Contraceptive Responsibility Research Articles

Atitudes Surrounding Contraceptive Responsibility: Do Latino Youth Difer from Other Groups?

Recent estimates demonstrate that more than 75% of young women and men ages 15 to 19 used contraception at first sex and their most recent intercourse.1 However, there are notable disparities in contraceptive use by race/ethnicity. Female and male Latino adolescents are less likely than African American and white teens to report contraceptive use at first sex.2 In addition, Latino adolescents are less likely to report using condoms at last intercourse (54.9%) compared to African Americans (62.4%) and whites (63.3%) and were also less likely than whites to state they used hormonal methods (14.0% compared to 29.3% among whites).3 These lower rates of contraceptive use may be due, in part, to differences in attitudes about contraceptive decision-making. Several studies have noted that Latinos report that women are primarily responsible for contraception and preventing pregnancy,4-8 which is associated with less effective method use compared to when both partners are responsible for deciding on contraception.6,9-12 However, it is not clear whether attitudes placing responsibility for contraceptive use on women are more widely endorsed among Latinos compared to other racial/ethnic groups. Some of these studies have only included Latinos,4,7 and others that assessed attitudes across racial/ethnic groups found few differences.13 Additionally, little is known about the underlying beliefs and values that shape ideas about which partner or partners have responsibility for contraception and how these might vary by race/ethnicity. Such information is important in order to identify target areas for interventions that promote shared decision-making, and therefore increase effective use of contraception. In this study, we explore youths' attitudes toward contraceptive responsibility. The specific questions we address are: Which partner is usually responsible for contraception and why? How do these attitudes and beliefs vary, if at all, across racial/ethnic groups and gender? To answer these questions we used data collected from focus groups with Latino, African American and white young women and men. Focus groups are particularly well-suited for the study of this topic because they highlight values and norms within groups sharing similar characteristics, as well as identify beliefs underlying attitudes and behaviors.14

Understanding Perceptions about Contraceptive Responsibility Among Adolescents

Understanding Perceptions about Contraceptive Responsibility Among Adolescents

Attitudes Surrounding Contraceptive Responsibility: Do Latino Youth Differ from Other Groups?

Attitudes Surrounding Contraceptive Responsibility: Do Latino Youth Differ from Other Groups?

Men's Narratives of Vasectomy

This article interrogates the modes by which cultural constructions of male contraceptive use emerge in Costa Rica by analyzing men's narratives of vasectomy. Drawing on ethnographic research data, I examine men's contraceptive decision making and perspectives on vasectomy and specify the ways they work through their vasectomy to rearticulate the relationship between masculinity and contraceptive responsibility and tensions in an emerging Costa Rican social modernity. Following Oudshoorn's (2003) analysis on male contraceptive research, this article highlights contraceptive technologies and men's narratives of these technologies as key sites for examining gender politics in contemporary societies and the materialization of new social orders. In the discussion, I argue that the men's narratives examined here potentiate creation of an "alternative technosociality" (Oudshoorn 2003) in Costa Rica, in which men taking contraceptive responsibility does not constitute performing a subordinate masculinity, but simply another way of acting as men.

Factors Associated with Condom Use among Male College Students in Wuhan, China

BackgroundUsing condoms consistently could prevent unintended pregnancy among young people. This study highlights multiple domains of influence on condom use among male college students in China, including knowledge, attitudes, health services utility on condom use and reproductive health information sources.Methodology/Principal FindingsTo identify factors associated with condom use in Chinese male college students, we examined a sample of 870 sexually experienced male students in seven colleges in Wuhan, China, 2009. 535 (61.5%) of 870 male students reported condom use during their most recent sexual encounter. Male students with steady partners were more likely to use condoms than students with casual partners (adjusted OR = 3.11, 95%CI 2.30–4.20). And positive attitudes toward contraceptive responsibility were associated with greater odds of condom use (adjusted OR = 1.40, 95%CI 1.02–1.92). Only 54(6.2%) and 83(9.5%) of respondents reported that free condoms and reproductive health counseling were available at the student health center. Providing free condoms and reproductive health counseling at the student health central were associated with increased condom use among college students (both P<0.05). In addition, students who gained reproductive health information mainly through websites, television and radio programs were more likely to use condoms than through school education (all P<0.05).ConclusionsImproving attitudes of male students toward contraceptive responsibility, providing proper reproductive health information through mass media and making free condoms and reproductive health counseling available in school may help increase condom use among college students in China.

Hormonal male contraception: end of a dream or start of a new era?

This article discusses the widespread pessimistic view about male contraceptives stating “none of the 250 abstracts submitted…deals with male contraception.” Despite the lack of pervasive interest in the matter there are a number of scientists who study ways to promote the absence of sperm during intercourse. However study trials are difficult because they include negative side effects couples participation long term commitment and potential infertility. Furthermore the end result is not lack of pregnancy for a male trial so it is difficult to recruit men who see value in these trials. Male contraceptives are also more difficult to activate than the female alternative; the contraceptive cannot be ingested rather must be inserted. Until these issues are resolved women will be burdened with the responsibility of contraception.

Attitudes towards the male contraceptive pill: psychosocial and cultural explanations for delaying a marketable product

Abstract Even though years of research on the male contraceptive pill have been conducted, a marketable product is still absent from the arsenal of male and female products of contraception. In this paper, the following psychosocial and cultural factors have been elicited from the literature in order to reveal explanations for this delay: acceptability, trust, fear of side-effects, perceptions of contraceptive responsibility and fear of losing connotations of masculinity. Regardless of cultural variation, overall there seems to be a positive attitude towards the acceptability of male contraceptive for both males and females, especially males in stable relationships. Some indication shows that the media have played an important role in distorting the results of research regarding male and female trust. Ongoing and future researches into several projects on psychosocial and cultural factors are described.

Contraceptive Justice: Why We Need a Male Pill

A more just sharing of the responsibility for contraception can only be achieved through the development of male birth control methods and reconceptualizing responsibility for contraception as shared between men and women.

Dimensions of gender relations and reproductive health inequity perceived by female undergraduate students in the Mekong Delta of Vietnam: a qualitative exploration

IntroductionIncreasing evidence indicates that gender equity has a significant influence on women’s health; yet few culturally specific indicators of gender relations exist which are applicable to health. This study explores dimensions of gender relations perceived by female undergraduate students in southern Vietnamese culture, and qualitatively examines how this perceived gender inequity may influence females’ sexual or reproductive health.MethodsSixty-two female undergraduate students from two universities participated in eight focus group discussions to talk about their perspectives regarding national and local gender equity issues.ResultsAlthough overall gender gaps in the Mekong Delta were perceived to have decreased in comparison to previous times, several specific dimensions of gender relations were emergent in students’ discussions. Perceived dimensions of gender relations were comparable to theoretical structures of the Theory of Gender and Power, and to findings from several reports describing the actual inferiority of women. Allocation of housework and social paid work represented salient dimensions of labor. The most salient dimension of power related to women in positions of authority. Salient dimensions of cathexis related to son preference, women’s vulnerability to blame or criticism, and double standards or expectations. Findings also suggested that gender inequity potentially influenced women’s sexual and reproductive health as regards to health information seeking, gynecological care access, contraceptive use responsibility, and child bearing.ConclusionFurther investigations of the associations between gender relations and different women’s sexual and reproductive health outcomes in this region are needed. It may be important to address gender relations as a distal determinant in health interventions in order to promote gender-based equity in sexual and reproductive health.

Young men, sexual health and responsibility for contraception: a qualitative pilot study

Background and methodologyDespite increasing interest over the last decade or more in men's views of sexual health services and use of contraception, most published literature focuses on women. It is...

Men Bring Condoms, Women Take Pills

The most popular form of reversible contraception in the United States is the female-controlled hormonal birth control pill. Consequently, scholars and lay people have typically assumed that women take primary responsibility for contraceptive decision making in relationships. Although many studies have shown that men exert strong influence in couple’s contraceptive decisions in developing countries, very few studies have considered the gendered dynamic of contraceptive decision making in developed societies. This study uses in-depth interviews with 30 American opposite-sex couples to show that contraceptive responsibility in long-term relationships in the United States often conforms to a gendered division of labor, with women primarily in charge. A substantial minority of men in this study were highly committed contraceptors. However, the social framing of contraception as being primarily in women’s “sphere,” and the technological constraints on their participation, made even these men reluctant to discuss contraception with their women partners.

Perceptions of Contraceptive Responsibility Among Female College Students: An Exploratory Study

An important, although understudied, area related to contraceptive use is perceptions of contraceptive responsibility. The purpose of this exploratory study was to investigate these perceptions among female college students. Web-based or mailed questionnaires were completed by 326 students from 2006-2007. Logistic regression was used to obtain odds ratios and 95% confidence intervals (CI) to model the associations between select demographic and lifestyle characteristics and contraceptive responsibility (shared vs. individual responsibility). Although 89.1% of women felt that contraceptive responsibility should be shared, only 51.8% indicated that responsibility is actually shared in their relationships. After adjustment for age, race/ethnicity, marital status, and year of study, women using "other" methods of contraception (i.e. withdrawal, rhythm, sterilization, etc.) had 3.25 times the odds of stating that contraceptive responsibility is actually shared as compared to hormonal users (95% CI: 1.20, 8.80). For college women, there is a disconnect between who they feel should be responsible for contraception and who actually is responsible. Insight into perceptions of contraceptive responsibility in the university setting may help guide health educators and clinicians in designing pregnancy and sexually transmitted infection prevention programming.

Attitude of Couples towards Family Planning

The study entitled 'Attitude of Couples towards Family-Planning' was conducted with an aim to assess knowledge, understanding and attitude of couples towards family planning across the two ecological settings of Jammu district. The influence of education on the attitude under consideration was also evaluated. Sample for the study comprised 200 married couples drawn from Jammu district through stratified random sampling technique. The tools for data collection included interview schedule, questionnaire and a rating scale. The results witnessed a high prevalence of illiteracy and associated ignorance among rural masses (35%) especially regarding the concepts and measures of family planning (χ2= 14.24, Sig. 1%). Majority of rural respondents especially women folk (51%) were unaware of concepts related to family planning. Condoms were by far the most favourable contraceptive measures across both settings (81% males and 77.5% females) followed by birth spacing pills (39%). The appropriate knowledge regarding other measures e.g. Copper-T (13.5%) and male sterilization was lacking. Further, urban respondent entrusted the contraceptive responsibility on their respective partners (43% males, 44% females), while rural couples (74% females and 64% males) followed the same age-old traditional concept of male dominance and superiority. Television and magazines were found to be the major accessible sources of information. Results from rating scale revealed a major difference (χ 2 = 54.66, Sig. 1%) in the attitude of respondents. Education was found to be significantly associated with the respective attitude of respondents towards family planning.

Hormonal male contraception—a goal finally realized?

Surveys show that both men and their female partners are interested in a 'male pill'. A near-unanimous majority of women in stable relationships would trust their partner to assume responsibility for contraception. The results of a Chinese multicenter, phase III trial of monthly testosterone injections bring us a step closer to making this great leap forward.

College Students' Views On Pregnancy Intention And Contraceptive Responsibility

Parenting stress (PS) is prospectively associated with children’s lowered socio-emotional functioning; however, little is known about the antecedents and consequences of changes in postpartum parenting stress and its relationship to problematic behaviors in early childhood. This research examined the longitudinal relationships between multiple measures of cognitive readiness to parent, parenting stress (initial level and growth) and child social-emotional competence at age 3. It was hypothesized that lack of cognitive readiness to parent would predict initial level and growth in PS and that initial level and change in parenting stress would, in turn, would be related to poor social-emotional development. Cognitive readiness to parent was assessed at baseline shortly after childbirth; parenting stress, conceptualized as difficult child, parent-child dysfunction and parental distress, was assessed at 6, 12, 24 and 36 months postpartum (i.e. when children were 6 months, 1, 2 and 3 years of age) using the Parenting Stress Index (PSI-SF; Abidin, 1995); children’s socio-emotional functioning was assessed with behavioral rating scale of the Bayley Scales of Infant Development (BSID-II) (BSID-II; Bayley, 1993) which was administered by professionals at age 3. Using a second order growth curve, or curve-of-factors model, the study’s hypotheses were tested with data from the Predicting and Preventing Neglect in Teen Mothers Study (2001–2007), a longitudinal study of 682 first-time mothers. Results from the latent growth curve analyses demonstrated that parenting stress predicted child socio-emotional problems. Specifically, mothers who began parenthood with high stress levels had children with lower levels of pro-social functioning (i.e. more behavior problems). Two measures of cognitive readiness to parent were associated with lower levels of postpartum PS at baseline but social support moderated the relationship between readiness to parent and parenting stress. Implications for interventions aimed at identifying families with children at risk for emotional and developmental problems and/or new parents who demonstrate changes in parenting stress during the postpartum period are discussed in context.

Contraceptive methods with male participation: a perspective of Brazilian couples

To assess the perspectives of couples who requested vasectomy in a public health service on the use of male participation contraceptive methods available in Brazil: male condoms, natural family planning/calendar, coitus interruptus and vasectomy. A qualitative study with semi-structured interviews was held with 20 couples who had requested vasectomy at the Human Reproduction Unit of the Universidade Estadual de Campinas, Brazil. Data analysis was carried out through thematic content analysis. The couples did not, in general, know any effective contraceptive options for use by men and/or participating in their use, except for vasectomy. The few methods with male participation that they knew of were perceived to interfere in spontaneity and in pleasure of intercourse. Men accepted that condom use in extra-conjugal relations offered them protection from sexually transmitted diseases; that their wives might also participate in extra-marital relationships was not considered. The few contraceptive options with male participation lead to difficulty in sharing responsibilities between men and women. On the basis of perceived gender roles, women took the responsibility for contraception until the moment when the situation became untenable, and they faced the unavoidable necessity of sterilization. Specific actions are necessary for men to achieve integral participation in relation to reproductive sexual health. These include education and discussions on gender roles, leading to greater awareness in men of the realities of sexual and reproductive health.

Acceptability of an injectable male contraceptive regimen of norethisterone enanthate and testosterone undecanoate for men

We assessed attitudes towards and acceptability of male hormonal contraception among volunteers participating in a clinical trial of a prototype regimen, consisting of progestin and testosterone injections. After completing screening, eligible men were randomly assigned to the no-treatment group (n = 40) or to receive injections of norethisterone enanthate and testosterone undecanoate or placebo at different intervals (n = 50) according to a blocked randomization list. They underwent self-administered questionnaires. The average age of the participants was approximately 28 years; most were involved in a stable relationship and had no children. Ninety-two percentage of the respondents thought that men and women should share responsibility for contraception and 75% said they would try a hormonal contraceptive if available. At the end of the treatment phase, 66% of the participants said that they would use such a method, and most rated its acceptability very highly; none reported it to be unacceptable. The injections themselves were indicated as the biggest disadvantage. No significant changes in sexual function or mood states were detected among the men who underwent hormone injections. The contraceptive tested in this study was well accepted by the participants over the course of 1 year.

Male hormonal contraceptives: a potentially patentable and profitable product

Although women have traditionally shouldered the responsibility of contraception, up to one-third of couples worldwide employ a male form of contraception (e.g., vasectomy or condoms). Vasectomy should be considered irreversible and long-term use of condoms is associated with a relatively high failure rate (pregnancy). Because many women are unable to use hormonal contraception and men want more contraceptive options, there is a need for a safe, effective, reversible and well-tolerated male hormonal contraceptive agent. Two large multicentre, multinational trials sponsored by the World Health Organization in the 1990s showed that high-dosage exogenous testosterone provided contraceptive efficacy similar to currently available female oral contraceptives. However, the supraphysiological dosages of testosterone used resulted in androgen-related adverse effects such as weight gain and suppression of high-density lipoprotein cholesterol levels. Subsequent efforts have been directed at combining testosterone with other agents, such as progestogens or gonadotropin-releasing hormone analogues, to decrease the dosage of testosterone (and thus androgen-related side effects) whilst achieving uniform azoospermia. In this article, the latest developments in male hormonal contraception supporting the feasibility of such an agent will be reviewed and suggestions for future directions of research and development will be offered.

Book Review: Tales of Trauma: A Review of Leigh Gilmore'sTHE LIMITS OF AUTOBIOGRAPHY: TRAUMA AND TESTIMONY(Cornell University Press, 2001) and Janice Doane and Devon Hodges'sTELLING INCEST: NARRATIVES OF DANGEROUS REMEMBERING FROM STEIN TO SAPPHIRE(University of Michigan Press, 2001).

undergraduate philosophy and women's studies courses. Individual articles would be good supplements to the classic works in undergraduate level philosophy courses, where they would liven up the curriculum and allow students to foster their critical thinking skills. For example, Naoko T. Miyaji's article, Friendly Persuasion? Legislative Enforcement of Male Responsibility for Contraception, might provoke thoughtful and interested discussion in the context of an undergraduate introductory ethics or social and political philosophy course. Many of the articles would be suitable for such teaching purposes, even if there is not enough room on the syllabus to warrant assigning the entire book. In all, Globalizing Feminist Bioethics is a worthwhile and enjoyable collection.

Male Involvement in Bangladesh's Reproductive Health Programme: A Status Report

Male Involvement in Bangladesh's Reproductive Health Programme:A Status Report Tehmina Ghafur Introduction The issue of men's involvement in reproductive health services emanates from the underlying inequalities and inequities in the established gender-specific roles and responsibilities of men and women. Gendering of the roles and responsibilities tends to disengage men from core areas at the family and societal level (e.g., general health and nutrition, reproductive health, child care). Disengagement excludes men from participating and sharing responsibility in core areas of their life. Such exclusion is thought to be a major source of many gender-specific inequalities and inequities. Since its inception in the 1960s, the family planning programme (FPP) has primarily ignored men (Drennan, M., 1998). Since women bear the risk of pregnancy and child birth, FPP have assumed women have the greatest stake in protecting themselves against unwanted pregnancy. In the 1980s FPP started giving limited attention to men through workplace programmes and condom social marketing (Drennan, M., 1998). Focus of male involvement was then limited to promotion of male contraceptives. Population planners promoted men's participation as family planning method acceptors in order to ensure sustained use of contraceptive methods. On the other hand, feminists promoted men's inclusion in the FPP with the hope that such inclusion would lead to a situation where men would shoulder the responsibility of contraception. In the 1990s, the concept of male involvement was intensified in the wake of the HIV/AIDS pandemic. It was understood that the dominance of men in every sphere of life demanded the inclusion of men in sexual and reproductive health programmes (RHPs). Efforts to include men in RHPs were intensified during the 1990s. Intensified efforts to include men in RHP were taken in the wake of rising apprehension about HIV/AIDS and other STIs; increasing reports and information on ill effects on women and children resulting from some men's risky sexual behaviour; growing recognition that in many societies men make critical decisions that affect the reproductive health of women; and an increasing awareness that gendered roles affect sexual behaviour, reproductive decision making, and reproductive health in many ways (Drennan, M., 1998). In 1994, the International Conference on Population and Development (ICPD) gave momentum to the concept of male involvement in RHP. After ICPD, male involvement in RHP gained popularity in many countries. The concept of "male involvement" that resulted from ICPD was wide-ranging, with the intention of addressing gender inequality and inequity in all aspects of reproductive health. The Platform of Action of the Fourth World Conference on Women, in 1995, [End Page 70] followed the same tone with regard to the role of men in promoting reproductive health. Initiatives taken by many countries to incorporate and promote male involvement in reproductive health, however, failed to grasp the profundity and spirit of the concept of involving men in many ways. Only recently has the issue of male involvement received due attention in RHP and policies in Bangladesh. However, this prioritization of male involvement has been conceived from a very narrow perspective. Such a narrow conceptualization is likely to have serious implications for the health of both men and women. In this report, male involvement initiatives in Bangladesh, both past and present, are critically examined, and the prospect of fully involving men in RHP in Bangladesh is explored. The report is based on review and analysis of the male involvement approach and associated initiatives by the RHP of the government of Bangladesh. Male Involvement Initiatives in the RHP of Bangladesh The RHP of Bangladesh has its legacy in the family planning programme of the 70s and 80s. The family planning programme (FPP) had remarkable success with respect to bringing down fertility level from 6.3 births per woman in 1975 to 3 births per woman in 2004 (NIPORT, 2004). Over the last three decades, use of any method of contraceptive by married women has increased from 8 to 58 percent and use of modern methods of contraceptives by married women has increased almost tenfold, from 5 to 47 percent (NIPORT, 2004). One of the major reasons for the success of the FPP in reducing fertility was its women-centered-door-to...