Finding Information About Men's Health on the Internet

Summary

It's a well-known fact that men are less likely than women to seek health care. Men tend to wait as long as possible to see a doctor about a health problem, making early diagnosis of a disease difficult if not impossible. When one looks at the statistics related to men's health, the apparent aversion to seeking health care is disconcerting. Given the fact that men seem to be more private about their illnesses, the Internet provides an excellent place for them to seek health care information. A search of “men's health” finds an overwhelming number of sites on the Internet. This article provides a highly selected list of Web sites intended as a starting place for finding information about men's health on the Internet.     

Social and cultural contexts of concurrency in a township in Cape Town,South Africa

Following the 1994 International Conference on Population and Development, the world has seen a shift in paradigm away from focused family planning programmes towards reproductive and sexual health more generally. This paper considers how the traditional emphasis on women's health and family planning can result in men's sexual health needs being overlooked. A biomedical rationale to target men with health services evolved from the rising interest in control programmes for HIV and sexually transmitted infections (STIs). To plan appropriate health interventions more needs to be known about how men perceive their sexual health. Unique data from Orissa (India) and rural Bangladesh illustrate men's perceptions of their sexual health problems and demonstrate that men are willing to seek care. While public sector programmers and health planners may be focusing their attention on the control of STIs, men in both studies indicated that their major concerns relate more to matters of psychosexual disorders. The failure of public sector programmes to take cognisance of male sexual health problems may lead to men continuing to seek care for all their sexual health problems (including STIs) in the unregulated and possibly ineffective private sector. If programmes addressing the sexual health needs of men are to be effective, they will need to be comprehensive in their scope and coverage, just as they are now aiming to be for women.     

Recruiting low-income healthy women to research: an exploratory study

Objective. The study goals were (1) to assess the feasibility of using an existing telephone health information and referral service for low-income, ethnically diverse women to recruit women for research participation; (2) to assess the feasibility of recruiting low-income, African American and Latino men into health research through the women callers to the telephone service; and (3) to describe the challenges women face and the strategies they use when talking to men about the men's health and research participation.

Design. We recruited women for individual semi-structured qualitative interviews via the Every Woman Counts (EWC) telephone information and referral service, a California Department of Health Services Cancer Detection Program. This paper describes our eligibility and recruitment assessment, and our qualitative data from 23 interviews with low-income African American and Latino women who called EWC.

Results. We found that it was feasible to recruit women, but not to recruit men through women who call this telephone service. Almost 50% (113) of women demographically eligible for recruitment, completed our screening questionnaire, despite calling EWC for a different purpose. Some 48% (54) of those women were eligible for an interview. Of interview-eligible women, 58% (10) of African Americans and 35% (13) of Latinos completed an interview. Only 17% (4) of women referred a man for participation in an interview for our study. Several themes emerged from our analysis of interview data: (1) women's role in men's health can be significant but is often uneasy; (2) challenges when talking to men about their health include health access, gender dynamics, and men's fear of health care; (3) women's understanding of research may be limited; (4) women use a range of strategies to address and overcome men's resistance to taking care of their health and participating in research.

Conclusions. The challenges women face when talking with men about their health affect their ability to effectively speak to men about research participation. However, EWC and similar telephone health services may be an effective means for recruiting low-income women to chemoprevention and other studies requiring healthy participants.     

Men's contribution to the food and nutritional situation in the Tanzanian household

More is presently known about women's than men's role in food production and nutrition in Africa. The present article is an attempt to remedy this shortcoming. A special focus is put on the influence men exert through their labour and decision‐making on the household food situation. Findings from a study in a subsistence agricultural community in Tanzania give a differentiated picture compared to current literature. Most men put a substantial amount of labour into food production, but not as much as their wives, while a minority did almost nothing. When men worked hard in the fields, their wives worked hard too. Both men's and women's labour input in the field was important for household food availability. However, no direct relationship was found between men's work and child nutrition. In decision‐making women had a subordinate position and men were apt to favour cash above food. However, women usually had their way with men to insure that family food needs were met. The potential for improving women's situation by increasing men's contribution is discussed.     

The status of men's health in Asia

ObjectivesThis study aims to compare health status and its risk factors between men and women who are from countries of different income status in Asia.MethodWe have included 47 Asian countries and 2 regions in this study. Life expectancy, mortality rate from communicable disease, non-communicable disease and injuries, the prevalence of non-communicable diseases risk factors and their trends were extracted from the WHO and respective governmental database. Subgroup analysis was performed based on country income groups.ResultsOverall, men have shorter life expectancy and higher mortality rates compared to women. Men from higher-income countries lived longer compared to men from lower-income countries. There is a wide variation of male life expectancy in upper and lower middle income countries. The mean systolic blood pressure, fasting blood glucose and body mass index in Asia have also increased over the years.ConclusionThis study confirms that Asian men have poorer health compared to women besides the growing concerns on NCD risk factors. The findings from this study calls for a concerted effort to find solutions in addressing men's health problems in Asia.     

Men's attitudes to condoms and female controlled means of protection against HIV and STDs in south-western Uganda

There is widespread demand for the development of female controlled methods of protection against sexually transmitted diseases (STDs) and HIV. The success of such methods will not only depend on their acceptability to women but also to their male partners. This paper reports on men's attitudes to female controlled methods in south west Uganda. Data was gathered in individual interviews with 50 men and 7 focus group discussions with 42 men. Male attitudes to the male condom, the female condom and female controlled methods of protection generally were characterized by ambiguity and anxiety. They liked the male condom because it protects against infection and unwanted pregnancy, but were worried by rumours that it was unreliable. The central theme in the discussions was men's anxiety about retaining control over their female partners. The men wanted women to be protected (and therefore safe as potential partners) but they also wanted to remain in control, at least to some extent, of the means of protection. Once suitable female controlled methods have been identified, it will be necessary to use education and social marketing in such a way that men can be reassured of the positive benefits of these products to them, as well as to women.     

A Guy Thing

Abstract

The Men's Movement, celebrity disclosures about prostate cancer, and recent epidemiologic research identifying gender-related health risks for men have all resulted in, and simultaneously fostered, a burgeoning demand for information on men's health issues. The Internet may serve as a convenient, timely, and interactive service complementing traditional print resources for patients, their families, and their affectional partners looking for information on sexual and reproductive health and other health conditions as they present in men. Included in this article is a select list of Web-based men's health resources, with annotations, available from the Internet.     

Masculinity in the doctor's office: Masculinity,gendered doctor preference and doctor–patient communication

ObjectiveMortality and morbidity data suggest that men have shorter life expectancies than women and outrank women on several leading causes of death. These gendered disparities may be influenced by psychosocial factors like masculinity.MethodsThree studies (Total N = 546) examined the role of masculinity in men's doctor choices and doctor–patient interactions. In Studies 1 and 2, men completed measures of masculinity, gender bias, and doctor preference. Using structural equation modeling, we tested the direct relationship between masculinity and male doctor preference and the indirect relationship of masculinity on male doctor preference through an association with gendered competence stereotypes. Participants in Study 3 disclosed symptoms in private followed by disclosure to a male or female interviewer in a clinical setting. Using repeated measures analysis of variance (ANOVA), we examined the interaction among symptom reporting, masculinity and doctor gender, controlling for participant comfort.ResultsIn Study 1, results suggested that masculinity encouraged choice of a male doctor directly and indirectly via beliefs that men make more competent doctors than women; Study 2 directly replicated the results of Study 1. In Study 3, independent of participant comfort, an interaction between interviewer gender and masculinity emerged such that men scoring higher on masculinity reported symptoms less consistently to male interviewers (relative to higher scoring men reporting to female interviewers); the reverse was found for men scoring low on masculinity.ConclusionsTaken together these studies suggest that masculinity may affect men's health by encouraging choice of a male doctor with whom doctor–patient communication may be impaired.     

Men’s hopes,fears and challenges in engagement in perinatal health and the prevention of mother-to-child transmission of HIV in rural Kenya

Abstract

Male involvement in antenatal care has been shown to improve health outcomes for women and infants. However, little is known about how best to encourage male partners to support essential perinatal health activities. We explored men’s perceptions of facilitators and barriers to involvement in antenatal care and HIV prevention including fears, hopes and challenges. Forty in-depth interviews were conducted with the male partners of HIV-positive and HIV-negative pregnant women in southwest Kenya. Most male partners believed engaging in pregnancy health-related activities was beneficial for keeping families healthy. However, thematic analysis revealed several obstacles that hindered participation. Poor couple relationship dynamics seemed negatively to influence male engagement. Some men were apprehensive that clinic staff might force them to test for HIV and disclose the results; if HIV-positive, men feared being labelled as ‘victimisers’ in situations of serodiscordancy, and described fears of abandonment by their wives. Some men avoided accompanying their wives, citing local culture as rationale for avoiding the ‘effeminate’ act of antenatal care attendance. Amidst these obstacles, some men chose to use their partners’ HIV status as proxy for their own. Findings suggest that improving male engagement in essential maternal and child health-related activities will require addressing both structural and interpersonal barriers.     

Pregnancy Motivations and Contraceptive Use: Hers,His, or Theirs?

ContextStudies increasingly consider the role of pregnancy motivations on contraceptive use. Few studies include measures of men's pregnancy motivations.MethodsWe used baseline data (from a couples-intervention study) to examine the contribution of women's and men's pregnancy motivations and participation in decision making to contraceptive use by women in relatively stable relationships who were not trying to get pregnant. In addition to conducting multivariate analyses, we assessed agreement between a woman's perceptions of and her partner's reports of his pregnancy motivations.ResultsWe observed moderate agreement between men's pregnancy motivations and their partners' perceptions of those motivations. Levels of agreement about participation in decision making were somewhat lower. In bivariate analyses, effective contraceptive use was significantly associated with two measures of pregnancy motivation for men and women. In multivariate analyses, only women not wanting a child in 2 years (adjusted odds ratio [aOR], 1.73), women's (aOR, 1.80) and men's (aOR, 0.78) participation in decision making, women believing their partners favored contraceptive use (aOR, 2.01), relationships lasting 2 or more years (aOR, 1.98), and ethnicity/race (Latina aOR, 0.27; other race aOR , 0.45) were associated with effective contraceptive use.ConclusionProviders and those developing interventions must recognize that some women who are “not trying to get pregnant” have weak motivations to avoid pregnancy, and so should help women to clarify their motivations and seek support from their partners for contraceptive use. To understand the role of pregnancy motivations, future research may include both qualitative and longitudinal quantitative studies.     

(Not) talking about sex: couple reports of sexual discussion and expression in Bangalore,India

Adolescent marriage is common in India, placing young women at risk of HIV, early pregnancy and poor birth outcomes. Young women's capacity to express their sexual desires is central to negotiating safe and mutually consensual sexuality. Men, too, play an important role in shaping women's sexual and reproductive health outcomes, but little research has examined how men influence women's sexual expression. Using paired husband and wife data, this paper reports on a preliminary investigation into the patterns of and concurrence between women's sexual expression and their husbands' attitudes about it, as well as the influence of men's approval of their wives' sexual expression on women's actual expression of sexual desire. The results suggest that, among this sample, men are more open to sexual expression than their wives and that, for women, expressing desire not to have sex is far more common than expressing desire to have sex. Further, men's approval of sexual expression from wives appears to positively influence women's actual expression. These findings suggest that men may be resources for women to draw upon as they negotiate sexuality in adolescence and early adulthood.     

Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base

Men's involvement in the health of women and children is considered an important avenue for addressing gender influences on maternal and newborn health. The impact of male involvement around the time of childbirth on maternal and newborn health outcomes was examined as one part of a systematic review of maternal health intervention studies published between 2000 and 2012. Of 33,888 articles screened, 13 eligible studies relating to male involvement were identified. The interventions documented in these studies comprise an emerging evidence base for male involvement in maternal and newborn health. We conducted a secondary qualitative analysis of the 13 studies, reviewing content that had been systematically extracted. A critical assessment of this extracted content finds important gaps in the evidence base, which are likely to limit how ‘male involvement’ is understood and implemented in maternal and newborn health policy, programmes and research. Collectively, the studies point to the need for an evidence base that includes studies that clearly articulate and document the gender-transformative potential of involving men. This broader evidence base could support the use of male involvement as a strategy to improve both health and gender equity outcomes.     

Racial and ethnic differences in men's knowledge and attitudes about contraception

BackgroundLittle is known about racial/ethnic differences in men's contraceptive knowledge and attitudes.Study DesignWe used multivariable logistic regression to examine racial/ethnic differences in contraceptive knowledge and attitudes among 903 men aged 18–29 in the 2009 National Survey of Reproductive and Contraceptive Knowledge.ResultsBlack and Hispanic men were less likely than Whites to have heard of most contraceptive methods, including female and male sterilization, and also had lower knowledge about hormonal and long-acting reversible methods. They were less likely to know that pills are ineffective when 2–3 pills are missed [Blacks: adjusted odds ratio (aOR)=0.42; Hispanics: aOR=0.53] and that fertility was not delayed after stopping the pill (Blacks: aOR=0.52; Hispanics: aOR=0.27). Hispanics were less likely to know that nulliparous women can use the intrauterine device (aOR=0.47). Condom knowledge was similar by race/ethnicity, but Blacks were less likely to view condoms as a hassle than Whites (aOR=0.46).ConclusionsEfforts to educate men, especially men of color, about contraceptive methods are needed.     

Men’s Response to Obulamu Campaign Messages about Male Involvement in Maternal Health: Mukono District,Uganda

ABSTRACT

Men’s involvement makes a difference in maternal health. Well-informed and supportive men may encourage their wives to get more complete and regular antenatal care. In much of sub-Saharan Africa, however, men’s involvement with their wives’ health during pregnancy is minimal. This study investigated men’s response to Obulamu: How’s Your Pregnancy radio campaign messages about attending antenatal care with their wives, delivering at a health facility, being tested for HIV, maintaining maternal nutrition, and using malaria prevention. We conducted eight focus group discussions ranging from six to ten participants each: two groups of men from a rural area, two groups of men from a peri-urban area, and two groups each of expectant or recent mothers from the same rural and peri-urban areas. We also conducted six key informant interviews of midwives and other healthcare providers. Findings revealed that participants were highly exposed to the Obulamu campaign and knowledgeable about campaign messages. Most men expressed positive attitudes toward behaviors promoted by the campaign and voiced an intention to change their behaviors. Key informant interviews confirmed that since the start of the campaign an increase in male involvement with maternity visits had taken place. However, a sizeable minority of men, mostly rural residents, resisted involvement in their wives’ antenatal visits because of poverty, gender and cultural stereotypes, fear of HIV testing, and incongruity between messages and the realities of antenatal clinical practice. An interaction between individual and institutional-level factors as posited by the social ecological model was clearly evident; there was an incongruity between encouraging Obulamu messages about men’s involvement and the discouraging realities of antenatal clinical practice.     

Views of men with Parkinson's disease regarding physical activity health messaging

BackgroundMany men with Parkinson's Disease (PD) do not meet the recommended levels of physical activity (PA) for health benefits. Tailored, meaningful, and culturally sensitive PA health messages may be a catalyst to shape men's motivations toward participation.ObjectiveWe explored the views of New Zealand (NZ) men with PD about existing PA health messages, and how these could be adapted to be more effective.MethodsThis qualitative study recruited six community dwelling, regularly physically active, NZ European men with PD (aged 54–69 years, 2–18 years post-diagnosis) from a community exercise class in Canterbury, NZ. Participants engaged in semi-structured interviews which were audio-recorded, transcribed verbatim, and analyzed inductively for themes.ResultsParticipants expressed that effective PA health messages should reflect men's motivations for PA which included physical and mental well-being and social connection. Inclusive, positive, and relatable language and imagery were considered crucial PA message communication strategies. Participants viewed health professionals' PA advice as superficial and unhelpful; however, celebrities with PD were considered inspirational messengers. Messages endorsed by trustworthy sources, such as the Parkinson's Society, were perceived to enhance the credibility.ConclusionsEffective PA messages should be gain framed and tailored to the target audience. We recommend health professionals provide comprehensive PA advice or consider onward referral. Future research which uses a co-design participatory methodology to collaborate with men with PD from culturally diverse backgrounds and represent all stages of PA behaviour change is recommended to provide comprehensive insights for meaningful, effective, and culturally sensitive PA health messaging.     

Percepciones de los hombres sobre las complicaciones asociadas a la mutilación genital femenina

ObjectiveTo explore men's knowledge of the negative consequences of female genital mutilation (FGM) to women's health in countries where this practice is performed.MethodsA qualitative methodology was used with an ethnomethodological approach. Both individual and group semi-structured interviews concerning FGM were conducted with 25 men, selected by triple sampling. A study presentation letter was provided to participants, together with an informed consent declaration. Permission was also procured to record the interviews in audio format. Data analysis was performed using the Atlas Ti7 software.ResultsThose participants against FGM are aware of the range of complications this practice can cause, being able to identify physical, obstetric, psychological, sexuality and social consequences in women subjected to FGM. However, those men who are in favour display a general ignorance of the problems resulting from this practice.ConclusionsParticipants from countries where FGM is performed who are against this practice are more aware of the negative consequences than those who claim to be in favour. The design of awareness-raising programmes and other tools to combat female genital mutilation must highlight the implications for women's and girls’ health, and include family-targeted campaigns which involve men in the process of eradicating this practice.     

Trends in Ages at Key Reproductive Transitions in the United States, 1951–2010

BackgroundKey sexual and reproductive health milestones typically mark changing life stages with different fertility intentions and family planning needs. Knowing the typical ages at such events contributes to our understanding of changes in family formation and transition to adulthood and helps inform needs for reproductive health services.MethodsWe used data from the 1982–2010 National Surveys of Family Growth and the 1995 National Survey of Adolescent Males and event history methods to examine trends over time for women and men in the median ages at several reproductive and demographic events.FindingsWomen's reports indicate that age at menarche has changed little since 1951. Women's and men's median ages at first sex declined through the 1978 birth cohort, but increased slightly since then, to 17.8 years for women and 18.1 for men. The interval from first sex to first contraceptive use has narrowed, although Hispanic women have a longer interval. Age at first union (defined as the earlier of first marriage or first cohabiting relationship) has remained relatively stable, but the time between median age at first sex and median age at first birth has increased to 9.2 years for women and 11.4 for men. For some women and men born in the late 1970s, median age at first birth was earlier than median age at first marriage for the first time in at least the past several decades.ConclusionThe large majority of the reproductive years are spent sexually active. Thus, women have a lengthy period during which they require effective methods. In particular, the period between first sex and first childbearing has lengthened, but long-acting method use, although increasing, has not kept up with this shift. Moving the contraceptive method mix toward underutilized but highly effective contraceptive methods has the potential to reduce the unintended pregnancy rate.     

Time to Father

Abstract

This paper reports the qualitative findings from 40 couples involved in a study exploring men's post-natal mental health. Interviews were conducted with individuals soon after the birth of their first child. Findings suggest that new fathers want to be more involved in the direct care and nurturing of their children than their fathers were with them. Discourses which construct fathers and inform social structures have not kept pace with men's changed attitudes and role expectations limiting the options available to men as fathers. In particular men's employment circumstances figure in their experience of adjusting to life as a father. Those fathers having least flexibility and autonomy in their work report experiencing, since the birth of their child, more unhappi-ness, anxiety, and generally higher levels of stress. These findings suggest increasing workplace flexibility and provisions such as parental leave are important for men's post-natal mental health.     

Sociodemographic,Psychological and Health-Related Factors Associated with Poor Mental Health in Spanish Women and Men in Midlife

ABSTRACT

Background: The purpose of this work was to examine the sociodemographic, psychological, and health-related factors (considered jointly) associated with poor mental health in midlife and to analyze whether risk and protective factors differed in men and women.

Methods: A cross-sectional study was conducted with a middle-class sample of 252 women and 189 men between 45 and 65 years of age from Spanish rural areas. Mental health status was measured with the 12-Item General Health Questionnaire (GHQ-12; Goldberg & Williams, 1988). Multiple logistic regression models were used to calculate odds ratios with confidence intervals of 95%, adjusting for confounding variables.

Results: The percentage of women (14.3%) with poor mental health was twice that of the men (7.4%). In women, the following variables were significantly and positively related to poor mental health: consumption of psychoactive drugs, physiological and cognitive anxiety; self-esteem and family satisfaction were protective factors. For men, physical complaints and cognitive anxiety were significant risk factors, and job satisfaction was a protective factor.

Conclusions: In general, the psychological variables were more clearly related to poor mental health. Women had a more unfavorable profile, and the variables related to poor mental health differed for men and women, perhaps due to social roles associated with gender. To facilitate diagnosis and take preventive measures, men's and women's risk factors for poor mental health should be differentiated.