Masculinity and Its Public Health Implications for Sexual and Reproductive Health and HIV Prevention

Author(s):  
Margaret E. Greene ◽  
Gary Barker
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Manjulaa Narasimhan ◽  
Carmen H. Logie ◽  
Kevin Moody ◽  
Jonathan Hopkins ◽  
Oswaldo Montoya ◽  
...  

Abstract Background Self-care interventions are influencing people’s access to, expectation and understanding of healthcare beyond formal health delivery systems. In doing so, self-care interventions could potentially improve health-seeking behaviours. While many men proactively engage in maintaining and promoting their health, the focus on men’s health comes from the recognition, at least partially, that male socialization and social norms can induce men and boys to have a lower engagement in institutionalized public health entities and systems around their sexual and reproductive health and rights, that could impact negatively on themselves, their partners and children. Main text A research agenda could consider the ways that public health messaging and information on self care practices for sexual and reproductive health and rights could be tailored to reflect men’s lived realities and experiences. Three examples of evidence-based self-care interventions related to sexual and reproductive health and rights that men can, and many do, engage in are briefly discussed: condom use, HIV self-testing and use of telemedicine and digital platforms for sexual health. We apply four core elements that contribute to health, including men’s health (people-centred approaches, quality health systems, a safe and supportive enabling environment, and behaviour-change communication) to each intervention where further research can inform normative guidance. Conclusion Engaging men and boys and facilitating their participation in self care can be an important policy intervention to advance global sexual and reproductive health and rights goals. The longstanding model of men neglecting or even sabotaging their wellbeing needs to be replaced by healthier lifestyles, which requires understanding how factors related to social support, social norms, power, academic performance or employability conditions, among others, influence men’s engagement with health services and with their own self care practices.


Author(s):  
Fermina Chamorro Mojica ◽  
Faride Rodriguez ◽  
Selvis Stocel ◽  
Ruth De León

<p>Introducción: Los derechos a la salud sexual y reproductiva (DSSR) son básicos, y la capacidad de las mujeres para ejercerlos influye en lograr objetivos de desarrollo. Objetivos: Estimar indicadores de DSSR en mujeres de 20-29 años identificando factores asociados. Métodos: Con datos de la Encuesta Nacional de Salud Sexual y Reproductiva 2014-2015 se analizaron 1206 casadas/unidas (982 con demanda de planificación familiar, 1082 con hijos, y 978 usuarias de anticonceptivos), midiéndose la violencia conyugal en el último año, conocimiento sobre prevención del VIH, demanda satisfecha con anticonceptivos modernos, atención profesional al parto y autonomía. Se utilizó la regresión logística multivariada para probar asociaciones. Resultados: Padeció violencia conyugal 13.0%, tenía conocimiento sobre prevención del VIH 38.8%, satisfacía su demanda de planificación familiar con métodos modernos 62.0%; recibió atención profesional al parto 81.1%; y mostró autonomía 10.3%. Las oportunidades relativas ajustadas (ORa) de violencia conyugal eran mayores en mujeres que la justificaban ORa=1.92;IC95%:1.09-3.39); el conocimiento sobre prevención del VIH aumentaba con la escolaridad (ORa=1.13;IC95%:1.04-1.22); la satisfacción de la demanda con métodos modernos era menor si justificaban la violencia conyugal (ORa=0.42; IC95%:0.20-0.85) y mayor en aquellas con una mayor percepción de empoderamiento (ORa=2.33;IC95%:1.15-5.00). Las ORa de atención profesional en el último parto disminuyen cuando aumentaba la edad (ORa=0.72;IC95%:0.62-0.84), y era menor si experimentaron matrimonio infantil (ORa=0.43;IC95%:0.19-0.95). Las ORa de mayor autonomía resultaron menores en casadas (ORa=0.22;IC95%:0.10-0.47) y amas de casa (ORa=0.53;IC95%:0.28-0.98). Conclusiones: El ejercicio de DSSR y sus factores asociados constituyen desafíos al diseño de políticas públicas.</p><p>Abstract</p><p>Introduction: Sexual and reproductive health rights (SRHR) are basic, and women capacity to exert them influence achieving development goals. Objectives: Estimate indicators of SRHR in women aged 20-29 years, identifying associated factors. Methods: A total of 1206 married/cohabitant women (908 with need for family planning, 1082 with children and 978 contraceptive users) were analyzed with data from National Sexual and Reproductive Health Survey 2014-2015. It was obtained the proportion of conjugal violence victims in the last year, with knowledge about VIH prevention, family planning needs satisfied by modern contraceptive methods, with professional care at delivery and with autonomy. Multivariate logistic regression was used to test associations. Results: The 13.0% of women suffered conjugal violence, 38.8% had knowledge about HIV prevention, 62.0% used modern contraceptives for satisfying family planning needs, 81.1% received professional care at delivery, and 30.7% made informed decisions about SRH. Adjusted odds ratio (AOR) for conjugal violence were greater when women justified violence (AOR=1.92;95%CI:1.09-3.39); knowledge about HIV prevention increases with schooling (AOR=1.13;95%CI:1.04-1.22); family planning met with modern contraceptives methods was lower, if they justified violence (AOR=0.42;95%CI 0.20-0.85) and higher in women with a higher empowerment perception (AOR=2.33;95%CI:1.15-5.00). The AOR for professional care at last delivery decrease with increasing age (AOR=0.72;95%CI:0.62-0.84) and was lower if they experienced child marriage (AOR=0.43;95%CI:0.19-0.95). The AOR for autonomy was lower in married women (AOR=0.22;95%CI:0.10-0.47) and housewives (AOR=0.53;95%CI:0.28-0.98). Conclusions: The exert of SRHR and its associated factors challenge public policies design.</p>


Author(s):  
Marie Thoma ◽  
Carie Cox ◽  
Jasmine Fledderjohann ◽  
Rudolph Kantum Adageba

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Global Public Health. Please check back later for the full article. Infertility remains a neglected area in sexual and reproductive health, yet its consequences are staggering. Infertility is estimated to impact about 15% (estimates range from 48 million to 180 million) of couples of reproductive age worldwide. It is associated with adverse physical and mental health outcomes, financial distress, severe social stigma, increased risk of domestic abuse, and marital instability. While men and women are equally likely to be infertile, women often bear the societal burden of infertility, particularly in societies where a woman’s identity and social value is closely tied to her ability to bear children. Despite these consequences, disparities in access to infertility treatment between low- and high-income populations persist, given the high cost and limited geographic availability of diagnostic services and assisted reproductive technologies. In addition, a significant proportion of infertility arises from preventable factors, such as smoking, sexually transmitted infections, pregnancy-related infection or unsafe abortion, and environmental contaminants. Accordingly, programs that address the equitable prevention and treatment of infertility are not only in keeping with a reproductive rights perspective, but can also improve public health. However, progress on infertility as a global concern in the field of sexual and reproductive health and rights is stymied by challenges in understanding the global epidemiology of infertility, including its causes and determinants, barriers to accessing quality infertility care, and a lack of political will and attention to this issue. Tracking and measurement of infertility is highly complex, resulting in considerable ambiguity about its prevalence and stratification of reproduction globally. A renewed global focus on infertility epidemiology, risk factors, and access to and receipt of quality of care will support individuals in trying to reach their desired number and spacing of children and improve overall health and well-being.


2012 ◽  
Vol 40 (9 Suppl) ◽  
pp. 176-196 ◽  
Author(s):  
M. Danielsson ◽  
T. Berglund ◽  
M. Forsberg ◽  
M. Larsson ◽  
C. Rogala ◽  
...  

2019 ◽  
Vol 3 (1) ◽  
pp. 31 ◽  
Author(s):  
Putu Erma Pradnyani ◽  
I Gusti Ngurah Edi Putra ◽  
Ni Luh Eka Purni Astiti

Background: Adolescent sexual and reproductive health (SRH) problems remain an important public health issue in many developing countries, such as Indonesia. Therefore, assessing SRH knowledge, attitude, and behavior among adolescents are worth considering for public health intervention purpose in order to reduce their vulnerability to SRH problems. Aims: This study aimed to assess SRH knowledge, attitude, and behavior among adolescent students in Denpasar, Bali, Indonesia.Methods: This was a cross-sectional school-based study conducted in Denpasar, Bali, Indonesia from July to September 2016. This study applied multi-stage random sampling to recruit 1,200 students out of 24 junior, senior, and vocational high schools. Variables in this study consisted of socio-demographic characteristics, knowledge, attitude, and behavior related to SRH. Data were analyzed using descriptive analysis and cross-tabulation to identify proportion differences.Results: Regarding knowledge on SRH, students had less knowledge on a reproductive process (10.1%) and reproductive risk (11.4%), but half of them knew about the sexually transmitted infections (STIs) and HIV&AIDS (55.6%) and almost all had sufficient knowledge on puberty (90.7%). Meanwhile, few students argued that several sexual behaviors can be performed before getting married, such as kissing and hugging (48.9%), petting and oral sex (18.7%) and sexual intercourse (vaginal sex) (13.8%). Out of 1,200 adolescent students, 880 (73.3%) reported for have ever been in dating with someone. Among adolescent dating, few students reported for an experience of petting (14.3%), oral sex (9.8%), vaginal sex (6.5%), and anal sex (2.6%).Conclusion: Adolescent students in Denpasar, Bali, had a low level of sufficient knowledge in some SRH aspects, a few students reported for permissive attitude and performed premarital sexual behaviors. Therefore, providing comprehensive sexuality education (CSE) is worth considering to improve knowledge and appropriate skills in order to prevent risky sexual behavior among adolescents. Keywords: Sexual and reproductive health, adolescents, students, knowledge, attitude, sexual behavior.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geri Donenberg ◽  
Katherine G. Merrill ◽  
Millicent Atujuna ◽  
Erin Emerson ◽  
Bethany Bray ◽  
...  

Abstract Background South African adolescent girls and young women (AGYW) report significant mental distress and sexual and reproductive health concerns. Mental health problems and trauma symptoms are consistently associated with sexual and reproductive health behavior. Despite their intersection, few interventions address them simultaneously or engage female caregivers (FC) as collaborators. This study presents findings from a pilot test of an empirically supported culturally adapted family-based HIV-prevention program, Informed Motivated Aware and Responsible Adolescents and Adults- South Africa (IMARA-SA), on AGYW anxiety, depression, and trauma. Methods Sixty 15–19-year-old AGYW (mean age = 17.1 years) and their FC from outside Cape Town were randomized to IMARA-SA or a health promotion control program. AGYW reported their anxiety using the GAD-7, depression using the PHQ-9, and trauma using the PC-PTSD-5 at baseline and follow-up (6–10 months post). Both interventions were delivered by Xhosa-speaking Black South African women in groups over 2 days for approximately 10 h. We examined intervention effects using zero-inflated negative binomial regression for anxiety, multinomial logistic regression for depression, and logistic regression for trauma. Results At baseline, groups did not differ in demographic characteristics but AGYW randomized to IMARA-SA had higher depression scores than controls (p = 0.04) and a greater proportion screened positive for PTSD (p = .07). Controlling for baseline mental health scores, AGYW who received IMARA-SA compared to controls had significantly fewer anxiety symptoms at follow-up (adjusted incidence rate ratio for count model = 0.54, 95% CI = 0.29–0.99, p = 0.05), were less likely to report at least one depressive symptom relative to no symptoms (relative risk ratio = 0.22, 95% CI = 0.05, 0.95, p = 0.04), and were less likely to report symptoms of PTSD relative to no symptoms, but this difference was not statistically significant. Conclusions Mental health is implicated in risky sexual behavior, and reducing emotional distress can mitigate exposure to poor sexual and reproductive health outcomes. This pilot study yielded promising findings for the mental health impact of IMARA-SA, justifying replication in a larger randomized trial. Trial registration ClinicalTrials.gov Number NCT04758390, accepted 17/02/2021.


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