Men's sexual health matters: promoting reproductive health in an international context

Abstract

SummaryRecent concern regarding the control of sexually transmitted infections (STIs) has resulted in an increased interest in the sexual health of men. This interest has primarily focused on strategies to 'encourage and enable men to take responsibility for their sexual and reproductive behaviour and their social and family roles' (United Nations, 1994). Whilst men are deemed to have 'responsibilities', women are said to have 'rights' with regard to making choices about reproductive health and accessing appropriate and effective services. Here it is argued that, whilst provision of services and interventions against STIs in men should never be at the expense of those for women, it is often clinically easier and more effective to diagnose and treat men with STIs compared to women in resource-poor settings. Indeed, this may prove to be an effective strategy in controlling the spread of STIs, and hence reducing the disproportionate burden of their complications suffered by women. The paper reviews key issues in relation to improved service delivery for sexual and reproductive health in men, notably: the heterogeneity of male populations; current knowledge regarding men's sexual behaviour; the role of sexuality; methods of studying sexual behaviour in resource poor countries; men's own concerns in relation to sexual and reproductive health; and where and how they access treatment. It is argued that the time has now come to determine and address men's sexual health needs if we are to expect them to participate fully as responsible partners in improving and protecting their own and others' sexual and reproductive health. keywords men, sexual health, reproductive health, health services, sexual behaviour, sexuality correspondence Sarah Hawkes, LSHTM,

‘Clinics aren't meant for men’: Sexual health care access and seeking behaviours among men in Gauteng province, South Africa

“…One recommendation was 'male involvement, male motivation, and services for men ' (WHO, 2007). In some societies, men may be the 'key players' in STI transmission (Hawkes & Hart, 2000) as they often migrate for employment, marry later and are more likely to purchase sex. To encourage men to access sexual health care services and receive appropriate treatment, health services must reflect and respond to men's needs (Pearson, 2003).…”

Reconceiving masculinity and ‘men as partners’ for ICPD Beyond 2014: Insights from a Mexican HPV study

“…In an attempt to counter unproductive framings of men as sole and inevitable sources of harm, a number of researchers have recently called for more attention to men's experiences of sexuality and reproduction in a variety of global settings (Barker & Das, 2004;Culley, Hudson, & Lohan, 2013;Dudgeon & Inhorn, 2003;Hawkes & Hart, 2000). Their call is part of a greater move within gender studies to incorporate men, masculinity and fatherhood into discussions of gender systems and dynamics (Inhorn, Chavkin, & Navarro, 2014;Whitehead, 2002), including in discussions of development (Cleaver, 2002).…”

Peer Advocates for Health: A Community-Based Program to Improve Reproductive Health Knowledge and Lifestyle Choices among Adolescent Males

“…high-risk cohorts suffered from multiple STDs, which increases the risk of subsequent HIV infection (Das, Yemul, & Deshmuk, 1998;Hawkes & Hart, 2000).…”

“…These projects have developed a series of key principles for an effective male-oriented reproductive health service: (a) ability to communicate in culturally and socially appropriate terms about men's sexuality (Grenon & Tazeem, 1996); (b) provision of information, education, and counseling on a variety of health topics in a sensitive, direct, and honest manner without judgment (George, 1997;Ndong et al, 1999;Raina & Malhotra, 1998;Raju & Leonard, 2000;Sachdev, 1997;Verma, Khaitan, & Singh, 1998); (c) promotion of communication, education, testing, and treatment for both partners in order for STD programs to be effective (Bloom, Tsui, Plotkin, & Bassett, 1999;Ndong et al, 1999;Singh et al, 1998;Wegner, 1998); (d) diagnosis, treatment, education, and partner notification in relation to sexually transmitted infections integrated into male-focused reproductive healthcare (Shelton 1999; UNAIDS/WHO, 2000); and (e) promotion of condom use for both family planning and prevention of disease transmission (Hawkes & Hart, 2000;Raju & Leonard, 2000). Although these pilot programs have shown selective effectiveness, many more community-level interventions need to be undertaken to fully understand and implement effective male-oriented reproductive health programs in India and other parts of the world.…”