Factors that determine prevalence of use of contraceptive methods for men

Abstract

Globally, men have not shared equally with women the responsibility for fertility regulation. While family planning efforts have been directed almost exclusively toward women, the lack of male involvement may also reflect the limited options available to men. Current methods for men are either coitus-dependent, such as the condom or withdrawal, or permanent, such as vasectomy. The 20-year history of social science research on male contraceptive methods is examined here in terms of the human and method factors related to the acceptability of hypothetical methods and the prevalence of use of existing methods. New male methods, particularly if reversible, may alter men's willingness to accept or share responsibility for the control of fertility. Research opportunities in the areas of gender, decision-making, communication, health education, and service delivery will be enhanced when methods for women and men are comparable.

PIP: Most men believe that men should share fertility regulation responsibilities with their partners, but only a small proportion do so. Most family planning (FP) programs are designed to serve only women. Limited contraceptive choices may also explain this inconsistency. Vasectomy is the only new male method in 25 years, the other methods being condoms, coitus interruptus, and periodic abstinence. Before men or even women use a method, they must have already thought about fertility regulation. They must also consider their life style and stage of reproductive life. Men are more likely to accept a noncoitus-dependent and long-acting contraceptive method. In developing countries, the number of children men have indicates their social status and wealth, so men's demand for contraception is low. Further, couples do not often use the traditional methods of spacing births: postpartum abstinence and prolonged breast feeding. Long-acting, noncoitus-dependent, and reversible male contraceptive methods could fill the traditional method gap and be used to space births. Such methods are currently being researched and include injectable or implantable hormones and vas occlusion using a silicone plug. Population specialists believe introduction of new male methods may merge with a realization of the economic cost of children, thereby increasing male involvement and contraceptive use. A likely target group for new methods is new fathers. Social science research would identify other target groups. Expected development of new male methods encourages sociologists to study partner communication, decision-making process, and gender issues. Researchers can also evaluate the effectiveness of sex-specific health education messages and communication channels. Operations research can examine the effect of male methods on FP programs which serve women. FP staff can use life course techniques to follow method use and method switching by each partner in a couple.