Real Men Do…Real Men Don’t: Young Latino and African American Men’s Discourses Regarding Sexual Health Care Utilization

Abstract

There is growing recognition that men as well as women have a need for sexual and reproductive health care. At a minimum they need information and counseling, and, when relevant, testing and treatment related to sexually transmitted infections (STIs), birth control, pregnancy prevention, emergency contraception, reproductive cancers, and the basics of sexual development and supportive healthy intimate relationships (Alan Guttmacher Institute, 2003;Brindis et al., 2005;Lindberg, Sonfield, & Gemmill, 2008;Sonenstein, 2000;Sonenstein et al., 2004;Sonfield, 2002). While historically such services have targeted women, compelling arguments have been advanced for providing sexual health care (SHC) services to men, the primary one being that sexual health outcomes are rooted in sexual relationships which typically involve men and women. As such, efforts to improve the sexual health of individuals and communities cannot succeed by focusing only on women. These arguments for the need to augment male sexual and reproductive health services have been affirmed at the federal level by Healthy People 2010 (U.S. Department of Health and Human Services [USDHHS], 2000) and by the Family Planning Male Research Program administered by the Office of Family Planning, the U.S. federal agency that is responsible for Title X, the national family planning program.Despite the above, men's sexual and reproductive health care needs are not being met in the United States. An analysis of data from the male sample of the 2002 National Survey of Family Growth indicated that in the year before the survey, half of sexually active men between the ages of 20 and 44 had received no SHC (Kalmuss & Tatum, 2007). Moreover, men who received care tended to receive services that were neither comprehensive nor integrated. For example, the most common sexual health service that men received was a testicular exam; half of men who received SHC in the past year received a testicular exam and no other services.Several systemic factors have been suggested as explanations for the high levels of unmet need for SHC among men. These include economic barriers in the form of limited access to public or private health insurance, insurance plans that do not cover sexual and reproductive health services for men, and the lack of resources to pay for such services without insurance In addition, there is an insufficient supply of clinical sites where men can receive comprehensive sexual health services, and a lack of targeted sexual health AbstractThere is growing recognition that men as well as women need sexual health care (SHC) services. Despite this, male friendly sexual health services are not readily available in the United States, and men are underutilizing the services that are available. This situation needs to be rectified to improve sexual health outcomes for men and women. In this study we conducted 10 focus groups with young adult Latino and African American men to examine their perceptions of the factors influencing SHC utilization among the men they know, w...

Sexually Transmitted Infection Related Stigma and Shame Among African American Male Youth: Implications for Testing Practices, Partner Notification, and Treatment

“…Through this investigation, we noted a significant trend: higher median (IQR) stigma and shame scores among participants who had never been tested for STI [stigma = 15 (9-17); shame = 17 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)], average stigma and shame scores among those who were tested and received a negative result [stigma = 11 (7)(8)(9)(10)(11)(12)(13)(14)(15); shame = 14.5 (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)], and the lowest scores among those who tested and received a positive result for an STI [stigma = 8 (5-15); shame = 11 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)]. …”

“…Bivariate analysis showed a positive association between having been tested for STIs with the following characteristics: older age ( p = 0.01), more years of schooling ( p = 0.01), higher level of education ( p = 0.02), having had sex in the last (12) 17 (15) 15 (14) 11 (10) Getting an STD would make me feel lonely 0.72 41 (37) 15 (14) 18 (16) 20 (18) (16) 16 (14) 16 (14) 9 (8) Most people I know think that an STD is a sign of a weak character 0.57 30 (27) 19 (17) 30 (27) 21 (19) 11 (10) Getting an STD means I have no morals 0.91 49 (44) 16 (14) 27 (24) 13 (12) (32) 15 (14) 19 (17) 23 (21) 18 ( (21) 20 (18) 30 (27) 23 (21) 15 (14) Getting and STD means I don't keep myself clean 0.91 47 (42) 14 (13) 19 (17) 18 (16) 13 (12) People with STDs should be ashamed of themselves 0.84 42 (38) 8 (7) 36 (32) 15 (14) 10 (9) Getting and STD means I don't take care of myself 0.89 47 (42) 10 (9) 24 (22) 18 (16) 12 (11) Getting examined for an STD means I'm not clean 0.79 55 (50) 10 (9) 25 (23) 11 (10) 10 (9) 3 months ( p = 0.02), and being < 13 years of age at sexual debut ( p = 0.03). It was also found to be associated with inconsistent condom use with a main partner ( p = 0.02).…”

“…The median and interquartile range (IQR) of the STIrelated stigma scale was 12 (7)(8)(9)(10)(11)(12)(13)(14)(15); median (IQR) of the STIrelated shame scale was 15 (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). Good global model-data fit was obtained with five items in the stigma dimension and six items in the shame dimension [v 2 (43) = 92.06, p £ 0.01; comparative fit index (CFI) = 0.97; root mean square error of approximation (RMSEA) = 0.10; weighted root mean square residual (WRMR) = 0.72]; 25 all factor loadings were strong in magnitude (see Table 1).…”

“…8 Furthermore, African American men are less likely than women to have contact with the healthcare system, 9 tend to wait longer to seek care when they experience symptoms, and are less likely to perform self-examinations or be screened for chronic/ infectious diseases. 10 As a result, young African American men comprise a priority population for facilitating improved access to and utilization of healthcare services, including sexual health services. This need is exemplified by the National HIV/AIDS Plan, which has reducing HIV-related health disparities as one of its three primary goals.…”

Male Adolescent Sexual and Reproductive Health Care

“…These barriers include fear; stigma; shame; denial; lack of social support; lack of confidential services; lack of health insurance options especially as they get older; and not knowing where to go for care. [141][142][143][144][145][146] Given the asymptomatic nature of many STIs, including HIV infection, strategies are needed to raise young men's awareness about sexual/reproductive health services, STI and HIV testing options, and related resources. Promoting sexual/reproductive health for young men can lead to sexual responsibility, healthy intimate relationships, and responsible fatherhood.…”