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Class 4 – Primary
prevention among
youth interventionscurricula + other
approaches
380.720 – Masculinity, Sexual Behavior & Health, 2012 Qtr 2
Approaches to work with men
Gender neutral
Gender aware
Gender sensitive
•
Take into account gender-specific ways a male may
experience health problems & illness differently than a female
& has capability to effectively communicate with a young man
Gender transformative
•
Work to change societal gender relations (& male culture)
such as helping a young man redefine need to be sexually
promiscuous to prove his manhood & promoting healthy
sexuality
Rao Gupta G. Gender, Sexuality and HIV/AIDS: The What, the WHY
and the How. SIECUS Report 2001;29(5).
1
Improving sexual/reproductive
health among teenage & young
adult men in Baltimore?
•  What would be your approach?
•  Needs assessment?
•  Best bets given reading?
Decisions
•
•
•
•
Who ?
What?
Where?
Partners?
Target populations: Who?
•
•
•
•
Teenage & young adult men?
Teenage & young adult women?
Couples
Adults? Which ones?
2
What?
Considerations for intervention design
•  Theory as basis for behavior change – which to use?
•  Benefit of addressing gender role(s) vs. masculinity?
•  What SRH content to cover?
-  Should care seeking be included?
•  Benefit of including social marketing/media campaign?
•  Does matching on gender & race/ethnicity matter?
Questions for discussion
Outcomes
•  What outcomes to focus on?
-  Attitudes; Behaviors; Intentions; Biological vs. selfreport
•  How would outcomes of interest be different if
audience with mixed sexual experience vs. not?
•  What groups are not well addressed?
-  GBQT; Special health care needs
Questions for discussion
Follow-Up
•  How long to monitor outcomes?
-  Is 3- ; 9-; 12-month long enough?
Cost Considerations
•  What would be considered a cost-effective program?
3
Formal sex education by topic
•  Most teens receive formal sex education in school/
community before age 18
Proportion of teens receiving any formal
instruction about birth control declined…
Source: Lindberg LD, Changes in formal sex education: 1995–2002, Perspectives on Sexual and Reproductive Health, 2006, 38(4):182–189.
…while proportion receiving information
only about abstinence increased
Source: Lindberg LD, Changes in formal sex education: 1995–2002, Perspectives on Sexual and Reproductive Health, 2006, 38(4):182–189.
4
Similarly, number of teens receiving
information about both abstinence &
contraception declined
% of teens receiving information about both abstinence & contraception
Source: Lindberg LD, Changes in formal sex education: 1995–2002, Perspectives on Sexual and Reproductive Health, 2006, 38(4):182–189.
Many male teens do not receive sex
education before 1st sex
% who have sex before getting education on various topics
100
80
62
60
53
45
42
34
40
30
20
0
How to put How to say
on a condom no to sex
STIs
Birth control
AIDS
prevention
Any
Source: Abma JC et al., Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2002, Vital and Health Statistics, 2004, Series 23, No. 24.
Parent sex education
by gender & topic
•  Parents talk to 2 of 3 sons (vs. 4 of 5 daughters) about 1 of 6
sex education topics
•  Parents more likely to talk…
- Females >> males
about:
* Saying no to sex
* Birth control
*
*
*
*
- Males >> females
about condoms
5
Many male youth do not talk to
their parents either
Adolescent report of discussions of
STDs & birth control methods with
parents in 1988, 1995 & 2002
Weighted percentages
Birth control
STDs
STDs & birth control
None
1988
1995
2002
1988
1995
2002
1988
1995
2002
1988
1995
2002
Female
58e
66ce
52ae
50e
68c
57a
42
58ce
44ae
34
24ce
35a
Male
43
41
32ab
6