- The Washington Times - Thursday, March 7, 2002

Men are less aware than women about sexual health issues because of a flawed information network, says a new study on male reproductive health.

There are "significant gaps" in the way the nation meets men's sexual health needs, says David J. Landry, a lead researcher of "In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men," published this week by the Alan Guttmacher Institute (AGI).

Women, researchers explain, are compelled by biology, pregnancy and public health campaigns to seek regular medical attention, where they are routinely asked about their sexual history. Women also have the advantage of thousands of federally funded and private clinics waiting to serve them.

Men, meanwhile, are not required to see a doctor except for sports or employment physical exams and may not be asked about their sexual activity even at these appointments, said AGI researchers, who looked at dozens of national surveys on the sexual health of men aged 15-49.

Moreover, sexual and reproductive health has been feminized. The typical family planning clinic features pink walls, posters of gigantic ovaries and a mostly female staff.

The result appears to be that men know less about sexual health, reproduction and sexually transmitted diseases (STDs) than they should, AGI researchers said. Men begin to pay more attention to this aspect of personal health later in life, when prostate cancer becomes a possibility.

Two consequences of this ignorance, they added, are "alarmingly high" STD rates among young men and rising rates of men with AIDS who were infected through heterosexual contact.

It's like trying to fight unintended pregnancy and STDs "with one hand tied behind our back," said Sara Seims, AGI president and chief executive officer.

"We must pay more attention to men, who have sexual and reproductive health needs in their own right as well as in their roles as partners and fathers," she said.

The dearth of sexual health services for men was identified several years ago.

"There is no traditional medical or public health infrastructure oriented to the sexual and reproductive needs of men," said an Urban Institute report on young men's health, issued in December 2000.

The AGI report is an important milestone in the issue because it looks at men's sexual health from the teen years into middle age and comes from the nation's premier reproductive research organization, said researcher Freya L. Sonenstein, who worked on the Urban Institute study.

Saying that men deserve good sexual health care "in their own right" and not just because they are women's partners is a critical symbolic shift, she said.

Ms. Sonenstein also applauded the Bush administration's "great interest" in fostering strong families and fathers' connections to their children.

"I would hope that [the administrations] efforts to strengthen relationships between men and women, and to strengthen families with children, would [recognize] that we need to address sexual and reproductive health needs of both women and men," she said.

While identifying problems regarding men's sexual health and education is a giant step forward, those who work with teen boys and young men said a lot of work remains to be done. In Los Angeles, for instance, Planned Parenthood clinics try to attract men with an outreach program, male voices in radio ads and male staff in the clinics.

"We see lots of men in our clinic, but they're usually hanging out in the waiting room or on the street in their cars, waiting for their partners while they're in the clinic," said Nancy Sasaki, president of Planned Parenthood Los Angeles.

"Our goal is to get more of them out of our waiting rooms and into an exam room for their own health care," she said, adding that 5 percent of their clients are men.

Men's need for sexual and health education is huge, said German Rodrigues and Caesar Castro, who are part of Planned Parenthood's male outreach program.

"So many guys we work with have no idea about how their bodies work or even their partners' [bodies]," Mr. Rodrigues said. Many men still think "you can't get a woman pregnant the first time you have sex" or get a disease from oral sex, he said.

Old-fashioned macho attitudes also block men from taking a more active role in preparing for a child or taking care of themselves.

"Typically, a guy will think that once he gets a girl pregnant, he's pretty much done," said Mr. Rodrigues, the outreach program coordinator.

"Men don't get the same message that women tend to get, which is be careful, take care of yourself, get checked," said Mr. Castro, an outreach worker. "Men would rather play Russian roulette with sex."

Jeff Rodrigues, who taught sex education to young men in Texas during the 1990s, said in his experience, guys aren't overly interested in their own "plumbing."

"They're more interested in the girls," partly because they want to be good lovers, he said.

However, the STD crisis generates intense interest in sexual health among both boys and girls, said Mr. Rodrigues, who now teaches the "Up Close" sex education program in high schools in Fort Worth, Texas.

"As we say in class, no one has sex with someone who they think is going to give them an STD. They pick someone who is 'safe,'" he said. But unfortunately, "you can't tell if someone has a disease" by looking at them, even intimately, said Mr. Rodrigues, noting that many incurable STDs are asymptomatic.

He said many teens are confused by STDs' mysterious behavior. "Sometimes our students think the STD will go away like a cold does," said Mr. Rodrigues. A syphilis sore, for instance, "does clear up and go away, and the discharge from chlamydia, if there is one, can come and go. So they can think, 'Well, whatever it was went away.'"

Sadly, this kind of attitude is contributing to the 15 million new STD cases a year, with 3 million among teens, he added.

Scott Phelps, co-author of "A.C. Green's Game Plan" abstinence education program, said they chose the sports motif, in part, to reach young males.

The program, which is distributed by Project Reality in Golf, Ill., calls for "making a game plan for your life," setting boundaries, "avoiding the penalties," choosing good "teammates" and viewing marriage as "the prize" that's worth winning.

"We try to get [teens] to look at the long term," said Mr. Phelps. "And we say that the same self-control and self-discipline that's required for abstinence is the same self-control and self-discipline that is going to help them accomplish their goals and dreams."

Game Plan also features male role models, such as soon-to-be-married basketball star A.C. Green, who is known for his premarital sexual abstinence and "Iron Man" reputation for not missing any games.


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