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Objective Fifty percent of pregnancies in the United States are unintended despite numerous contraceptive methods available to women. The only male contraceptive methods, vasectomy and condoms, are used by 10% and 16% of couples, respectively. Prior studies have shown efficacy of male hormonal contraceptives in development, but few have evaluated patient acceptability and potential use if commercially available. The objective of this study is to determine if a transdermal gel-based male hormonal contraceptive regimen, containing testosterone and Nestorone® gels, would be acceptable to study participants as a primary contraceptive method. Study Design As part of a three-arm, 6-month, double-blind, randomized controlled trial of testosterone and nestorone gels at two academic medical centers, subjects completed a questionnaire to assess the acceptability of the regimen. Of the 99 men randomized, 79 provided data for analysis. Results Overall, 56% (44/79) of men were satisfied or extremely satisfied with this gel-based method of contraception, and 51% (40/79) reported that they would recommend this method to others. One third of subjects (26/79) reported that they would use this as their primary method of contraception if it were commercially available today. However, men with concerns about sexually transmitted disease were significantly less satisfied than men without such concerns (p=0.03). Conclusions A majority of the men who volunteered to participate in this trial of an experimental male hormonal contraceptive were satisfied with this transdermal male hormonal contraceptive. If commercially available, a combination of topical nesterone and testosterone gels could provide a reversible, effective method of contraception that is appealing to men. Implications A substantial portion of men report they would use this transdermal male contraceptive regimen if commercially available. This method would provide a novel, reversible method of contraception for men, whose current choices are limited to condoms and vasectomy.

CONTEXT-Unintended pregnancy, an important public health issue, disproportionately affects minority populations. Yet, the independent associations of race, ethnicity and other characteristics with contraceptive choice have not been well studied.METHODS-Racial and ethnic disparities in contraceptive use among 3,277 women aged 18-44 and at risk for unintended pregnancy were assessed using 2006-2008 data from of the California Women's Health Survey. Sequential logistic regression analyses were used to examine the independent and cumulative associations of racial, ethnic, demographic and socioeconomic characteristics with method choice.RESULTS-Differences in contraceptive use persisted in analyses controlling for demographic and socioeconomic characteristics. Blacks and foreign-born Asians were less likely than whites to use high-efficacy reversible methods-that is, hormonals or IUDs (odds ratio, 0.5 for each). No differences by race or ethnicity were found specifically for IUD use in the full model. Blacks and U.S.-born Hispanics were more likely than whites to choose female sterilization (1.9 and 1.7, respectively), while foreign-born Asians had reduced odds of such use (0.4). Finally, blacks and foreign-born Asians were less likely than whites to rely on male sterilization (0.3 and 0.1, respectively).CONCLUSIONS-Socioeconomic factors did not explain the disparities in method choice among racial and ethnic groups. Intervention programs that focus on improving contraceptive choice among black and, particularly, Asian populations need to be developed, as such programs have the potential to reduce the number of unintended pregnancies that occur among these highrisk groups.Approximately half of all pregnancies in the United States are unintended, 1 and outcomes of these pregnancies-including abortion and unplanned childbirth-place a burden on women, families and the health care system. 2,3 Furthermore, unintended pregnancy disproportionately affects minority women. 1 Data from the National Survey of Family Growth (NSFG) show that black and Hispanic women have higher rates of unintended pregnancy than white women and, as a result, higher rates of unintended birth and abortion. 4 Author contact: shihg@fcm.ucsf.edu. While studies examining contraceptive use and nonuse can make important contributions to efforts to prevent unintended pregnancy, they are not sufficient to explain disparities in rates of unintended pregnancy. Since half of unintended pregnancies occur among contraceptive users, it is equally important to examine differences in method selection, especially because methods have a wide range of efficacy. 4 Permanent methods (female and male sterilization) have one-year failure rates of less than 1%. Some reversible methods (the IUD and implant) have similarly low failure rates, while others (the injectable, ring, patch and pill) have typical failure rates of 5-9%. Nonhormonal methods (e.g., the condom) have typical failure rates of 17-18%. 13 Studies of racial and ethnic differences in contraceptive s...

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