place by means of focus groups and field diaries, with the data being analyzed thematically. Results: two categories emerged: “A new female posture in a context of traditional gender norms” and “Violence in intimate relationships: the (non)perception of adolescents”. Traditional gender norms still occupy a significant place in the design of dating violence among adolescents. Such behaviors are more visible in these relationships, when commitment and exclusivity are seen as the main characteristics, authorizing possession and control. Jealousy emerges as the main trigger for violence and the technologies appear as contemporary resources to reinforce it. Conclusion: the need for early interventions with adolescents is reiterated, with a focus on actions that promote gender equality.


Introduction
In recent years, a number of studies have denoted the importance of violence in intimate relationships among adolescents (1)(2)(3)(4) . Such relevance is due to some factors, including the early establishment of unhealthy intimate relationships in people's lives (5) , as well as socio-cultural constructions on the gender relations.
Several terms have been used in the literature to conceptualize this violence among adolescents, and the term has been used internationally as teen dating violence (TDV). It is considered as physical, sexual, psychological or emotional violence in a dating relationship, including persecution. It is important to highlight that such violence can occur in person or by electronic means, as well as among casual or formal intimate partners (5) .
TDV is a common phenomenon that cuts across cultures, races and ethnicities. A descriptive crosssectional study whose participants were 403 adolescents between 14 and 19 years old, who reported having perpetrated some type of violence in their affective-sexual relationships during adolescence (62.4% female), high school students from public (64.5%), private (18.2%) and professional training (17.3%) schools, from the Metropolitan Region of Porto Alegre, Brazil (6) . A metaanalysis with data from 46 underdeveloped or developing countries indicated that young and rural women were more exposed to intimate partner violence (7) . A study with 930 pregnant black-skinned and Latino adolescents found that 38% experienced TDV in the last trimester of pregnancy (8) . A study conducted in 27 countries in sub-Saharan Africa found that a median of 25.2% of adolescents and young women reported TDV, reaching 43.3% in some countries (9) .
TDV has consequences for the adolescents' physical and mental health in the short-and long-term. A systematic literature review showed that it is associated with problems such as depression, anxiety, low selfesteem, alcohol and drug abuse and unprotected sex (10) .
In addition to that, adolescents involved in dating abuse are more likely to be involved in violent relationships in the adult phase (11) .
Understanding violence and its consequent prevention and coping are challenging and complex tasks, since they are rooted in social, economic and cultural factors -such as sexist gender norms -which, in turn, exert an influence on the daily lives of communities and families, as well as on the way in which these relationships are experienced by the adolescents (12) . In this sense, for understanding violence, the World Health Organization (WHO) proposes an ecological model, which is based on the evidence that no single factor can explain the greater risk and vulnerability of some people or groups to interpersonal violence, while others are more protected from it. Thus, such phenomenon is understood as a result of the interaction of multiple factors at four levels: individual, relational, community, and social (13) . Considering the ecological model, the perspective to contexts of social vulnerability stands out, being understood as those with absence of elements such as income, schooling, possibilities of insertion in the labor market, and access to goods and services (14) . The weaknesses of affective-relational bonds can also be included in such concept. Considering vulnerability and its determining factors, both in its ethical, political and technical aspects, circumventing the incidence of risks in the territories, it is indispensable for the subjects, based on their capabilities and empowerment, to be able to face these vulnerabilities imposed in their daily lives (15) .
Being in a context of social vulnerability can expose adolescents to situations of violence and has impacts at several levels. A recent literature review on the causes and consequences of TDV showed that poverty is identified as an important factor for the prevalence of TDV (10) .
Diverse evidence even suggests that financial stress and low income also increase the risk for TDV (16) . Reducing these situations can diminish the possibilities for relational conflicts (17) . In addition to this aspect, it is important to mention that regions with high social vulnerability are more prone to gender inequalities in education, employment and income, mainly when supported by the patriarchal culture and the power relationship between men and women (10) .
Considering the relevance and impact of TDV, especially for those inserted in contexts of high social vulnerability, as well as the importance of understanding this phenomenon from the ecological model, the following research question emerged: What are the perceptions of adolescents with high social vulnerability regarding their intimate relationships, considering healthy and violent aspects?
Therefore, this study aimed at understanding and analyzing the perceptions of adolescents with high social vulnerability regarding the establishment of violent intimate relationships.

Study design
A research study with a qualitative approach (18)

Study locus and participants
The study was carried out in a municipality of the Central Region of the state of São Paulo, Brazil, which has   221,950 inhabitants according to the 2010 census, with   an estimative of 249,415 inhabitants for 2018. A school in a peripheral neighborhood was selected, characterized as a group exposed to high social vulnerability for an urban sector, being classified as category 5 (five) according to the 2010 São Paulo Social Vulnerability Index (Índice Paulista de Vulnerabilidade Social, IPVS) (14) .
The study participants were 8 th and 9 th grade students, regularly enrolled and attending the selected school. All those who voluntarily agreed to be included in the study participated, signing the Assent Form and the Free and Informed Consent Form by the responsible person. If over 18, a FICF was signed. The choice for this period is justified because it is a time to experiment with intimate relationships (20) . The choice for inclusion by teaching period (8 th and 9 th grade) and not by age During the study period, there were 140 students enrolled; of these, 34 chose to participate in the study.
Seven students who did not attend during data collection were excluded; as well as two who were transferred to another school, and six that did not bring the terms signed. Despite not participating in the research, these students were heard through participation in an extension project.

Procedures for data collection
Focus groups and the field diary were used as data collection instruments. To characterize the participants, a questionnaire on socioeconomic characterization and intimate relationships was used.
The focus group is an important strategy for research studies that seek to understand group experiences and transform reality (21) . The focus groups had the last author as a moderator; the first author as an observer, and the second author as a rapporteur. It is clarified that the  The groups were recorded using a voice recording application on two cell phones, arranged throughout the room; the recordings were later transcribed in full for analysis. It was decided to carry out separate groups based on biological sexes as indicated by the literature; it is reported that younger adolescents may feel embarrassed to bring experiences in front of participants of different genders (20) . The field diary represented a relevant instrument for data analysis and methodological rigor.
The investigative experiences were described in it; as well as methodological appropriation; movements, doubts and concerns; and reactions of the participants. In this sense, the reports found in the field diary were incorporated into the transcripts of the groups, constituting the corpus for analysis and supporting the inferences made.
In this study, it was decided to seek meaning saturation, which corresponds to a deeper discussion, rich in details and complex with the data to ensure understanding of a phenomenon of interest (22) .

Data analysis
The participants' characterization was presented by means of descriptive statistics. The qualitative data were analyzed using the reflexive thematic analysis technique (23) . Essentially, thematic analysis is a method www.eerp.usp.br/rlae 4 Rev Latino-Am. Enfermagem 2021;29:e3499.
to identify and analyze patterns of qualitative data.
The following steps were conducted for the analysis: between two independent researchers, and a third one was resorted to for conflict resolution.

Ethical aspects
The study followed the recommendations set forth

Results
The focus groups were conducted with 19 participants, 09 of which were boys and 10, girls.  Ah, throw the ass in the face (PM2).
There are some that we don't even need to do anything, they already do it for you (PM2).
Keeps dancing in front of the others (PM3).
Having an attitude, that is, breaking with the passive Throughout the meetings with the adolescents, a dispute between them was noticed in heterosexual relationships. When they felt jealous, they generally turned against the possible "traitor" girl. When discussing the importance of trust for building healthy relationships, the adolescents unveiled that it must be tested and proven, maintaining a look that goes through unhealthy issues: Ah, confidence is built up, right, madam! (PM1).
You have to prove that you are reliable (PM3).

With your posture, right? Madam! (PM1).
Yeah, and in the beginning you always have to be suspicious indeed (PM8).

Discussion
The findings of this study allowed concluding that reproduction of a culture that favors inequality between genders and, consequently, situations of violence (6,25) .
One study examined the intergenerational influence on the quality of the intimate relationships among adolescents based on their mothers' experiences. In it, the adolescents apprehend dynamics from observing their mothers, leading to the intergenerational continuity of healthy or violent relationships. This theory postulates the repetition of behavior patterns that the adolescents observed in their parents' relationships (26) . Looking at the families of these adolescents can contribute to the advancement of this knowledge and to the understanding of how gender differences are built in the family dynamics.
The diversity herein found is being highlighted, that is: Brazilian adolescents who live in a highly vulnerable urban region. International studies have addressed these differences in understanding and coping that can advance knowledge of TDV (25,27) ; in Brazil, the discussion is still incipient (20) . A literature review with metaanalysis identified that higher rates of victimization and perpetration of physical TDV were found in samples from neighborhoods with fewer resources (weakened social ties, lower social control, fewer economic opportunities) and with a higher percentage of ethnic minorities for girls (25) .
A study of community relationships and TDV experimentation processes among adolescents and young individuals in the United States (27) revealed that adolescents who live in neighborhoods whose residents intervene in or discourage violent behaviors are less likely to experience TDV. In the sense of social cohesion, the study discussed that neighborhoods in disadvantaged conditions tend to weaken or limit social ties, reducing the possibility of the individual seeking help or using social resources to prevent violence. Less favored areas can be more exposed to TDV risk factors, and may see violence as an expected, tolerated or necessary response (27) .
The adolescents bring a movement of freedom and search to overcome the stereotypes of femininity. Most of these aspects occur in unhealthy ways, either in the aversion and rejection of the boys, as well as through violence against them. The developmental perspective related to gender and TDV has been highlighted in the literature. Intimate relationships usually start in adolescence, and the adolescents' knowledge of these relationships is derived from the media and from observing friends and family members. This process is permeated by narcissism, an attachment to specific gender roles and mystification of romantic love, leaving this population especially vulnerable to TDV (28) .
This perspective is used in a meta-analysis to determine the prevalence of physical and sexual TDV, as well as its associated factors (25,29) . In the emergence of tend to be more physically aggressive towards boys at the beginning of these relationships (29) . One explanation can be the childhood legacy when it comes to problem solving; girls tend to be more aggressive and boys are socially trained to inhibit these behaviors. Aggression against boys by girls is also less socially questioned than aggression by boys against girls. However, as the female adolescents gain skills in intimate interactions and in the progress of relationships, this situation tends to be altered with reinforcement of the social gender norms already discussed (25) . In any case, it is important to point out that the literature has pointed out greater consequences for girls, including inversion of this relation throughout the relationship (29) . Another point that deserves to be highlighted is the possibility of boys underreporting situations of violence given the social stigma of violence by boys against girls, or even for them to accept themselves as victims of violence (25) .
Furthermore, this finding evidences the importance of studies that address younger adolescents and the construction of intimate relationships in this population.
Other studies have essentially addressed older adolescents, with relationships and violence being constructed in different ways. In these studies, the adolescents report higher frequencies of TDV and greater relevance for the perpetration of violence by boys (6,30) .

The progression of violence in intimate relationships
seems to be associated with the progression of commitment in relationships. The term crush is used for a relationship still idealized, which has not materialized; going out remains as a physical approach, which can evolve into a dating relationship. These concepts are reinforced by another study; except the term crush, which for younger adolescents emerges in a place still idealized in the relationship (31) . It is at the time of courtship that violence gains lighter and invisible shades by the adolescents. In such relationship, dominance, possession, non-privacy, and distancing from friends are allowed; despite the major influence of gender stereotypes; these aspects are present reciprocally in the relationships. in the outline of TDV in Brazil (1,33) and in the world (4,34) .
A qualitative study with adolescents aged from 12 to 18 years old, carried out in the United Kingdom, sought to explore the role of using technologies in their intimate relationships (4) . Unlike our findings, this study found that girls exercise more control and monitoring through the social networks than boys. In order to understand this movement, the authors discussed the relationships of attachment and insecurity (35) . In intimate relationships, there may be a need for responsiveness from the partner and for a total sense of security (4) . Due to the adolescent developmental process, especially in the fact of experiencing relationships and their identity with peers, this fact acquires special relevance. In addition, aspects related to intimacy, publicity and privacy are emerging in discussions about intimate relationships with adolescents, and should be part of programs and actions that foster healthy relationships and prevent violence (4,33) .
International studies have shown the importance of developing preventive actions and programs for peers and spectators within the scope of TDV. These programs have significantly reduced perpetration and victimization by TDV (36)(37) . In the Brazilian context, it may be interesting to develop actions that promote solidarity among girls, in view of the findings mentioned in this paper. A study conducted in schools in Pennsylvania, United States, found that the students were excited about discussing healthy and unhealthy relationships with school nurses. Many adolescents involved in TDV reported to these nurses to inform their experiences (38) .
The limitations were related to the non-deepening of the intergenerational transmission of gender norms among the adolescents. In addition, the focus groups were carried out by dividing the participants by biological sexes; although this configuration allows for the emergence of