Ethnicity as a factor in reproductive health care utilization among males attending family planning clinics

Engaging Young Black Males in Sexual and Reproductive Health Care: A Review of the Literature

Young Black males (YBM) ages 18 to 24 years are more at risk of contracting sexually transmitted infections (STIs) and have a substantially greater need for sexual reproductive health (SRH) services than other groups. Despite this significant need, the extant literature does not provide a comprehensive picture of how YBM seek preventive care services (e.g., STI testing). Therefore, the purpose of this review is to address YBM’s SRH access and use of STI/HIV testing and screening in this population, with a specific emphasis on young heterosexual Black males, by identifying barriers and facilitators of engaging with SRH care. An electronic search was performed using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, PubMed, and Scopus online databases. Keywords were adapted to each database and included variations of “Black males,” “sexual reproductive healthcare services,” “youth (18-24 years old),” and “healthcare access and utilization.” Studies from the review reported that barriers to engaging in SRH care included lack of health insurance, ideas of masculinity that conflict with SRH care, stigma related to accessing services, and lack of knowledge regarding available services and care options. The top facilitators for utilizing SRH care were engagement on behalf of health clinics, confidence gained from social support, access to quality health care in one’s community, and trust in the health care system and providers. This review contributes to the current state of the science and is important to the improvement of high-quality services for this population, including respect, choice in care, confidentially, and compassion.

Missed Opportunities to Address Pregnancy Prevention With Young Men in Primary Care

Young men (aged 15-24 years) have pregnancy prevention needs, yet little is known about whether they perceive they learn about pregnancy prevention in primary care. A sample of 190 young men seen in primary care in one city from April 2014 to September 2016 were assessed on perceived learning about pregnancy prevention, background and visit characteristics, pregnancy prevention care receipt, and contraception needs at last sex. The majority of participants were non-Hispanic black (92%), aged 15 to 19 years (54%), seen for a physical examination (52%), and established patients (87%). Few participants perceived they learned about pregnancy prevention (32%), regardless of sexual activity (33% among sexually active participants, 26% among never sexually active). Poisson regression models determined that perceived learning about pregnancy prevention was independently associated with young men's pregnancy prevention care receipt and contraception needs at last sex. Findings highlight the need to improve providers' delivery of pregnancy prevention services to young men.

Sexual and reproductive health care: adolescent and adult men's willingness to talk and preferred approach

INTRODUCTION

Sexually active adolescent and adult men have substantial sexual and reproductive health (SRH) needs, but little is known about their willingness and preferred approach to talk about SRH with their healthcare provider.

PURPOSE

To examine participants' willingness to talk about 11 SRH topics, including sexually transmitted disease (STD) risk; human papilloma virus (HPV) vaccine; condom use; female birth control methods; emergency contraception; concerns about sexual performance or making someone pregnant; being a father; relationships; testicular cancer; and acne, with their healthcare provider and their preferred approach (provider- or self-initiated).

METHODS

This cross-sectional clinic-based survey of 346 men aged 16-35 years was conducted in 2011. Bivariate analyses conducted in 2012 examined variation in study outcomes by participants' predisposing (age, race/ethnicity); enabling (education, past provider SRH discussion); and need factors (SRH concern).

RESULTS

Almost all participants (84%-98%) were willing to talk about all SRH topics. The top three topics included STD risk (98%); testicular cancer (98%); and HPV vaccine (97%). Among those willing to talk, the majority preferred their provider initiate the discussion (52%-88%). Participants reporting past provider discussions were more likely to prefer that their provider initiate discussions on condom use, female birth control methods, concerns about sexual performance and making someone pregnant, and relationships. Study outcomes did not vary by any other participant predisposing, enabling, or need factors.

CONCLUSIONS

These findings indicate that adolescent and adult men are willing to discuss a wide range of SRH topics with their healthcare provider. Providers need to move beyond whether male patients want to talk about these topics and instead proactively promote these conversations.