The Invisible Men: finding and engaging with the male partners of street sex workers

Men, in general, remain less likely than women to seek medical care, and are only half as likely as women to undertake preventive health visits and/or screening tests. There is a great need to increase men's health awareness and reduce this significant gender disparity. Furthermore, marginalised and socially excluded men rarely access health services, even though the reasons for their social exclusion, particularly drug and alcohol dependency, invariably mean that their need for health interventions is greater than in the normal population.The Open Doors Sexual Health Service has been working with female street sex workers (SSWs) in the London Borough of Hackney since 2006, in order to help them address their physical, psychological and social needs. Open Doors is based in, and partly funded by, City and Hackney Primary Care Trust. As Open Doors’ staff's relationships with the women grew and the team developed an understanding of the lives of the women and their networks, it became clear that their relationships with the men in their lives (historically characterised as “pimps”) were more significant and enduring than had previously been assumed, and that working with couples had the potential to be of greater benefit than working with the women only.In July 2008, a male worker joined the Open Doors team, in order to work exclusively with the male partners of women using the service, and to develop access to clinical and social services for this shadowy group. During the first 12 months, the male partners’ coordinator (MPC) engaged with 23 men, each one of whom has needed intensive case management, as illustrated by a Case Study. The MPC's contract has been renewed for a further year, and the scope of the post widened to include other marginalised men, such as street drinkers, squatters and undocumented migrants, achieved by close collaboration with key services, especially the TB service, the Department of Sexual Health (DoSH) and the Specialist Addictions Unit (SAU) in Hackney's local hospital, the Homerton.This paper will describe the work done by the MPC during the first 12 months of his tenure.     

Evaluation of a community-based sexual health intervention for young adult Latino and African-American men

BackgroundRecent research has documented men's unmet need for sexual and reproductive health (SRH) care, a situation which negatively affects their sexual health outcomes as well as those of their partners. This unmet need is due, in part, to men's reluctance to seek health care in general and sexual health care in particular. In this study we evaluated an educational intervention for men designed to promote more positive attitudes toward health care utilization and increase their use of SRH care. The secondary aims of the intervention were to improve men's knowledge about sexually transmitted infections and emergency contraception as well as to promote positive condom attitudes and safer sex behaviors.MethodsThis study used a non-equivalent control group design with pretest and post-test assessments to evaluate a 3-session SRH educational intervention delivered in small group community settings. A total of 231 men participated in the intervention and completed pretest and post-test assessments, 113 in the intervention and 118 in the control group. To be eligible for the study men had to be aged 18–30, Latino or black and able to participate in an English-language educational program. Study participants were recruited from community-based organizations. Men completed self-administered pretest interviews at study enrollment and a brief telephone interview 3 months later.ResultsThe intervention promoted more positive health care utilization attitudes and modestly improved use of SRH care services. In addition, post-test comparisons indicated that men in the intervention group, when compared to those in the control group, had higher levels of sexual health knowledge, more positive attitudes on one of two condom attitude measures, and fewer sex partners in the past 3 months. No significant intervention effect was observed for the frequency of condom use in general or with casual sex partners.ConclusionsThis modest success supports the viability and efficacy of delivering sexual health education to young adult men of color in community programs that address men's educational and job-related needs.     

Physician attitudes to the concept of ‘men''s health’ in Asia

BackgroundMen's health is an emerging medical and public health concept, but it is confronted by special challenges in the Asia-Pacific medical and cultural context.MethodsA telephone survey was conducted with physicians in Korea, Taiwan and Singapore. The interview was conducted in Korean (Korea), Mandarin (Taiwan) or English (Singapore) by trained interviewers. The physicians interviewed were drawn from a variety of medical specialties including urology, primary care, endocrinology and cardiology.ResultsIn total, 810 physicians from various medical specialities took part in the survey. There was only broad general agreement (>50%) between the physicians in the various countries on a range of questions relating to men's health, such as the conditions most associated with men's health, the predictability of illness/disability with age etc, and physician willingness to discuss problems in sexual health.ConclusionsThe data from this survey suggest that, although not as clearly defined as women's health, the treatment of men's health cuts across many different medical specialties and takes in a broad spectrum of health conditions. Therefore, there is a clear opportunity for the medical community to define, refine and improve the treatment and understanding of men's health in Asia.     

男性生殖健康热线使用情况分析

探索为男性参与计划生育/生殖健康提供咨询服务的途径,2000年3月设立“避孕套和生殖健康热线—加强生殖健康中男性的责任”人工台和自动台。热线开通以来,通过宣传干预共接听咨询电话3 724次。对其使用结果、咨询对象性别、咨询内容等进行统计分析。人工台接听咨询电话826个,自动台接听2 898个,男性咨询对象占70.1％。人工台咨询较多的问题依次为避孕节育知识、生殖系统疾病诊治、性卫生与性传播疾病,而自动台咨询避孕套使用和性卫生与性传播疾病较多。实践证明,热线是一种保密性强、文明便捷的服务方式,为男性参与生殖健康开辟了新途径。     

Bringing to light the health needs of African-American men: the Overtown Men's Health Study

Background

The harsh intersections of racism and sexism in US society have contorted roles for African-American men and damaged their social ties, thereby contributing to excess morbidity and mortality in communities of color. The Overtown Men's Health Study is used here as a case study to examine the health needs of African-American men.

Methods

Men aged 18 years and older who resided in the neighborhood of Overtown within Miami, Florida, USA completed an in-person survey administered at 15 community sites: 3 housing complexes, 3 rooming houses, 3 commercial sites, 2 abandoned buildings, 1 large and 1 small public park, 1 union hall, and 1 community center.

Results

The vast majority of respondents (n = 129) were identified as Black/African-American (95.3%). Just 9.3% of the men surveyed were currently married, yet over half were fathers (59.7%). Nearly two-thirds (62.8%) of the men in Overtown reported drinking alcohol, and almost half (47.3%) reported smoking cigarettes. Only one of three (33.3%) Overtown men reported having a primary care physician or health practitioner, and only one of five (20.2%) had received dental care in the previous 12 months. A remarkable one of four (25.6%) Overtown men reported having been a victim of police violence, and nearly two-thirds (65.9%) reported having been incarcerated.

Conclusions

These findings are a call to action issuing from Overtown to other distressed neighborhoods of color within central cities through the USA. Urgent pursuit of measures for reducing social disparities in health for African-American men is ethically compulsory.     

SELECT shows no effect on prostate cancer prevention

To determine whether selenium, vitamin E, or both could prevent prostate cancer and other diseases with little or no toxicity in relatively healthy men. Oral selenium (200 μg/d from L -selenomethionine) and matched vitamin E placebo, vitamin E (400 IU/d of all rac-α -tocopheryl acetate) and matched selenium placebo, selenium + vitamin E, or placebo + placebo for a planned follow-up of minimum of 7 years and a maximum of 12 years. Number of men diagnosed with prostate cancer and prespecified secondary outcomes, including lung, colorectal, and overall primary cancer. Selenium or vitamin E, alone or in combination at the doses and formulations used, did not prevent prostate cancer in this population of relatively healthy men.     

Midwives' experiences of routine antenatal questioning relating to men's violence against women

OBJECTIVE: to describe and use the experience gained by antenatal-care midwives who routinely questioned pregnant women about personally experienced violence. DESIGN: qualitative, using focus-group discussions. SETTING: antenatal care in a city in south-central Sweden. STUDY POPULATION: 21 midwives. DATA COLLECTION AND ANALYSIS: the midwives participated in any one of five focus-group discussions held by the same moderator and observer. The discussions were audiotaped, transcribed verbatim and analysed using qualitative content analysis. FINDINGS: the importance of routine questioning about violence was emphasised in all groups. Midwives felt they had failed in their duty when women were not questioned. The two main obstacles to such questioning were the delicacy of the subject and the routine of inviting the partner to all visits. The perceived delicacy underlined the need to devise a natural setting for the questioning. The midwives wanted to connect questions about abuse with related subjects routinely established in early pregnancy. As the partner was invited to every visit, it was not practicable to establish a procedure whereby the assessment was connected with a particular visit. Other obstacles included the following: time constraints, oversight, a preconceived notion of who might be a victim of abuse and language difficulties. The midwives emphasised the importance of training, easy access to support for abused women, and personal counselling for midwives. They described their role as raising awareness of the problem of male violence, reducing the shame of being abused, informing, giving emotional support and mediating help. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: in order to ensure that the establishment of experience of violence is a routine enquiry in antenatal care, midwives must have a reasonable opportunity of carrying out such questioning. A routine that offers each woman a private consultation will ease the questioning and save time and distress.     

Health benefits of seafood for men

Background

Evidence supports the idea that the regular consumption of Omega-3 polyunsaturated fatty acids (Omega 3s) has positive effects on men's health. The best source of these essential fatty acids is seafood, particularly oily fish. This article summarises evidence pertaining to the benefits associated with regular dietary intake of fish on men's health.

Methods

An extensive review of international academic libraries, databases and published literature was conducted. Quality assessment ratings were applied and thematic classifications based on major health issues relevant to men were constructed.

Results

A total of 168 articles from peer-reviewed journals were identified, with 60 studies providing moderate to high level evidence of an association between the consumption of Omega 3s and health benefits for men. The majority of the studies showed a positive link between the intake of Omega 3s and the prevention and management of chronic disease in men. Evidence also showed a reduced risk of prostate cancer and lower lung cancer mortality in men who consumed high seafood diets.

Conclusion

There is conclusive evidence of an association between the dietary intake of Omega 3s and health benefits for men. However, men are less likely to consume fish as a main protein source, often tending towards diets high in red meat. Health promotion interventions should consider: the attitudes of men toward food and the impact of these attitudes on food choices; men's perceptions of fish and seafood, particularly in comparison to other protein sources; and the role that particular foods play for males in traditional social situations.