Brazil Confronts Adolescent Sexual Health Issues

(October 2002) Sérgio de Castro Nascimento does not hesitate when you ask him what the greatest challenge of being an adolescent in Brazil is. Nobody knows how to talk to you about sex, he says. Not the government, not the family, not the teachers. Even health professionals have trouble communicating clearly.

Sérgio should know. Born near the capital city of Brasilia, he is the coordinator of Grupo Atitude (Attitude Group), a nongovernmental organization (NGO) working at schools, bus stops, and other public places to spread knowledge about sex to young people. His objective is to combat a lack of awareness that took a personal toll on him: Sérgio has a 5-year-old son who was born when he was 18.

“If I can, I will do something to change the destiny of so many young people in Brazil,” says Sérgio, referring to a reality that includes drugs, domestic abuse, a lack of education, unwanted pregnancies, sexually transmitted infections (STIs), and even forced labor.

Brazil has 21.2 million people between 12 and 18 years of age, representing 12.5 percent of its 174 million inhabitants, according to A Voz dos Adolescentes (The Voice of Adolescents), a report by the United Nations Children’s Fund (UNICEF). Since 1990, when the government approved a Statute for Children and Adolescents, the country has been struggling to deal with the specific needs of this segment of the population. While many new programs have been implemented and there is some notable change of attitudes and behaviors among adolescents, both the government and NGOs agree that there is still much to be accomplished.

Early Sexual Activity Produces Unwanted Consequences

A survey conducted by the Brazilian Center for Analysis and Planning of the Ministry of Health from December 1997 to December 1998 shows that among young people 16 to 19 years old, 61 percent had already engaged in sexual relations. Among those, 40 percent said their first time was before age 15. Boys had sex earlier than girls and blacks earlier than whites (see Table 1). The same survey, published in 2000, found that adolescents who lived with their parents and had formal education tended to initiate sexual activities later.

Table 1
Age of First Sexual Experience Among Brazilian Adolescents 16 to 19 Years of Age, 1998

Age of First Sexual Experience
Under age 14 14 and older
Total 40.2 59.8
Male 46.7 53.3
Female 32.3 67.7
White 25.7 74.3
Black 53 47
Education Level
Did not complete high school 42.3 57.7
At least high school complete 38.8 61.2
Family Structure
Living with both parents 36 64
Living with one parent 63.5 36.5

Source: “Sexual Behavior of Brazilian Population and HIV/AIDS Perceptions,” study conducted by Ministry of Health in Brazil and CEBRAP (Brazilian Center for Planning and Analysis) (São Paulo, September 2000).

Brazilian health authorities consider this precociousness, which is accompanied by a tendency toward drug use at earlier ages, as the most serious adolescent health problem in Latin America’s largest country. Among the most worrisome consequences are the resulting pregnancies and STIs, including HIV. The Ministry of Health reports that a baby is born to a girl between the ages of 10 and 14 every 17 minutes, and every minute to a girl 15 to 19 years old. In 2001, more than 51,000 adolescent girls were seen at public hospitals for postabortion complications. In Brazil abortions are strictly prohibited with the exception of a few special circumstances such as sexual violence. There are no firm numbers in Brazil that reveal the dimensions of sexual violence, and researchers agree that Brazilian women are less likely to report sexual crimes than their North American counterparts.

These issues present consequences for the whole society and for the long term. Early pregnancies are the main reason for school dropouts in Brazil since, according to the Ministry of Education, a majority of pregnant girls choose to leave school, frequently because of the stigma associated with early pregnancies.

This problem is especially acute among the poorer sectors of the society, where young mothers quit school so that they can work to provide for the child. To make matters worse, a recent demographic survey conducted by the Ministry of Health — the National Study of Demography and Health — showed that poorer adolescent girls have a 10 times greater risk of becoming pregnant than girls from wealthier and better-educated families.

Adolescents Are Victims of Their Own Ignorance

That adolescents in Brazil are having sex at earlier ages is not surprising. Over the last 15 years, Brazilian society has gone through a process of liberalization of social norms and behaviors.

Table 2
Adolescents and Sexual Experience in Brazil, 1998


Year of Survey Status Age range
16 to 19 20 to 24
1984 Never had sex 40.1 15.4
Have had sex 59.9 84.6
1998 Never had sex 39.0 7.7
Have had sex 61.0 92.3

Source: Ministry of Health, Brazil, “Pesquisa sobre Comportamento Sexual e Percepções da População” (1998).

“Sex in Brazil today is no longer as controlled as it used to be,” said Maria Helena Brandão Vilela, a sex education specialist. “The sexual life of kids is not subjected to the same level of repression as was the case with their parents.”

Much of this freedom is reflected in television programs broadcast throughout Brazil, especially in the country’s famed soap operas that deal openly with sexual issues. But even as television has pushed the limits of permissiveness, more freedom for the adolescent has not been accompanied by better education to instill the necessary responsibility. Many Brazilian families and institutions are still tied to an old system of values, leaving children with ambiguous messages about sexuality and reproduction.

“Regardless of what you see on television, sexuality in Brazil is still taboo,” says Vilela, who is director of the São Paulo-based Instituto Kaplan, an organization that specializes in sexuality education.

For the last 10 years, Vilela has been the coordinator of a sexual education orientation service that receives 2,000 phone calls each month, 70 percent of them from adolescents asking about their first sexual experience. Vilela says that the high demand for her services is a clear sign that families, schools, and even doctors have come up short in communicating with adolescents about sexuality, causing young people to become victims of their own ignorance.

“Mothers and teachers still believe that their kids are not going to have sex, and that they are capable of resisting all the stimulation generated by Brazil’s frequently daring television programming and peer pressure,” says Vilela.

A poll taken in urban areas last year by the government showed that 60 percent of parents in 14 of Brazil’s largest cities lacked information about sexuality and reproductive health to give to their kids, and that 32 percent had never recommended the use of condoms. Among teachers, 47 percent said that their own knowledge about sexuality and reproductive health was insufficient. Among teachers who did have some training on the subject, 45 percent found the courses weak. Brazil’s social realities make matters worse. Adolescents living in households where the per capita income is less than half of Brazil’s minimum wage of approximately US$30 a month are, on average, five school grades behind their peers in higher income households, according to the UNICEF report, A Voz dos Adolescentes.

Promoting Better Health for Brazil’s Youths

The government of Brazil has several agencies involved in efforts to promote better health for the country’s youth. The focal point of these efforts is the training of health professionals, educators, and social workers to deal with the specific issues facing the adolescent. Certain regions of Brazil that have better social infrastructure, including the country’s south and southwest, are benefiting more. In northern Brazil and the midwest, there are still strong cultural obstacles to overcome regarding sex education.

“In some places, it is difficult to make sexual health a relevant public policy issue, a problem that is compounded by the fact that health services in such places are generally more deficient,” says Ana Sudária de Lemos Serra, who works with adolescent health in Brazil’s Ministry of Health.

Concern about the health of youths has grown fastest in the larger cities, where young people have yet one more problem to deal with: violence. Among boys 15 to 19 years of age, violence and murder are the number one cause of death. Each year, about 30,000 adolescents are jailed. “Brazil has had a traditional focus on setting the minor offender on the right path,” says Rogerio Giugliano, a sociologist and professor at the Catholic University of Brasilia. “Only recently have we woken up to other aspects of being young, such as health.”

Since the beginning of the AIDS epidemic, 37,000 adolescents in Brazil have been infected, and HIV infection rates are still growing. The government estimates that 2 percent of Brazilians between the ages of 15 and 19 have HIV. In 1994, the government established a joint task force between the Ministries of Health and Education to avoid the spread of AIDS, which has already claimed 13,000 lives of people 13 to 24 years of age, according to the 2001 Epidemiological Bulletin of the Ministry of Health.

Government programs run the gamut from training of teachers and health professionals, to changing school curricula and addressing such difficult issues as sex, homosexuality, STIs, pregnancy, and drug use head on. But while thousands of teachers have received special training, so far only 8 percent of students in public schools have been reached by this effort, according to the ministries of Health and Education. Part of the explanation is that students still prefer to speak to their friends and families about sexuality, according to A Voz dos Adolescentes.

To reach those between the ages of 10 and 14 who are far behind in school and cannot read, or who are on the streets where they may start using drugs and having sex much earlier, the government has created more than 50 projects that involve NGOs.

The largest project is headed by the National Movement of Street Boys and Girls, which coordinates 400 community programs that reach about 30,000 young people who are considered “excluded.” Another initiative was begun by the NGO Criar Brasil (Create Brazil), which launched radio programming for 8- to 18-year-olds living in poor urban neighborhoods in the interior of the country. Last year, the project reached 1,100 radio stations throughout Brazil. The government also works with the News Agency for the Rights of Children (Agência de Notícias dos Direitos da Infância or ANDI). The importance of using the right means of communication in a country like Brazil, where an adolescent sees an average of four hours of TV a day, cannot be overstated.

Even the NGOs that work with reproductive health issues recognize that there is room to do more. “For instance, today there is still an imbalance in the amount of effort we put into programs directed to girls in Brazil,” says Nanan Catalão, coordinator of ANDI. “There is still much work to be done in dealing with the health of boys.”

While the problem seems daunting, there is some good news. According to the National Coordination of Sexually Transmitted Diseases and AIDS of the Ministry of Health in Brazil, the number of adolescents using condoms in their first sexual experience has grown from 4 percent in 1994. In 1999, about 48 percent said they used condoms regularly. There is no doubt, also, that hardships related to unwanted pregnancies and the havoc STIs can bring to a young life are much more a part of the consciousness of the adolescent in Brazil than they were just a few years ago.

Lidia Rebouças is a freelance writer with the Brazil Information Center, based in Washington, DC.


United Nations Children’s Fund (UNICEF), A Voz dos Adolescentes (The Voice of Adolescents), accessed at, October 10, 2002.

Brazilian Center for Analysis and Planning of the Ministry of Health (CEBRAP), Projeto “Comportamento Sexual da População Brasileira e Percepções do HIV/AIDS,” accessed at

pesquisa_cebrap.htm, October 29, 2002.

Coordenação Nacional de DST e Aids (National Coordination of Sexually Transmitted Diseases and AIDS), accessed at, October 10, 2002.

Ministry of Health of Brazil, Boletim Epidemiológico XIV, no. 2 (April-June 2001), accessed at, October 10, 2002.


For More Information

ECOS – Communication on Sexuality


Workgroup and Research on Sexual Orientation

Instituto Kaplan

Abrinq Foundation for Children and Adolescents Rights