Contraception and men attending a genitourinary medicine clinic

Aims. To identify men’s knowledge and attitude to contraception and to determine whether there are differences in those men who have previous experience of termination of pregnancy (TOP) compared to those without experience. Method. Cross-sectional survey by written questionnaire of male attenders at a genitourinary medicine (GUM) clinic. Results. In total 999 men, aged 15 to 70 years, completed questionnaires, 97.2% of those eligible. Over 96% of men wishing to avoid pregnancy with regular sexual partners were using contraception. However, with casual sexual partners 36% of men would not ensure that they were covered for contraception. The majority, 68.8%, of men did not have enough knowledge to access appropriate emergency contraception. Experience of a TOP was reported by 16.5% of men. Compared to men who did not have termination experience there were no differences in contraceptive use or their knowledge of emergency contraception. Conclusion. Use of contraception with regular sexual partners was good, but this was not the case with casual sexual partners or with respect to knowledge of emergency contraception. No significant differences were found in contraceptive use or attitudes between men with or without experience of TOP, but this may be influenced by several factors including the cross-sectional nature of the study. Improved targeting of men at the time of their partner’s termination and the development of a National Sexual Health Strategy which takes into account men’s needs may address this. Introduction Since the advent of oral contraception, family planning has primarily been perceived as the responsibility of women. This was not only practical, but also pragmatic as the majority of contraception involved the user being female and also gave women control over their own fertility. However, as the problem of unplanned pregnancies increases, there is growing awareness that one of the ways of tackling the discrepancy between contraceptive need and use is to target a previously neglected group involved in the use of contraception, that is men.1–3 Various campaigns have been organised to try and target the male population including the ‘Men this is for you’ campaign run jointly by the Health Education Authority and the Contraception Education Service. However, the issue of increasing men’s involvement in contraception is far from resolved. There are few published studies looking at men’s attitudes to contraception. The major studies on contraceptive use and attitudes in the UK have studied women exclusively.4,5 Hence, the need to focus specifically on men’s contraceptive knowledge and attitudes. Aims To identify men’s knowledge and attitude to contraception and to determine whether there are differences in those men who have previous experience of termination of pregnancy (TOP) compared to those who have no experience of TOP. Method Consecutive male attenders at the genitourinary medicine (GUM) clinic at Nottingham City Hospital NHS Trust, over a 2-month period December 1999-January 2000, were invited to self-complete a confidential written questionnaire. The questionnaires were completed prior to seeing the health care professional and collected before leaving the clinic. Data were collected on: current contraceptive use with regular sexual partners; use of contraception with casual sexual partners; knowledge of emergency contraception; and experience of pregnancy and/or its termination. Emergency contraceptive knowledge was graded as follows: no knowledge; minimal knowledge: aware emergency contraception existed but unsure of details; reasonable knowledge: enough knowledge to access one method of emergency contraception; good knowledge: aware of more than one method of emergency contraception and appropriate use. The questionnaire has not been reproduced here, but a copy is available on request. No one completed the questionnaire more than once. Statistical analysis was by Chi squared tests where appropriate. Ethical committee approval was obtained. Results Background data The questionnaire was offered to 1134 men; 28 declined to complete the questionnaire and 107 were excluded as they were men who exclusively had sex with men. This provided 999 questionnaires for analysis. The ages of the men ranged between 15 to 70 years, with the majority of men being aged 21 to 30 years (Table 1). Of the cohort, 369 (37%) were living with their sexual partner, 217 Contraception and men attending a genitourinary medicine clinic Suzanne VF Wallace, BM BCh, Senior House Officer; Elizabeth M Carlin, FRCP, Consultant, Department of Genitourinary Medicine, Nottingham City Hospital NHS Trust, Nottingham, UK Correspondence: Dr EM Carlin, Department of Genitourinary Medicine, Nottingham City Hospital NHS Trust, Hucknall Road, Nottingham NG5 1PB, UK. Tel: 0115 9691169 ext. 46746, Fax: 0115 962 7684 (Accepted 12th January 2001) The Journal of Family Planning and Reproductive Health Care 2001: 27(4): 217-220