Although U.S. men’s sexual and reproductive health risks are fairly well documented, patterns of their use of sexual and reproductive health services are considerably less clear. Information from the 2002 National Survey of Family Growth (NSFG), the first in the NSFG series to sample men as well as women, makes it possible to begin exploring, on a national scale, the frequency with which men obtain services and the types of services they receive. In the lead article in this issue of Perspectives on Sexual and Reproductive Health (see article), Debra Kalmuss and Carrie Tatum use NSFG data to examine the use of sexual and reproductive health services among men aged 20–44 who have ever had sex with a woman.
The findings reveal the need for much improvement in services for men: In the past year, half of men have received no sexual or reproductive care, and only three in 10 have received services other than a testicular exam. Some 32–63% of men who engage in various risky behaviors—perhaps as many as 1.4 million American men—have an unmet need for services. Patterns of services received vary by men’s race, age and insurance status.
To ensure that men have access to and use comprehensive sexual and reproductive health services, Kalmuss and Tatum press for the development of a consensus document specifying standards of care; communication of those standards to providers and consumers; training to enable providers to deliver the recommended services; and advocacy to ensure adequate government funding of services and health insurance coverage of sexual and reproductive health care.
Also in This Issue
•Given the large number of stepfamilies in American society, understanding how family context influences young people’s attitudes toward sex often requires understanding the impact of stepfathers in their lives. In analyses based on data from the National Longitudinal Study of Adolescent Health (Add Health), Chadwick Menning and colleagues find that adolescents’ disposition toward having sex is inversely related to their degree of involvement with their stepfathers (see article); however, this relationship holds only for males. Therefore, programs that encourage feelings of closeness between stepfathers and stepsons may hold promise for promoting healthy sexual activity.
•Using results of a 2004 survey of a nationally representative sample of adult women, Jennifer J. Frost and colleagues examine the reasons that close to one in four women at risk of unintended pregnancy fail to use contraceptives for one or more months per year (see article). Their findings suggest "a critical need to foster decisive attitudes toward preventing pregnancy, to encourage regular communication with providers, to identify women whose sexual relationships may put them at greater risk of inconsistent contraceptive use, and to provide better information and counseling about contraceptive methods and pregnancy risk."
•Studies of adolescent sexual behavior typically focus on first intercourse or contraceptive use, or examine young people’s behavior across relationships. Lucia O’Sullivan and colleagues take a step toward broadening the inquiry by examining the trajectory of adolescents’ social, romantic and sexual behaviors within a specific recent relationship (page 100). The analyses, based on Add Health data, reveal that social and romantic behaviors are far more common than sexual ones, and uncover patterns of behaviors that might help point the way to the most effective sexual health interventions for youth.
•Earlier studies have looked at pregnancy or childbearing among teenagers whose mothers or sisters had been teenage parents; Patricia L. East and colleagues examine the incremental risk of pregnancy among teenagers who have both a mother and a sister who had been teenage mothers (see article). In their sample of 127 black and Latina adolescents, having a sister who had been a teenage mother was more strongly associated with a teenager’s pregnancy risk than was having a mother who had given birth during adolescence. The authors examine how sibling relationship dynamics affect the association and suggest ways in which older sisters might help younger women break the cycle of teenage pregnancy within a family.
•As public debate continues to swirl around the question of whether parents or schools should be children’s primary sex educators, Ronny A. Shtarkshall and coauthors argue (see article) that there is a role for both. In their viewpoint article, the authors outline the differences between sex education and sexual socialization, and contend that whereas schools are better equipped to handle the first, parents are the appropriate choice for fostering the second.
—The Editors