Advances in male contraception.

SummaryThis study was aimed at finding the attitude of Nigerian women to contraceptive use by their male partners. A total of 417 women received the questionnaire; 71% of these were sexually active and 34.8% were not aware of any male contraceptive method. Only 1.7% reported regular use of condoms by their spouses, however this was significantly higher if the women were better educated. Most of the women had a positive attitude to contraceptive use by their spouses, as 54% (225/417) of them showed preference to male dependant contraceptives in their relationship. However, only 32.3% (135/417) of the women had ever-requested their spouse to use a condom and in just 18.5% (25/135) was such a request regularly complied with. Significantly more Muslim women prefer their partners to use a contraceptive rather than themselves (p = 0.001), but the condom usage by their spouses is significantly lower than their Christian counterparts (p = 0.000). There is a need to offer counselling on male contraceptives to both genders so that they can make an informed choice, especially with the dual protection offered by the use of condoms.

Background: One of today's global problems is the rapid growth of population. Population growth can be controlled through contraceptive method utilization. However, contraceptive use among males in most developing countries, including Indonesia, remains low. This study aimed to determine the social, economic, and cultural factors affecting male contraceptive use in family planning village, Yogyakarta, Indonesia, using Theory of Planned Behavior (TPB) and path analysis.Subjects and Method: A case-control study was carried out in Yogyakarta, Indonesia. A sample of 200 men aged 15 to 49 years was selected for this study by fixed disease sampling. The dependent variable was male surgical contraceptive method use. The independent variables were age, knowledge, education, intention, attitude, perceived behavior control, subjective norm, social culture, access to health service, and health service quality. The data were collected by questionnaire and analyzed by path analysis.Results: Male surgical contraceptive method use was directly affected by older age (b = 1.50; 95% CI = 0.54 to 2.46; p= 0.002), better knowledge (b= 1.48; 95% CI= 0.48 to 2.49; p= 0.004), stronger intention (b= 1.10; 95% CI= 0.15 to 2.06; p= 0.24), more positive attitude (b= 1.33; 95% CI= 0.35 to 2.30; p= 0.008), stronger perceived behavior control (b= 1.21; 95% CI= 0.23 to 2.20; p= 0.016), better access to health service (b = 1.59; 95% CI = 0.58 to 2.59; p= 0.002), better health service quality (b= 1.17; 95% CI= 0.22 to 2.12; p = 0.016), and supportive subjective norm (b= 2.07; 95% CI= 1.12 to 3.01; p<0.001). It was also indirectly affected by subjective norm, social culture, education, education, and access to health service.Conclusion: Male surgical contraceptive method use is directly affected by age, knowledge, intention, attitude, perceived behavior control, access to health service, health service quality, and subjective norm. It is indirectly affected by subjective norm, social culture, education, education, and access to health service.Keywords: male, contraceptive method, use, determinants, path analysisCorrespondence: Bettya Kartikasari. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: bettyakartikasari21@gmail.com. Mobile: +6285817606484.Indonesian Journal of Medicine (2018), 3(2): 89-98https://doi.org/10.26911/theijmed.2018.03.02.05

During the second half of the 20th century, progress in developing novel, practical contraceptive methods for men has lagged significantly behind developments for women. Despite the lack of reliable, reversible methods, men throughout the world continue to be strongly involved in family planning but a greater involvement will require more attractive and reliable contraceptive options for men. The closest to fruition are hormonal methods the features of which are reviewed. Landmark WHO contraceptive efficacy studies have established that hormonally-induced azoospermia provides highly effective and reversible contraception for at least 12 months with minimal short-term side effects. Even among the small subgroup of men who remain oligozoospermic during hormonal suppression, good contraceptive efficacy is achieved. The present goals are to develop improved second generation hormonal regimens which provide more uniform azoospermia to obviate the need for monitoring of sperm output and to develop long-acting depot testosterone formulations used alone or with additional gonadotrophin suppressive agents such as progestins or GnRH antagonists. Significant obstacles to progress are the flight of industry from contraceptive R&D dur to the financial deterrent posed by the product liability crisis as well as the low priority accorded male reproductive health. Together those will determine whether the range of contraceptive options available to our children in the 21st century will improve, or whether the historically recent unbalanced increase in reliance on women for family planning will continue.

Contraception is a fundamental human right as it affects the lifestyle, health, and wellbeing of society as well as the environment. Despite the significant advances in the contraceptive options available for women, vasectomy and condoms are the only contraceptive methods available for men. But nowadays many men want to contribute equally to family planning with their partners. Various trials have been performed over the last few decades to develop a safe, effective, and reversible male contraceptive. Thus, different hormonal and non-hormonal approaches have been employed for the development of male contraceptives. The hormonal approach is mainly based on the repression of gonadotropins and, thus, spermatogenesis. This approach achieved efficient contraception in most men but not in all. Additionally, various efforts are underway to reduce the side effects and improve till full efficacy is achieved. The non-hormonal approach is specific and can target sperm production, maturation, and function. A range of non-hormonal agents have been identified and studied in animal models; however, this approach is also in its preclinical stage. This study aims to provide a comprehensive overview of pre-existing and upcoming techniques applied for male contraception. From all these efforts, men's situation can change, and in the near future, men will be able to choose the best contraceptive suited to their needs. 

BackgroundSupportive male involvement is strongly correlated with contraceptive use. In Rwanda, where the contraceptive prevalence rate among married women increased from 17 to 52% from 2005 to 2010, and stagnated at 53% in 2015, understanding the role of male partners in collaborative couple contraceptive use can help inform programs designed to further increase the use of contraception in Rwanda.MethodsThis study utilized qualitative methods in 2018, specifically 32 in-depth interviewers with mostly current users of modern contraceptive methods and eight focus group discussions with family planning providers—both family planning nurses and community health workers (CHWs). Respondents were from Musanze and Nyamasheke Districts, the districts with the highest and lowest modern contraceptive use, respectively, to explore the role of couple collaboration in family planning use in Rwanda. Data were analyzed using the thematic content approach in Atlas.ti (8).ResultsFindings demonstrate that some men are opposed to use of male methods of contraception, and some are opposed to any contraceptive use, which can lead to covert use. Women and providers prefer collaborative couple contraceptive use—as a result, providers advocate for and encourage male partner participation in contraceptive use. Women are most often burdened with seeking out information, initiating discussions, and sharing information discovered about contraceptive use with partners. Decision-making about contraceptive use, once discussed, can be collaborative and motivated by financial considerations. When couple contraceptive use is collaborative, benefits range from marital harmony to husband’s support of sustained use through reminders about appointments, joint counseling, and support in managing side effects.ConclusionFamily planning providers at the community and clinic levels encourage collaborative contraceptive use among couples and some Rwandan couples communicate well about family planning use. Despite the positives, women are expected to source family planning information, share that information with their male partners, seek out family planning services, and use family planning. If more Rwandan male partners accepted use, used male methods of contraception, and participated even more in the work it takes to use family planning, the potential for sustained, and even enhanced, contraceptive use in Rwanda could be realized.

ObjectiveTo determine the knowledge and practice of contraception among United Arab Emirates (UAE) men.DesignCross-sectional survey.ParticipantsFour hundred UAE monogamously married men with children.MethodThe participants were randomly selected from the community and...

BackgroundOutbreaks of mosquito-borne viral illnesses commonly occur after storms. As storms are predicted to worsen in intensity and frequency, mosquito-borne viruses, including the Zika virus are expected to spread, and with devastating consequences. While the disease is self-limited, pregnant women who contract Zika can transmit the virus to their fetuses, causing neurodevelopmental abnormalities, including microcephaly. An overlooked vector of the Zika virus, however, is men whose semen can transmit the virus at the time of sexual intercourse. Current recommendations for preventing the sexual transmission of Zika are inadequate and need to emphasize male reproductive responsibility, via expanding services for men’s family planning and developing novel male contraceptives.Main bodyTo prevent the sexual transmission of Zika, the World Health Organization recommends that couples use condoms or abstain from sexual activity for at least 6 months when traveling in Zika-infected areas. Strict adherence to these recommendations is neither practical nor adequate to address Zika’s sexual transmission. As up to 13% of couples who use condoms experience unintended pregnancy, semen and consequent viral exposure is imminent. The use of contraception beyond just barrier methods is essential. However, the burden of contraception largely falls upon women and efforts to prevent vertical transmission are often aimed at educating women, when the outcome is equally undesirable among their male partners. These short-comings highlight the lack of attention to men’s options for family planning. Educating men about the full range of contraceptive options, correcting misconceptions about the efficacy of withdrawal and barrier contraceptive methods, increasing access to vasectomy, and developing novel male contraceptive options would allow shared responsibility for the prevention of unintended pregnancy and Zika-related morbidity.ConclusionGaps in recommendations to prevent the sexual transmission of Zika provide an opportunity to develop men’s family planning initiatives and the range of accessible contraceptives to men.

Canadian Contraception Consensus (Part 2 of 4).

Sperm-specific ion channels: targets holding the most potential for male contraceptives in development

Male contraception.

Semen Analysis, Male Infertility, and Male Contraception

BackgroundDespite the growing body of evidence on use of modern contraceptives among women in sub-Saharan African countries, little is known about the broader context in which female decision-making concerning contraceptive use occurs, particularly the role of their male partners’ awareness and support of modern contraceptives.MethodsWe conducted a cross-sectional survey of 2468 pregnant women and their male partners enrolled in the Healthy Beginning Initiative (HBI), an intervention to increase HIV testing among pregnant women in Enugu, southeast Nigeria. The aims of this study were to determine: 1) male partners’ awareness of, and support for, female contraceptive methods, and 2) influence of male partners’ contraceptive awareness and support on pregnant women’s expressed desire to use contraception. We used logistic regression models to examine the association between male partners’ awareness and support of modern contraceptives on their spouses’ desire to use contraceptives.ResultsMen’s awareness of, and support for, use of modern contraceptives were significantly associated with their female partners’ desire to use contraception. A majority of the men who were aware of modern contraceptives (66.5 %) and those who supported their spouses’ use of contraception (72.5 %) had partners who expressed a desire to use contraception. Men who were aware of female contraception were 3 times more likely to have spouses who desired to use contraception (AOR = 3.17, 95 % C.I: 2.70–3.75). In addition, men who showed support for their spouses’ use of contraception were over 5 times more likely to have spouses who indicated a desire to use contraception (AOR = 5.76, 95 % C.I: 4.82–6.88). Living in a household of 5 or more people (AOR = 1.45, 95 % C.I: 1.23–1.72) and residing in an urban area (AOR = 0.81, 95 % C.I: 0.67–0.97) were also significantly associated with women’s expressed desire to use modern contraception.ConclusionMen’s awareness of, and support for, use of modern contraceptives were markedly associated with their spouses’ desire to use contraception. This underscores the need for men’s involvement in programs that seek to address women’s uptake of contraception in low and middle income countries.

BackgroundMany young women experience important key life transitions during adolescence and early adulthood, such as initiation of sexual activity, first use of contraceptives, marriage, and childbirth. For young women to be able to plan and manage their lives, it is critical to understand how these life events intersect and shape their contraceptive decision-making. This study aims to explore young women's contraceptive method use trajectories, including the factors that influence contraceptive decision-making throughout adolescence and youth.MethodologyIn 2019, the Full Access, Full Choice project (FAFC), implemented by the University of North Carolina at Chapel Hill and the African Institute for Development Policy, conducted 30 in-depth interviews with young women aged 18–24 years in three counties in Kenya (Nairobi, Mombasa and Migori). Eligible respondents had used two or more modern contraceptive methods. Interview guides utilized a modified life history approach to capture details about respondents' contraceptive use and life experiences from the time they first used contraception until the time of interview.ResultsWe identified five separate contraceptive use trajectories based on the occurrence and timing of marriage, childbirth, and contraceptive method choice as well as various influences on contraceptive decision-making. The majority of respondents began their contraceptive journey by using male condoms or emergency contraception, but subsequent contraceptive decisions were varied across trajectories and influenced by different factors. For many women, the initiation of a non-coitally dependent method occurred after the birth of a child; for some, this was the first method used. Once women transitioned to using a non-coitally dependent method such as injectables or implants, many cycled through different methods to find one that had fewer side effects or provided the desired duration of protection.DiscussionThis study highlights the nuanced needs of young women throughout their adolescent and youth years in Kenya. This suggests that programs and policies need to encompass young women's diversity of experiences and motivations to best serve them.

Male contraception is relied upon by many couples around the world in the form of condoms, vasectomy, and withdrawal. Novel male contraceptives are a collection of interventions in development including hormonal, non-hormonal, immunological and reversible vas-occlusive methods. A large multinational trial of a novel hormonal contraceptive has recently concluded, and while the results are awaited, this narrative review discusses the field and potential methods on the horizon.

Novel male contraceptives have been in development for well over half a century, and despite a robust predicted global market for new methods, funding for research and development has been extremely limited. While the pharmaceutical industry previously supported male contraceptive research and development, industry partners are only spectators in the current space, awaiting a product that has been de-risked by the public sector before re-entering the field. Current male contraceptive development efforts are thus primarily funded by nonprofit, non-governmental, and government agencies who also act as the primary advocates for the field. Specific organizations include the International Consortium on Male Contraception, the Population Council, the Male Contraceptive Initiative, the World Health Organization, and the US National Institutes of Health. The funding provided by these public agencies, alongside their social and policy-based advocacy efforts such as market research, public education, and calls to action have kept the male contraceptive product development space afloat, resulting in a pipeline of potential products advancing towards market approval. However, as these products mature into more expensive clinical stages of development, they continue to face significant funding challenges, which many programs may not overcome. To fully realize the benefits of novel male contraceptive options, it is incumbent on philanthropic entities, impact investors, venture capital, and/or the pharmaceutical sector to provide significant and timely support for male contraceptive research and development.