Context: Family planning programs and policies increasingly focus on the male partner's roles and responsibilities in contraceptive decision-making and use. To effectively tailor services for males, policymakers and providers must refine their understanding of men's psychosocial and reproductive health needs.
Methods: Using self-administered questionnaires, 1,540 sexually active males aged 19 and younger who attended family planning clinics in California provided information about their sexual behavior, contraceptive use, pregnancy and parenting history, and psychosocial characteristics. Logistic regression was used to examine factors that contributed to effective contraceptive use.
Results: Although 73% of participants reported having used a birth control method at first intercourse, only 59% said that they or their partner had used an effective method at last intercourse, and 35% had used no method. If the client was uncomfortable with his method, the odds that he had used an effective method at last intercourse were reduced (odds ratio, 0.4). The likelihood of use at last intercourse was increased among males who agreed with their partner about their method and those who had never impregnated a partner (1.4 and 1.9, respectively).
Conclusions: To adequately serve young males, clinics must take into account their sexual and contraceptive histories. But screening should go beyond traditional family planning techniques to discuss how to improve communication with partners and other lifestyle issues that may interfere with consistent use.
PIP: Findings are reported from 1780 young male clients of the California Office of Family Planning's Expanded Teen Counseling Program's (ETCP) family planning clinics during 1992-94 on their sexual behavior, contraceptive use, pregnancy and parenting history, and psychosocial characteristics. 37% were Hispanic, 30% White, 18% Black, 12% Asian, and 6% members of other racial or ethnic groups. 14% were aged 14 years or younger, 50% were aged 15-17, and 36% were aged 18-19. 9% reported having Medicaid insurance and 3% received Aid to Families with Dependent Children. 31% of the young men reported going to the clinic in search of a birth control method, 27% to determine whether they were infected with an STD, 26% for a physical exam, 22% because their partner or girlfriend wanted them to, and 15% for information or someone to talk to. 88% reported recent episodes or symptoms of depression and 23% were having problems in school. 86% were currently sexually active, with 48% of those sexually active being age 14 or younger when they had their first sexual encounter. 73% reported using a condom at first sexual intercourse, while 12% had never used a contraceptive method. 50% reported using a condom the last time they had sexual intercourse, 71% of condom users reported being comfortable with the method, 21% had impregnated a partner and 8% were parents, and 25% reported having 4 or more sex partners during the past 6 months. 9% reported ever having an STD, 31% reported being always or sometimes high on alcohol or drugs during sex, and 6% reported having been forced or tricked into having sex. The odds were reduced that a client had used an effective method at last intercourse if he was uncomfortable with that method. The likelihood of contraceptive use at last intercourse was increased among males who agreed with their partner about their method and those who had never impregnated a partner.