A systematic review: Male engagement in adolescent and young adults’ sexual and reproductive health in the Americas

Abstract

Progress towards sexual and reproductive health (SRH) goals for adolescents across the Americas has stagnated. Of all the regions worldwide, Latin America has experienced the slowest decline in adolescent fertility rates. Reports published by the United Nations and multiple nongovernmental organizations demonstrate a growing consensus for a masculinities framework that engages men and boys in public health and social change. Male engagement acts as a complement - and not a replacement - of current SRH. Emerging evidence indicates that Coronavirus disease in 2019 has worsened SRH outcomes, especially related to gender-based violence; new evidence-based interventions are ever more urgent. This systematic review includes a focus on education-based male engagement, a special consideration of gender equity, and systematic searches by fluent speakers in three most populous languages in the Americas (English, Spanish, and Portuguese). PubMed, EBSCO, SCOPUS, and Google Scholar databases were digitally searched. Publications were excluded if their focus did not align directly with sexual reproductive health, their location was outside the scope of study, its content derived from information collected before 2010, or its study’s population’s age of focus was not between 15-24 years of age. After abstract screening and full-text review, the original 10,721 articles identified were narrowed down to 13 articles whose references were further examined through hand searching, leading us to a total of 32 final articles chosen for analysis. The results were classified by geographic regions of the American continent. The literature emphasized that society often defines masculinity as a hegemonic role grounded in aggressive high-risk sexual behavior. Adolescent males internalize this and hold their peers to these expectations. These beliefs have detrimental SRH consequences that have yet to be fully understood among adolescent boys and males. The efficacy of future interventions will depend on further exploration of these topics, especially among minority populations.