Patterns of men's use of sexual and reproductive health services

CONTEXT: Men have been neglected as a target population for sexual and reproductive health services. As a result, little is known about the rates and antecedents of men's service utilization. METHODS: Data from the 2002 National Survey of Family Growth were used to examine utilization of sexual and reproductive health services among 3,611 men aged 20-44 who had ever had sex with a woman. Associations between demographic and behavioral variables and measures of service utilization were assessed in univariate and logistic regression analyses. RESULTS: Only 48% of men reported receiving sexual and reproductive health services in the past year. The testicular exam was the most commonly received service (35%), but half of men who had had a testicular exam had received no other sexual and reproductive health services. Levels of unmet need for services among men engaging in sexual risk behaviors were substantial (32-63%). The odds of having received nontesticular services were elevated among men who were nonwhite and older, engaged in sexual risk behaviors, had had a physical exam and had public health insurance. The odds of having received only a testicular exam were elevated among men who were white, had lower levels of sexual risk, had had a physical exam and had private or no insurance. CONCLUSIONS: Men who have sex with women are not receiving adequate levels of sexual and reproductive health care, and the care they receive is neither comprehensive nor integrated. Standards of clinical care need to be defined and communicated to men and providers.     

Men's expectations of physicians in sexual health concerns

This study assessed 62 men for their expectations of primary care physicians in attending to sexual health concerns. The physician was the professional most preferred for consultation regarding sexual concerns, and men look for qualities of professionalism, empathy, trust, and comfort in their physician. While 97% of the men reported prior sexual concerns, only 19% had discussed these issues with their doctor. Most were hesitant, but wanted to deal with sex problems. They preferred that the physician initiate the discussion. These findings suggest an under-utilization of sexual health care by men and support the role of the primary care physician as an important sexual health provider.     

Young males' sexual education and health services

This study examined the basis for one hospital's decision to restructure its teen family planning clinical services. We examined results of surveys conducted from 1998 to 2003 with more than 2000 mostly African American eighth-grade boys. Most young males wanted to postpone sexual intercourse, but an even greater percentage were willing to use a method of protection. The hospital determined that it needed to give the same in-hospital clinical and counseling support to young males as it gives to young females.     

Teenagers' use of sexual health services: perceived need, knowledge and ability to access

INTRODUCTION: An individual teenager's use of services may depend on perceived need, on knowledge of sexual health and local services, and on ability to access. This paper presents the first UK large-scale quantitative analysis of these factors, comparing those who use services with those who do not. METHODS: 15/16-year-olds (n = 5747) were questioned about their use of sexual health services in the SHARE trial of a school sex education programme in 25 schools in Lothian and Tayside, Scotland, UK. Multilevel statistical models examined the role of different factors on service use. RESULTS: One-third of teenagers had used a service, and use was strongly related to sexual experience. In addition, some family influences and being a school leaver were associated with service use, although we found no evidence for class, ethnic or religious barriers to use. Proximity to specialist clinics was linked with greater use, while low spending money and high parental monitoring were associated with less use. Teenagers with better knowledge, who rated their school sex education as effective, who were comfortable talking about sex and who had discussed contraception with peers were more likely to have used services. Differences in use relating to sexual experience, knowledge, feeling comfortable talking about sex and talking with peers helped to explain gender differences in service uptake. CONCLUSION: There is potential to influence service use through better knowledge and confidence imparted through school sex education, and by improving the links between services and schools.     

Providing sexual health services for men in Bangladesh

International health advocates, planners, and policymakers agreed at the 1994 International Conference on Population and Development (ICPD) that special efforts should be made to stress men's responsibility in family planning and reproductive health, and to promote their involvement in preventing HIV/STDs and unwanted and high-risk pregnancies. Bangladesh is one of many countries now trying to control reproductive tract infections (RTIs) and STDs by establishing public health programs. Bangladesh's system of primary health care (PHC) has long focused upon maternal and child health and family planning (MCH-FP) rather than the delivery of comprehensive care for all. This exclusive focus has led to the almost total exclusion of men as recipients of reproductive health care services at the PHC level. Following consultations with the community, 4 male sexual health clinics were established and opened between August 1995 and January 1996 for 1 afternoon/week, with opening hours later expanded to 1 day/week. The first such services opened in either the public or nongovernmental organization sectors, the clinics were located in existing MCH-FP buildings and open to all men in the communities free of charge. Male staff were trained according to WHO guidelines on the syndromic management of STDs. By the time they opened, awareness of the clinics' existence had been spread in the served communities through word-of-mouth and interpersonal communication networks. To better serve the large proportion of men with psychosexual problems such as impotence, premature ejaculation, and sexual dissatisfaction, 1 staff member studied male sexual health services in India for 3 months, after which he returned to train his 3 male colleagues.     

Trends in US women's use of sexual and reproductive health care services, 1995-2002

I examined the 1995 and 2002 National Survey of Family Growth for patterns and trends in the use of sexual and reproductive health care services by US women according to type of provider. The percentage of women reporting receipt of contraceptive services rose between 1995 and 2002 (from 36% to 41%), and the level and mix of services received varied considerably according to type of provider. Women visiting publicly funded providers received a broader mix of services than did clients of private providers.     

Men's reproductive health services in family planning settings: a pilot study.

A 1984 pilot survey of administrators of 35 agencies offering family planning services revealed that all offered counseling/educational services for males, and 89 per cent offered medical/supply services for males. Nevertheless, total utilization of these services is low. Major barriers related to the provision of services to male clients are resource limitations, inadequate training, and negative or ambivalent staff attitudes; these factors may contribute to the discrepancy between service offering and utilization.