Young Adult Males' Perspectives of Male Hormonal Contraception

Megan R. Sax, MD; Emily G. Hurley, MD; Rocco A. Rossi, MD, MA; Suruchi Thakore, MD; Abhinav Hasija, PhD; Julie Sroga-Rios, MD

Disclosures

South Med J. 2021;114(2):73-76. 

In This Article

Discussion

According to the Guttmacher Institute, approximately 45% of pregnancies in the United States are unintended.[11] The options for pregnancy prevention by the male partner are extremely limited. Although previous research has demonstrated an interest among men in using MHC, no research has been directed toward young adult males. For this reason, we sought to determine whether there was an interest in MHC in young adult men from two distinct socioeconomic populations. Our study found that there is significant interest in MHC among young males in the greater Cincinnati area and that distinct socioeconomic young adult male populations have differing views on MHC. Understanding the obstacles and concerns for this young adult population is essential to developing a suitable method of contraception. Although the CHD population was overall less frequently willing to use MHC as compared with the UC population, the cited concerns about using MHC between men in both populations were different. The most frequently cited concern for CHD survey participants was potential adverse effects, whereas the greatest concern among the UC population was potential risk of contraceptive failure. It is possible that the males in the UC population may have been less concerned with potential adverse effects because they are more likely to have consistent access to health care. In addition, these males were more likely to be employed and therefore have financial support to satisfy any potential health costs associated with resolving future health-associated adverse effects. Contraceptive failure may not have been a common concern among CHD study participants because 52.9% of CHD participants reported not regularly using contraception, as detailed in the survey, which included condoms and partner medications/devices. Although it is evident that males of different educational and socioeconomic backgrounds may have different interests and concerns, further investigation into these concerns will be essential in future male contraceptive research.

Similar to our study, prior survey results have suggested an interest among older adult males in using hormonal contraceptive pills; however, these males were older. Our results demonstrate that there is a significant interest among young adult males in using various forms of MHC, especially in the form of injection. Prior studies have similarly shown that there is interest among men in using MHC; however, few have been directed at young adult males. One study directed at young adult males (mean age 18 years) completed by Marcell et al[7] compiled the results of interviews with young adult males and revealed concerns that hindered the male acceptance of MHC. Some of the most frequent concerns among these young men were gender roles and responsibilities surrounding contraception, male lack of involvement in health care, potential reliability to use these methods, and apprehension about using new medication.[7] In our study, concerns surrounding the use of MHC were different between the UC and CHD populations, with the UC population more frequently being concerned about the failure of the method to prevent pregnancy, whereas the CHD population was more frequently concerned about potential adverse effects.

One distinct difference in the results of our survey was the most favored method of MHC among both populations being the injectable formulation administered every 3 months. Conversely, a well-constructed multicontinent survey demonstrated that a daily birth control pill was the most desired route of administration among the men surveyed; however, this was among men with a mean age nearly 10 years older than our young adult male population.[8] It is interesting to consider the affect that age may have on preferred formulation, as young and adolescent females have similarly shown a greater interest in long-acting contraceptive methods when provided with multiple contraceptive options.[12]

The strengths of this study include having an adequate total survey response (n = 162) among two populations with statistically significant findings regarding willingness to use MHC and concerns about using MHC. The authors acknowledge that the lack of response rate in both study populations is a major limitation in interpreting the results; however, the response rate was unfortunately not feasible. Specifically, within the UC study population, not all of the program coordinators had contact information available online, nor did all of the program coordinators subsequently share the survey with individuals in their program; therefore, this introduces an element of response bias. Among the programs that participated in the survey, the response rate in the UC population could not be calculated because the graduate programs were not consistently able to provide the number of males applicable for study inclusion or guarantee consistency in offering the survey. In addition, within the CHD population, the authors could not guarantee consistency among CHD medical staff in reliably offering surveys to the targeted age group or document the response rate of male patients willing to take the paper survey. The men surveyed in this study may have been less likely to cite accessibility to health care as a concern given that they were either at the health department clinic at the time of the survey or in postgraduate training, likely with a healthcare plan. In future studies, recruitment may be expanded to include men who are not regularly accessing health care.

processing....