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© APRIL 2004

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Why Focus on Men? Mens sexual and reproductive health needs have been overlooked. Engaging men in the sexual and reproductive health care system promises benefits for men, women and families. Mens involvement is crucial to addressing sexual and reproductive health concerns such as sexually transmitted infections (STIs) and unwanted pregnancies.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Report Overview The most comprehensive resource available on mens sexual and reproductive behavior and needs worldwide Centers on key sexual and reproductive events for men 15–54 years old: Initiation of sexual relationships Marriage and the beginning of family building Fatherhood and the end of family building Includes information on 45 developed and developing countries Focuses on 23 countries representing five regions

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Presentation Focus: 12 Countries in Three Regions Sub-Saharan Africa Burkina Faso, Nigeria, Uganda, Zimbabwe Latin America and Caribbean Brazil, Dominican Republic, Mexico,* Peru Industrialized countries Great Britain, Italy, Japan, United States

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Information Sources National surveys (1990–2000) Qualitative and quantitative studies Census data Global health agencies Data from international research and health organizations active in service provision or advocacy

Key Milestones

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Men reach key milestones at different ages in different regions Age United States Latin America & Caribbean Sub-Saharan Africa First have intercourse First marry Become father Intend no more children

Men 15–24 Initiation of Sexual Relationships

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Most men have sex before age 20. Age

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Many young men have more than one sexual partner.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Young mens use of contraception varies by region and by country.

Men 25–39 Marriage and the Beginning of Family Building

©The Alan Guttmacher InstituteIn Their Own RightWorldwide By their late 20s, many men have married.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide By their late 30s, most men are fathers.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Many men discuss family planning with their partners.

Men 40–54 Fatherhood and the End of Family Building

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Men in developing countries often have more children than they desire.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Some men do not use contraceptives even though they do not want a child.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Sexually active men 40–54 have varying levels and patterns of contraceptive use. % of sexually active men using a contraceptive method

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Some men have extramarital relationships, but most do not.

Sexually Transmitted Infections and Condom Use

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Curable STIs are most prevalent in Sub- Saharan Africa and Latin America and the Caribbean. Estimated annual prevalence of curable STIs per 1,000 men and women 15–49

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Men in Uganda and Zimbabwe are more likely than others to know about the condom and either abstinence or monogamy as ways of preventing HIV/AIDS.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Sexual and Reproductive Health Needs Information Skills Counseling Preventive health services Clinical diagnosis and treatment

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Needs: Information Comprehensive sex education Genital health and hygiene Healthy relationships Pregnancy prevention STIs, including HIV Fatherhood Where and how to obtain reproductive health services

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Needs: Skills Pregnancy and STI prevention and sexual health skills Assessing and avoiding risk Resisting peer pressure Communicating with partners Using contraceptives properly Fatherhood skills Parenting Participating in childs health and well-child care

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Needs: Counseling Self-concept Life events and decision-making Values and motivation

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Needs: Preventive Services Sexual and reproductive health history Cancer evaluation screening Substance abuse screening Mental health assessment Routine physical Premarital blood test Referral for additional services, if needed

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Mens Needs: Clinical Diagnosis and Treatment STI/HIV diagnosis, treatment, counseling, and partner follow-up Sexual dysfunction diagnosis and treatment Fertility evaluation Contraceptive services, including vasectomy Urologic disease

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Barriers to Addressing Mens Needs Absence of political will to turn advocacy into action Lack of funding Logistic challenges of incorporating mens services into existing programs Inadequate staff

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Benefits of Addressing Mens Sexual and Reproductive Health Needs in Their Own Right Increase societal awareness of mens needs Improve the provision of information and services men need to protect their own health and that of their family.

©The Alan Guttmacher InstituteIn Their Own RightWorldwide Benefits of Addressing Mens Sexual and Reproductive Health Needs in Their Own Right Expand the scope of services available for men and women Reduce unintended pregnancies and sexually transmitted infections Promote healthier pregnancies and better parenting

This presentation was developed with support from The Bill & Melinda Gates Foundation. For more information, visit