Assessing young unmarried men's access to reproductive health information and services in rural India

Abstract

BackgroundWe investigated the accessibility of reproductive health information and contraceptives in a relatively less developed area of rural central India and assessed the risks facing young unmarried men.MethodsThis cross-sectional study used both qualitative and quantitative methods. Participants included 38 unmarried rural men in four focus-group discussions and a representative sample of 316 similarly profiled men, aged 17-22 years, in a survey. Information was collected on the men's socioeconomic characteristics; awareness, knowledge, and perceptions of family planning; attitudes toward future contraceptive use; intra-family communication; knowledge about STIs/HIV/AIDS; and access and use of condoms. Content analysis for qualitative information and descriptive analysis for survey data were used to draw conclusions.ResultsYoung unmarried rural Indian men's sexual and reproductive health (SRH) knowledge is limited, although the majority is familiar with condoms (99%). The young men identified electronic mass media (67%) as the prime source of reproductive health information, yet they lacked detailed knowledge of various contraceptives and felt ignored by health providers, who, they felt, would be capable of providing SRH information through interpersonal communication. Young men are more concerned about avoiding infections and securing sexual pleasure and less concerned about avoiding potential pregnancies. For example, 68% of the young men were aware of condoms and their HIV/AIDS preventive role, but only about two-fifths mentioned condom use to prevent unwanted pregnancies. Although most young men (96%) knew where to access a condom, they felt uncomfortable or embarrassed doing so in their own villages or close by because of socio-cultural norms that prevented them from using contraceptives. Very few respondents (4%) disclosed using condoms themselves, but 59% said they knew someone from their peer group who had used them.ConclusionsYoung unmarried men in rural India are underserved with regard to SRH information and services, because they are not recognized as key targets under the public health system, and they receive their limited knowledge and information mainly from the mass media; this situation could be greatly improved by public health service providers. It is important that programmers involve young men with effective communication strategies to enable them to act responsibly with regard to their own sexual health needs.

Gender differences in exposure to SRH information and risky sexual debut among poor Myanmar youths

“…We found that females received SRH information mainly from health personnel but most males responded that they received SRH information from unreliable sources, such as friends or older youths in their community. This finding was also evident in a study among Indian male youths in which participants happened to receive SRH information from unreliable sources [26]. …”

“…A study conducted among young-unmarried men in India showed that these men also received SRH information mainly from the mass media [26]. In contrast, mass media was significantly associated with beliefs that increased the likelihood of sexual exposure among adolescents in the US [30], a finding which highlights the importance of mass media among male youths and its ambiguous effects on their RH behaviors.…”

Sexually Transmitted Infection Services for Adolescents and Youth in Low- and Middle-Income Countries: Perceived and Experienced Barriers to Accessing Care

“…Youth’s concerns with confidentiality were both about the potential of being seen or overheard and about the provider’s ability to ensure confidentiality [19, 21, 22, 25, 26, 29–33]. Youth frequently feared being seen by friends and other members of the community, particularly by those who could tell their parents.…”

“…It would mean that we were doing something wrong. [… ]If someone saw me buying a condom, word would spread” (Unmarried Male, India) [26]…”

“…The prevailing norm, that youth should not be sexually active or use SRH services, frequently made it hard for youth to access care and for providers to deliver it [23, 26, 28, 30, 32, 33]. This norm was often related to youth being ‘too young’ or unmarried.…”