Male Willingness to Use Novel Contraception: Survey Data
Male willingness to use a novel male method has been studied through a number of survey studies, as have female attitudes toward male contraception. While surveys measure only hypothetical behaviors, they offer an important perspective and can gauge differences across groups.
A cross-cultural study to assess attitudes toward hormonal male contraception interviewed a total of 1843 men in Edinburgh, Cape Town, Shanghai and Hong Kong. The majority of participants (44–83%) stated they would use a male contraceptive pill. In a survey of over 9000 men aged 18–50 years from nine countries, 28.5–71.4% of various nationalities expressed willingness to use a hormonal male contraceptive, with an overall willingness rate of 55%; 55–81.5% of these participants indicated that both they and their partner participate in the selection of a contraceptive method. Even more positive figures were reported in a study of Australian men's attitudes toward male contraception in which 75.4% of new fathers interviewed indicated they would be willing to try a male method if it were available.
These surveys shed light on cultural differences in acceptability. The predominantly Muslim communities in Indonesia were less willing to use male contraceptives, citing religious beliefs and Australian migrants were less receptive than those born in Australia. However, even in Indonesia where willingness was lowest, a quarter of the population surveyed (28.5%) responded positively.
Survey data of women's attitudes also show support for male contraceptive methods. In a survey of women in Edinburgh, Cape Town, Shanghai and Hong Kong, more than 70% of all women and over 90% of women in South Africa and Scotland, thought that a 'male pill' was a good idea and 65% of women overall felt that the responsibility of contraception fell too heavily upon women. In Hong Kong and Shanghai, of the women who were negative or unsure about male contraception, the primary concern was health risks. In Scotland and South Africa, women were more likely to attribute their negative attitudes to a reluctance to rely on their partner. However, only 2% of women overall indicated that they would not trust their partner to use contraception. These data indicate that while women may not trust men in general to take the pill, they were more trusting when it came to their own partner.
In a UK survey of 134 female and 54 male users of contraceptives, acceptability of a 'male pill' was 49.5%. Forty-two percent of respondents expressed concerns that men would forget to take a male pill, women being much more likely to express this concern than men, contrasting with the 2% of women in the Glasier et al. (2000) study. Those who were unwilling or undecided about the pill were likely to express concerns about the effect of a pill on future fertility. Since the majority of current hormonal formulations do not require daily adherence and the return to fertility from current formulations is estimated to be 100%, there is potential to adequately address these concerns.
Finally, the attitudes of minority youth were assessed in a survey of 30 young, African American men and women. Overall, 67% of males and females had positive impressions of male hormonal contraception. A large majority (85%) of females indicated they would trust their partners to use the method and a majority of males (60%) indicated intentions to use the product were it available.
Survey data is very likely to overestimate the population of potential users of male contraception. However, even the lowest expressions of interest in male contraception from these surveys are many times the usage rates for most current, 'successful' female birth control methods (Table 2). Even assuming that only 25% of men who indicated they would 'definitely' or 'probably' use male contraception in the Heinemann et al. survey, the estimated number of potential users aged 15–64 years in those nine countries alone is close to 44 million (Table 3).
Expert Rev Pharmacoeconomics Outcomes Res. 2012;12(5):605-613. © 2012 Expert Reviews Ltd.