Why include men? Establishing sexual health clinics for men in rural Bangladesh.
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Subsequent to recommendations from the 1994 United Nations International Conference on Population and Development, and given recent findings outlining the links between control of sexually transmitted infections (STIs) and a reduction in HIV incidence, many countries are now seeking to establish STI control programmes. In many cases this is through a policy of providing comprehensive reproductive health care through the maternal and child health/family planning (MCH-FP) system. This involves management of all reproductive tract infections including STIs. This paper demonstrates how such an approach may miss one of the largest target groups--men. In general, men are at higher risk of initially contracting STIs, but, once infected, their clinical management is usually simpler than treating equivalent infections in women. It is argued that these two factors alone make the inclusion of men in STI control programmes critical. The paper outlines the experiences of one programme in rural Bangladesh in establishing sexual health clinics for men within the existing service structure. In response to client demand, the clinics moved beyond simple STI care towards provision of comprehensive sexual health services. Finally, the paper argues that whilst including men in sexual health programmes should never be at the expense of providing services for women, excluding them from service provision may make the objectives of STI control programmes unattainable. (+info)
Involving men in reproductive health: the Young Men's Clinic.
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OBJECTIVES: This report describes the population of young men who use the Young Men's Clinic in New York City, presents a profile of their reproductive behaviors, and describes the clinic's model of service delivery. METHODS: Data were gathered through a routine clinic visit form administered by clinic staff. RESULTS: The clinic sees approximately 1200 predominately Dominican young men each year for a wide range of clinical and mental health services. Two thirds of clients had ever been sexually active, three quarters had ever used birth control, and 69% had used birth control at their last sexual encounter. CONCLUSIONS: The Young Men's Clinic may serve as a model for health care delivery to adolescent and young adult males. (+info)
Contraceptive characteristics: the perceptions and priorities of men and women.
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CONTEXT: Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method. METHODS: The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics. RESULTS: Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status. CONCLUSIONS: Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices. (+info)
Older, but not wiser: how men get information about AIDS and sexually transmitted diseases after high school.
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CONTEXT: As they reach adulthood, young men are less likely to use condoms and are at increased risk for exposure to AIDS and other sexually transmitted diseases (STDs). Little is known about which prevention efforts reach men in their 20s. METHODS: Longitudinal data from the 1988, 1990-1991 and 1995 waves of the National Survey of Adolescent Males are used to identify sources of information about AIDS and STDs among 1,290 young men aged 22-26. Information receipt from four main sources, the topics covered by each source and the personal characteristics associated with getting more information are all explored. RESULTS: Twenty-two percent of men surveyed discussed disease prevention topics with a health provider in the last year, 48% attended a lecture or read a brochure, 51% spoke to a partner, friend or family member, and 96% heard about AIDS or STDs from the media (e.g., television advertisements, radio or magazine). Excluding media sources, 30% of young men reported getting no STD or AIDS prevention messages in the last year. Being black or Hispanic, having had a physical exam or an AIDS test in the last year, and having discussions about AIDS or STDs with parents or a health care provider in the past were associated with receiving more information. CONCLUSIONS: Although young men who are at higher risk for STD or HIV infection are more likely than other young men to get information about disease prevention, young adult men are much less likely than adolescents to receive AIDS or STD prevention education. More prevention efforts need to be aimed at young adults. (+info)
The role of son preference in reproductive behaviour in Pakistan.
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The sex of surviving children is an important determinant of reproductive behaviour in South Asia in general and Pakistan in particular. This cohort study evaluates the role of the sex of children on reproductive intentions and subsequent behaviour of women in urban slums of Karachi, Pakistan. The analysis is based on two rounds of surveys conducted in 1990-91 and 1995 of a cohort of married women aged 15-49 years. The results show that pregnancies became increasingly unwanted as the number of surviving sons increased. The sex of surviving children was strongly correlated with subsequent fertility and contraceptive behaviour. However, rather than an exclusive son preference, couples strove for one or more sons and at least one surviving daughter. The policy implications of the link between overt son preference and low status of women are discussed. (+info)
Trends in adolescent males' abortion attitudes, 1988-1995: differences by race and ethnicity.
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CONTEXT: Studying how adolescent males view abortion and how their attitudes toward abortion have changed over time can improve our understanding of the sexual, contraceptive and abortion behavior of these males and their partners. METHODS: Data from the 1988 and 1995 National Survey of Adolescent Males are used to describe changes in young males' attitudes toward abortion over time, as well as differences in abortion attitudes by race and ethnicity. Multivariate models are used to examine the relationship between religiosity and abortion attitudes. RESULTS: Between 1988 and 1995, young males' approval of abortion decreased significantly. In 1995, 24% of U.S. males aged 15-19 agreed that it was all right for a woman to have an abortion "for any reason," down from 37% in 1988. This decrease was driven almost entirely by non-Hispanic white males; there was little change in the abortion attitudes of non-Hispanic blacks and Hispanics. The decrease in white males' approval of abortion coincides with a significant increase in the self-reported importance of religion and in the proportion of whites who identified themselves as born-again Christians. The proportion of non-Hispanic white males indicating that religion was very important increased from 28% in 1988 to 34% in 1995, while the proportion identifying themselves as born-again increased from 18% to 24%. Multivariate analyses indicate that religiosity was more strongly related to the abortion attitudes of non-Hispanic whites than to those of Hispanics or non-Hispanic blacks. CONCLUSIONS: The large decrease in approval of abortion among white teenage males has closed the racial and ethnic gap in attitudes toward abortion that was evident in 1988, when such youth held significantly more liberal attitudes toward abortion than did either Hispanics or blacks. This trend toward more conservative abortion-related attitudes among whites coincides with increasingly conservative attitudes regarding premarital sex and greater religiosity among white male adolescents. (+info)
Axoneme-specific beta-tubulin specialization: a conserved C-terminal motif specifies the central pair.
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Axonemes are ancient organelles that mediate motility of cilia and flagella in animals, plants, and protists. The long evolutionary conservation of axoneme architecture, a cylinder of nine doublet microtubules surrounding a central pair of singlet microtubules, suggests all motile axonemes may share common assembly mechanisms. Consistent with this, alpha- and beta-tubulins utilized in motile axonemes fall among the most conserved tubulin sequences [1, 2], and the beta-tubulins contain a sequence motif at the same position in the carboxyl terminus [3]. Axoneme doublet microtubules are initiated from the corresponding triplet microtubules of the basal body [4], but the large macromolecular "central apparatus" that includes the central pair microtubules and associated structures [5] is a specialization unique to motile axonemes. In Drosophila spermatogenesis, basal bodies and axonemes utilize the same alpha-tubulin but different beta-tubulins [6--13]. beta 1 is utilized for the centriole/basal body, and beta 2 is utilized for the motile sperm tail axoneme. beta 2 contains the motile axoneme-specific sequence motif, but beta 1 does not [3]. Here, we show that the "axoneme motif" specifies the central pair. beta 1 can provide partial function for axoneme assembly but cannot make the central microtubules [14]. Introducing the axoneme motif into the beta 1 carboxyl terminus, a two amino acid change, conferred upon beta 1 the ability to assemble 9 + 2 axonemes. This finding explains the conservation of the axoneme-specific sequence motif through 1.5 billion years of evolution. (+info)
A latent variable model of developmental instability in relation to men's sexual behaviour.
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A single trait's fluctuating asymmetry (FA) is expected to be a poor measure of developmental instability. Hence, studies that examine associations between FA and outcomes expected to covary with developmental instability often have little power in detecting meaningful relationships. One way of increasing the power of detecting relationships between developmental instability and outcomes is through the use of multiple traits' FA. The way multiple traits have typically been used is in trait aggregates. Here, we illustrate another way of examining relationships with developmental instability using multiple traits' FA: through structural equation modelling. Covariances between measures of FA and an outcome variable are interpreted within the context of an explicit model of associations between variables, which is tested for fit and the parameters specified within the model are estimated. We used nine traits' FA as markers of a latent variable of men's developmental instability, which was associated with the number of sexual partners. The results indicate a sizeable correlation between developmental instability and men's sexual history, despite small correlations between individual traits' FA and sexual history. (+info)