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Melanie Croce-Galis
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Preventing HIV/AIDS and Unintended Pregnancy Worldwide Requires Greater Attention to Men's Health Needs

New Report Finds Information and Services for Men Dangerously Lacking

Although men around the world make considerable efforts to protect their own and their partners' sexual and reproductive health, the majority-particularly in developing countries-are in need of vital information and services to prevent unintended pregnancies and sexually transmitted infections (STIs), including HIV, according to a new report from The Alan Guttmacher Institute.

The Report, In Their Own Right: Addressing the Sexual and Reproductive Health Needs of Men Worldwide, is the most comprehensive resource available on men's sexual and reproductive behavior and needs, encompassing men aged 15-54 in 45 developing and developed countries from sexual initiation through marriage and parenthood. The report is based on data from nationally representative surveys conducted between the mid-1990s and 2001, as well as on a growing body of qualitative studies of men's attitudes, values and behavior in regard to sexual and reproductive health.

The findings indicate that sexual and intimate relationships and a stable family life are important parts of men's lives worldwide. Most men have only one sexual partner in a given year, nearly all marry and have children, and many have discussed family planning with their partners and practice contraception to space or limit births. In addition, many men who have an STI act to protect their partners by informing them of the infection, by avoiding intercourse while they are infected or by taking medication.

In spite of these efforts, many men lack the information and services required to effectively protect their own and their partners' sexual and reproductive health. Although men's behavior varies widely by region, the report illustrates the consistent need for sexual health education, diagnosis and treatment of STIs, and integrated contraceptive services and support:

• Some 20-46% of men 25-54 in Sub-Saharan Africa and 15-30% of those in Latin America and the Caribbean do not want a child soon or do not want any more children, but neither they nor their partners are using contraceptives to prevent unplanned pregnancy. Men (and women) who are educated beyond primary school are more likely than those with less education to discuss the use of contraceptives.

• In some Sub-Saharan African countries, more than half of couples disagree over the ideal family size. Overall, 32-79% of men want to have at least two more children than do their partners.

• The proportion of men 15-54 who know that condom use is a way of preventing HIV/AIDS varies widely in developing countries-from only 9% in Bangladesh to 82% in Brazil.

• In Sub-Saharan Africa and in Latin America and the Caribbean, as well as in the United States, most men with more than one sexual partner did not use a condom the last time they had sex.

• Resources for sexual and reproductive health care for men and women are severely inadequate, particularly in developing countries, and many developing countries face a serious shortage of health workers.

• In industrialized countries, poor and uninsured men face significantly greater barriers to accessing health care services than do men who are financially better-off.

"We know that sex and reproduction involve both men and women, but policymakers, health care providers and even men themselves are often not aware that men have sexual and reproductive health needs and that men can actively contribute to improving their partner's and their own health," comments Akinrinola Bankole, a lead researcher involved in producing the report. "The evidence clearly shows that men do need better information, counseling and clinical care, and that our failure to provide these services is jeopardizing efforts to fight STIs, including HIV, and reduce unwanted pregnancies."

The HIV/AIDS epidemic amplifies the consequences of neglecting men, but In Their Own Right shows that men's health care needs and the significance of men's roles go far beyond HIV/AIDS. Other STIs and unplanned pregnancies also have a range of negative consequences for men, women, families and communities-both direct (by affecting people's health) and indirect (by affecting the social and economic conditions of their lives and of the larger community). Addressing the sexual and reproductive behavior and health care needs of men therefore creates a win-win situation: The more informed men are and the more effective they become in living safer sexual and reproductive lives, the better it will be for them, their partners and children, as well as for society as a whole.

The full report can be found here.

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