Contextos de vulnerabilidade à saúde de puérperas adolescentes que tiveram filhos com sífilis congênita: um estudo qualitativo

Abstract

In recent years, congenital syphilis has shown a marked increase in incidence within the Brazilian population, particularly in the city of Rio de Janeiro. Among the affected maternal age groups, adolescents aged 15 to 19 represent the second largest proportion. Despite the existence of well-established diagnostic, treatment, and outpatient follow-up protocols, syphilis remains a public health issue of significant incidence. This dissertation aimed to understand the chain of events leading to these high rates by conducting individual semi-structured interviews with adolescent mothers of children diagnosed with congenital syphilis. The analysis was grounded in the epidemiological concept of vulnerability and its multiple dimensions, complemented by a comprehensive literature review on the subject. The findings revealed that various factors throughout the adolescents’ lives contribute directly to the persistence of congenital syphilis transmission. These include superficial sexual education lacking a focus on STI prevention, the perpetuation of family cycles, fragile support networks, sociodemographic barriers to accessing preventive policies, gender inequalities in relationships, and a healthcare system that is either insufficient or inadequately prepared to address the issue. Additionally, the study identified a pervasive sense of maternal guilt, exacerbated by the adolescents’ emotional networks and the healthcare system itself. It is concluded that vertical transmission of syphilis in children born to adolescent mothers involves them in a comprehensive manner, encompassing support networks, partnerships, and health institutions. The results of this study may support the development of more effective strategies to combat congenital syphilis in this demographic, while also underscoring the importance of examining the broader context surrounding the health-disease process.