From “combined prevention” to “comprehensive prevention”: building the response to the syndemic with adolescents and youth in São Paulo, Brazil (2020-2023)

Cad Saude Publica. 2025 May 19;41(4):e00084323. doi: 10.1590/0102-311XEN084323. eCollection 2025.

ABSTRACT

This essay discusses the need for and the possibilities of transitioning from the conceptual framework of combined prevention to the conception of “comprehensive prevention,” based on intervention research aimed at supporting and protecting the sexual and reproductive health of adolescents and youth in three cities in the state of São Paulo, Brazil (São Paulo, Santos and Sorocaba). Particularly effective in preparing for syndemic cycles within the context of environmental crises, the concept of comprehensive prevention contributed to understanding processes of vulnerability to COVID-19, mpox, sexually transmitted infections/AIDS, violence, unwanted pregnancy and psychosocial distress. It provided guidance for addressing the syndemic nature of pandemics intensified by social crises, and encouraged young people to develop creative responses to political polarization fueled by the far right, which aggressively inhibits approaches based on human rights, especially in the field of sexuality, enhancing the infodemic that downplays the severity of ongoing pandemics. We underline the productivity of the concept of comprehensive care in developing initiatives related to human rights and prevention which dynamically anticipate and address events that synergistically overlap in marginalized territories. By adopting “scenes” as units of interpretation and focal points for responding to contexts of vulnerability, we favor the co-construction of transversal skills in the personal, collective and territorial responses necessary for the prevention of adversities that threaten adolescents and youth both physically and mentally.

PMID:40396814 | DOI:10.1590/0102-311XEN084323