Going underground and going after women: trends in sexual risk behaviour among gold miners in South Africa.

This paper examines trends in risk behaviour among South African gold miners, a population with an estimated HIV prevalence of 10-20%. The study is based on a 1995 and 1997 survey of a random sample gold miners in the town of Welkom, South Africa. The results show that the percentage of miners who perceived they were likely to contract HIV increased from 33% in 1995 to 35% in 1997 (P<0.01). The percentage who had 4 or more partners in the past year decreased from 25% to 13% (P < 0.01), and the percentage whose last sexual partner was their spouse increased from 56% to 70% (P<0.01). Condom use in last intercourse with a spouse increased from 18% to 26% (P < 0.05). Condom use with other partners was considerably higher (67%), but did not increase significantly from 1995. The most likely contributors to this behaviour change were the AIDS awareness programmes implemented by the mining industry and the behaviour change communications of a condom social marketing campaign targeted at miners and commercial sex workers in the mining community.

PIP: This paper uses data from a 1995 survey of gold miners in the Welkom area and a 1997 follow-up survey to examine trends in HIV/AIDS knowledge, risk perception, sexual risk behavior, and condom use among gold miners in South Africa. Findings showed that the percentage of gold miners who believed that they were likely to get infected with HIV increased significantly from 22% in 1995 to 35% in 1997. The data likewise showed reduction in sexual activity with casual partners and commercial sex workers, and a decrease in the number of sex partners. Condom use during the last sexual contact with a spouse increased from 18% to 26%. Although condom use with other partners was high, the number did not significantly increase between 1995 and 1997. In conclusion, there is substantial evidence of an increased awareness of the personal risk of acquiring HIV/AIDS, with less risky sexual behavior and increased condom use. These changes are most likely due to the AIDS awareness programs implemented by the mining industry and the behavior changes resulting from condom social marketing campaigns specifically targeted at miners and commercial sex workers in the mining community.

Reproductive health in males with cystic fibrosis: knowledge, attitudes, and experiences of patients and parents.

Males with cystic fibrosis (CF) are generally infertile as a result of aberrant development of Wolffian duct derivitives. The personal significance of this and related reproductive and sexual health (RSH) issues is unknown. We set out to describe the knowledge, attitudes, and experiences regarding RSH in a group of adolescent and adult males with CF, as well as the knowledge and attitudes of parents. This descriptive study was based on a semi-structured interview utilizing in-depth interview techniques. Questions included aspects of knowledge, attitudes, and experiences. Adolescent (aged 14-17 years) and adult (at least 18 years) males attending the Children's Hospital Cystic Fibrosis Clinic, Boston, MA, USA, or hospitalized at the Children's Hospital over that period were eligible; the accompanying parent of the adolescent was also interviewed. Consecutive eligible males were interviewed over a 3 month period. Summary data are presented, attitudinal data are analyzed qualitatively, and a selection of representative transcript data are reported to describe the range of opinions. Fifty males (10 adolescents, 40 adults) participated; this constituted a consecutive sample of 44% of the eligible clinic population. Ninety percent of adults, 60% of adolescents, and 50% of parents knew of male infertility. The mean age (+/-SD) at which adults recalled first hearing this was 16.0 +/- 4.7 years and 13.9 +/- 1.6 years for those adolescents who knew of infertility. Nineteen (48%) of adults and 5 (83%) of adolescents first heard about infertility from their health care providers. Ninety percent reported no major distress upon first hearing about infertility during adolescence. Increasing significance of infertility with maturity was reported by 12 men (30%); only 4 adults (10%) reported that infertility was not a significant aspect of CF. Forty percent knew that males with CF have a small volume ejaculate, but none had been told this by a health care provider. Thirty percent of men had semen analysis performed and all were azoospermic. We conclude that the majority of males with CF know of likely infertility. The significance of this knowledge changes with time. Poor knowledge and confusion surround a range of RSH issues in males with CF.

PIP: Reproductive and sexual health issues are often neglected in work with patients with chronic, life-limiting diseases. Aberrant development of Wolffian duct derivatives generally leads to infertility in men with cystic fibrosis. The reproductive health-related knowledge, attitudes, and experiences of adolescent and adult males with cystic fibrosis were investigated in a descriptive study conducted at the Children's Hospital Cystic Fibrosis Clinic in Boston, Massachusetts (US). Enrolled were 10 adolescents 14-17 years old (mean age, 16 years) and 40 adult men 18-53 years old (mean age, 29 years). 90% of adults, 60% of adolescents, and 50% of parents of adolescent patients were aware of the risk of infertility associated with cystic fibrosis. The average age at which the adult men first learned of this risk was 16 years. A health care provider was the source of this knowledge for 48% of adults and 83% of adolescents. 90% of adult men reported no major distress upon first hearing of the likelihood of infertility during adolescence; however, the emotional significance of possible infertility increased over time for 30%. 20% confused infertility with impotence. 30% of adult men had requested semen analyses and all were azoospermic. There was agreement among respondents that 14 years of age is an appropriate time for health care providers to initiate discussions about the impact of cystic fibrosis on reproductive health. Semen analysis is important to offer all men with cystic fibrosis, providing it is coupled with counseling if azoospermia is confirmed.

Male participation in reproductive health.

PIP: Family planning programs (FPPs) have traditionally viewed women as their main clients because it is women who become pregnant, most contraceptive methods are designed for women, and reproductive health services can be conveniently offered as part of maternal and child health services. Some FPPs have avoided serving men because they believe that women need privacy and autonomy in reproductive health matters. However, this assumption that men are not interested in taking responsibility for family planning has become a self-fulfilling prophecy. FPPs have made little effort to consider men's reproductive health needs or to reach out to men. As such, men have few contacts with the reproductive health care system. Recent survey and study findings instead suggest that many men are highly interested in family planning and other reproductive health issues, and would participate in family planning if given the chance. While some family planning programs have been interested in involving men for more than a decade, men's participation has only recently become the focus of considerable attention. One reason for this newly directed focus is growing concern over the rapid spread of HIV and the targeting of HIV prevention programs upon both men and women to an almost equal extent.^ieng

Ignorance linked to men's risky sexual behavior in India.

PIP: An estimated 1.5 million HIV-infected people live in India. By 2000, more HIV-infected people will live in India than in any other country in the world. Research suggests that men aged 18-25 years rarely use condoms, and only 7.1% of currently married women in India aged 13-49 years report ever having used condoms for contraception. 1628 HIV-negative men were recruited to participate in a follow-up study evaluating the sex behavioral impact of repeated HIV counseling and testing. At the first and all subsequent visits, the men gave blood samples, received physical examinations, and answered questions on demographics, previous STDs, medical history, sex behavior, and knowledge of HIV and AIDS. Participants also received one-on-one counseling with a trained social worker. At 3-month intervals, the men were offered condoms, underwent clinical and behavioral exams, and counseled to remain monogamous and use condoms. Almost one-third of participants had never heard of AIDS at their initial screening visit. However, with each return visit, the level of consistent condom use increased. At 6 months, men were 2.8 times more likely to consistently use condoms with prostitutes; 3.6 times at 18 months, and 4.7 times at 24 months. Over the course of the study, the number of men who reported having sex with a prostitute fell from 63% to 16% by 6 months, then rose to 23% by 24 months of follow-up. Low education levels and ignorance of how HIV is transmitted were consistently associated with continued visits to prostitutes and a lack of condom use.^ieng

STDs and HIV / AIDS: a KAP study among drug operators.

PIP: This study presents the findings of a Knowledge, Attitude, and Practice Survey about sexually transmitted diseases (STDs) and HIV/AIDS in Rajasthan, India. Data were obtained from 153 truck drivers covering "Dhabas" at different highways. Truck operators (TOs), commercial sex workers (CSWs), and iv drug users are the primary at risk populations for HIV/AIDS. In 1997, 73.3% of the 3188 HIV-infected persons were infected through heterosexual intercourse. Findings from TOs indicate a high level of knowledge about STDs, which are prevalent among TOs. Many TOs rely on cleanliness (68.9%) as a safety measure, followed by use of condoms with multiple partners (56.8%). About 50% go for regular check-ups at clinics to avoid the problem of STDs. About 75% of 132 TOs had had at least one problem with STDs during the prior year. About 46.2% consulted a doctor for treatment, 26.5% ignored the problem, and 18.2% received no treatment. 72.7% of 132 TOs had accurate knowledge about AIDS, 62.1% were aware of transmission routes, and 50% knew about prevention. About 85% visited CSWs. Only 14.3% of 112 TOs who visited CSWs used condoms during sexual relations. 10.7% used condoms most of the time, 47.3% used condoms irregularly, and 27.7% never used condoms. Condom availability was an issue. Most TOs learned about HIV/AIDS from mass media, especially posters and banners, followed by the radio. Only 28% of all TOs had complete knowledge of STDs; 13.6% had misconceptions. 37.1% had complete knowledge of HIV/AIDS; 10.6% had misconceptions.^ieng

Condom use with casual partners by men in Kampala, Uganda.

OBJECTIVE: To estimate the prevalence and correlates of condom use with casual sex partners by men in urban Uganda and to identify barriers to condom use that are amenable to intervention. DESIGN: Cross-sectional, door-to-door survey of men residing in a poor area of Kampala, Uganda. SUBJECTS AND METHODS: A multistage, probability sample was approximated by recruiting participants within randomly selected neighborhoods. A total of 301 men between the ages of 18 and 45 years answered questions about condom knowledge, attitudes, beliefs and practices. The respondents also provided demographic and HIV risk-related information. RESULTS: Condom use was higher than previously found in studies in Uganda: 46% of men reported using a condom at the last casual sexual encounter; 31% reported always using condoms with casual partners. In multivariate analysis, independent correlates of condom use included higher condom self-efficacy (4-item scale, odds ratio 1.3 per scale point), lower embarrassment around condoms (3-item scale, odds ratio 0.44 per scale point), knowing where to buy a condom (odds ratio 3.9), knowing how to use a condom (8-item scale, odds ratio 1.4 per scale point), and increasing number of casual sex partners (odds ratio 1.4 per partner). CONCLUSIONS: These data suggest that condom use may be further increased in this population by conducting demonstrations of condom use skills, preparing individuals to anticipate circumstances that make using condoms difficult and using a variety of outlets to dispense condoms.

HIV-1 risk and vaccine acceptability in the Ugandan military.

Between July and October 1993, 570 19- to 22-year-old volunteers were screened for HIV-1, with a resulting seroprevalence rate of 18.3% (95% CI: 14.0%, 22.6%). A cohort of 249 HIV-1-noninfected military recruits in the Ugandan Peoples' Defense Forces was followed prospectively for up to 18 months to document rates of HIV-1 seroprevalence, seroconversion, and knowledge and attitudes related to vaccine acceptability. The HIV-1 seroincidence rate was 3.56 per 100 person-years (95% CI: 1.49, 5.62) over 309 person-years of observation. At the 3- and 12-month visits, subjects were interviewed on issues of acceptance and knowledge about vaccines, including anti-HIV vaccines in particular. More than 90% believe that HIV vaccines will not cause HIV infection, and if offered, 88% report that they would take the vaccine if they were not already infected. Nonvaccine prevention methods were considered less reliable; monogamy and condom use were considered effective by only 33.5% and 69.3% of the cohort respectively. After completing the vaccine acceptability questionnaire at the 12-month visit, subjects were offered an approved polyvalent meningococcal vaccine as an indicator of general vaccine acceptance. All subjects reported receiving at least one previous vaccination, and 95% willingly accepted the meningococcal vaccination. The Ugandan military is a stable population at substantial risk for HIV-1 infection and may be a suitable population for vaccine efficacy trials.

Dimensions of AIDS knowledge and risky sexual practices: a study of northern Thai males.

The relation between AIDS-related knowledge and sexual risk-taking for a sample of young men living in northern Thailand was examined. Data were collected during the fall of 1991. The sample of 1472 men includes university students, soldiers, store clerks, and laborers. Recent commercial sex patronage was variable among the subgroups, and consistent condom use among these recent patrons was far from universal. Several important misunderstandings among our respondents regarding the AIDS virus were identified. These misconceptions were most common among men of relatively low socioeconomic status (laborers and soldiers). Factor analysis identified four distinct domains of AIDS knowledge among the student and soldier groups: knowledge about the mechanics of contagion, knowledge about the consequences of infection, knowledge about appropriate strategies for avoiding the virus, and knowledge regarding inappropriate strategies for avoiding the virus. In multivariate logistic regression, knowledge about inappropriate strategies and knowledge about contagion were the only two domains predictive of recent commercial sex patronage: Men with a relatively good understanding regarding the inefficacy of inappropriate strategies and the mechanics of contagion had lower odds of recent commercial sex patronage compared with men who had a relatively poor understanding of these domains of AIDS knowledge. In the condom use analysis, knowledge about both appropriate and inappropriate strategies was predictive of consistent condom use among recent commercial sex patrons. Thus programs should attempt to improve knowledge about strategies for avoiding the virus and the mechanics of contagion. Special efforts should be made to debunk existing myths about the perceived effectiveness of inappropriate strategies.

Characteristics of risk-taking behaviors, HIV and AIDS knowledge, and risk perception among young males in southwest China.

A cross-sectional survey was undertaken to describe risk-taking behaviors and to assess the knowledge and risk perception of HIV and AIDS among young males aged 18 to 29 years in 82 villages in Longchuan, Yunnan, China, in 1994. Information on demographic, behavioral, and drug-using factors, and knowledge of HIV transmission and prevention, and risk perception was collected using an interviewer-administered anonymous questionnaire. A total of 1,548 individuals were interviewed and 433 drug users, including 52 nonsharing injectors and 140 sharing injectors, were identified. Over half the individuals scored 0 on HIV knowledge, but knowledge was greater among nonsharing drug injectors. Most drug injectors had initiated drug injection after 1990. The reported incidence continues to increase in all three major ethnic groups. Sharing of equipment was common (73%) among injectors. Drug users were four times more likely to have had premarital or extramarital sex, but condoms were used by only 2.5%. Thus, factors promoting spreading of HIV are common in this area. We recommend that a community-based intervention program, targeting both young men and women, be implemented and evaluated in Longchuan as soon as possible.

Men's knowledge, attitudes and practices with regard to family planning.

PIP: While African men are largely apathetic to family planning, they are not necessarily uninterested. Many African men want to participate more actively in deciding how many children they should have and when to have them, but they lack sufficient information to do so. In some cases, many men do not know about contraceptives. Even those who are aware have little access to such services because family planning programs are designed to serve women. In most African countries, family planning services are widely offered in the prenatal units of public hospitals where many African men feel uncomfortable visiting. Studies in parts of Africa have shown that there is a strong link between knowledge and the use of contraceptives and the level of education as well as economic status; the levels of knowledge and use of family planning methods are lower among the relatively less educated. Both print and electronic media are vital reproductive health information dissemination tools. Innovative Communications System (ICS) has operated a men's only family planning clinic at Kencom House, Nairobi, since 1993. Likewise, the Family Planning Association of Kenya is setting up male-only clinics in Nakuru, Kakamega, and Kisumu districts.^ieng

Sexual behaviour of adolescent boys -- a cause for concern.

PIP: A study examines the sexual behavior and level of knowledge about sexually transmitted diseases (STDs) of unmarried adolescent boys from 8 randomly selected villages of the Anand taluka in Gujarat, India. A house to house survey was conducted on all unmarried and sexually active males who were interviewed with the help of structured and pretested questionnaires. These questionnaires consisted of questions on their sexual practices; awareness of STDs and AIDS; and knowledge of proper condom use. Results revealed that from a total sample of 178 adolescent boys the mean age at first coitus was 18.01 years, and in over 87% of the cases a prostitute was the first sexual contact. About 82 of the sample population (46%) had not heard of AIDS and 34% had no knowledge of other sexually transmitted diseases. About 67 boys (37.6%) had never seen a condom and only 9 (5.05%) had ever used one. The mean knowledge score about correct condom use was only 1.44 on a 10-point scale and was found to be associated with the economic status of the subject population, the type of sexual partner, and the educational status of the parents.^ieng

Knowledge, attitude and beliefs amongst inhabitants of high density informal settlements with regard to sexuality and AIDS in Alexandra township.

OBJECTIVE: The main purpose of this study was to gain information on the knowledge that people living in squatter conditions have about AIDS, their attitude towards this disease and their sexual practices. METHOD: The study had two parts, in-depth interviews and a survey. The in-depth interviews were held with 68 male informal settlement dwellers to obtain information on the type of questions to ask in the quantitative part of the study, taking into account the sensitivity of the information we were seeking, and how best to phrase these questions. For the survey, the 300 male informal settlement residents who were interviewed, were located by means of systematic sampling techniques. RESULTS: The results of the survey showed that most of the respondents were living in squalid conditions, without recreation facilities. They were also likely to have had more than one partner (54%). Most of the respondents (90%) had heard about AIDS as a disease. Even though they were aware of AIDS as an epidemic in the country as a whole, they were not convinced that the disease exists in their community, the main reason being that they have never heard about nor seen a person with AIDS in the township. CONCLUSION: There is an urgent need for AIDS education. But this education cannot take place as a separate activity from other upliftment activities in squatter areas.

PIP: It has been estimated that by the year 2005, up to 20% of adults in South Africa may be infected with HIV. An urgent need to control the spread of HIV infection therefore exists. A study was conducted to gain information on male shack dwellers' and squatters' knowledge and attitude about AIDS, as well as their sexual practices. Interviews were first conducted with 68 male informal settlement dwellers to determine which questions to pose and how to ask them, then 300 men aged 15-49 years were surveyed in the main body of the study. 54% of respondents reported having more than one sex partner and 90% had heard about AIDS as a disease. While aware of AIDS as an epidemic in the country, the men did not believe that the disease exists in their community because they had neither heard about nor seen a person with AIDS in the township. AIDS education is urgently needed. However, that education cannot take place in isolation from other improvement-oriented activities in squatter areas.

AIDS-risk among street children and youth: implications for intervention.

PIP: 141 males aged 11-18 years (mean age, 15 years), 79 of whom were enrolled in shelter programs and the remainder living independently on the streets, participated in 14 focus group discussions held in Pietermaritzburg, Johannesburg, Soweto, Pretoria, East London, Cape Town, Durban, and Bloemfontein, South Africa. The discussions focused upon knowledge about the transmission of AIDS and prevention, attitudes toward AIDS and people with AIDS, and sexual and other behaviors related to AIDS risk. Each group comprised 8-10 boys, each person remaining anonymous except for providing his age and a first name to use in the group discussions. All but two participants had heard of AIDS and knew that it was incurable and sexually transmitted. 93% endorsed the idea that condoms can prevent infection, but all were overwhelmingly negative about condom use and people with AIDS. None had heard of HIV and none were able to specify sperm and blood as the media for transmission. Vulnerability to AIDS was attributed to casual sex and sex with particular groups of people, but not to the act of unprotected penetrative sex. 68% were certain that they could not get AIDS from someone who looks healthy. The boys harbored other misinformation on how one may contract AIDS. All agreed that selling sex, to both men and women, is the best way to get money on the streets. They reported earning R10-200 per day depending upon the city, the customer's gender, and other circumstances. Their clients usually insisted upon unprotected penetrative oral, anal, or vaginal sex. They also engaged in survival sex to enlist or mollify powerful others, in exchange for protection, accommodation, or other goods and services; had sex with their girlfriends, many of whom also work as prostitutes; and commonly used alcohol and other drugs. Once intoxicated, the boys are more likely to have risky sex; their vulnerability to being raped also increases. These youths are neither more nor less informed or misinformed about the transmission of AIDS than their counterparts in other countries. Information alone, however, is unlikely to induce behavior change. Study results are discussed in terms of their implications for intervention and the inadequacies of the Health Belief Model and related theories as the sole theoretical foundation for the design of intervention programs.^ieng

A survey on the knowledge and attitudes of men in Machakos town towards vasectomy.

PIP: In November and December, 1993, a self-administered questionnaire was distributed to men in the town of Machakos and to nonmedical hospital workers of Machakos General Hospital. The purpose of the study was to assess their knowledge about and attitude towards vasectomy. The majority of men were in the age group of 30-44 years and were married; the hospital group was more educated. The town men perceived the pill to be the best contraceptive method for women in contrast to the hospital group who gave more importance to bilateral tubal ligation. The hospital group also perceived vasectomy as the best method for men. Overall, 53.2% men were aware of the correct procedure of vasectomy, but only 24% had correct knowledge of how the procedure affects masculinity. The knowledge of the procedure among hospital workers was not very different from that of the town group. Recommendations were made to increase information and education to all groups of people through various media.^ieng

Attitudes of males on contraception: a KAPE survey.

Acceptance of Family Planning services has been at a very slow pace in Africa. It was generally believed that the African male, due to his conservatism, was an obstacle to the acceptance of contraception by the African female. The study however showed that this was not true. The attitude of the African male towards contraception has changed drastically during the last thirty years, from ultra-conservatism during the 60s to very liberal in the 80s and 90s. Further it can be said that the African male is as well informed and has the same degree of Family Planning and child spacing acceptance-level as his counterpart in the developed world. However the African male does not accompany his partner for Family Planning Counselling. The study showed that most African men associate Family Planning with the use of condoms and not other methods such as the pill or the intrauterine devices.

PIP: A research field assistant interviewed 260 men living in villages in Kgalagadi (Kalahari) district in Botswana to determine their acceptance of family planning (FP). 74% knew something about FP and 81.2% knew that the health facility provided FP services. While women in another survey in the same district were more likely to report a health worker as the first person to tell them about FP (86.3%), men were more likely to mention friends, family, and others (69.9%). Most men (75%) discussed FP with their partners. Just 13.5% went with their partners to FP counseling sessions. 36.5% believed contraceptives encourage infidelity and would be so angry if their partners were using contraceptives that they would beat them. Only 35.4% said that only women should practice FP. 30.8% considered prevention of transmission of sexually transmitted diseases to be a man's duty. 33.8% said that both men and women should cooperate in FP. 78.5% considered too many children for their partners as not good, but for financial reasons, not health reasons. 51.9% wanted more than 3 children. 88.4% believed contraceptives were safe. Most men linked condoms to FP. 45.7% consistently used condoms. 86.2% wanted their partners to use FP while the other believed it to be against biblical teachings. Only 6.9% would ever think about having a vasectomy. Just 20.8% knew about female surgical sterilization. In conclusion, most men knew about and accepted FP. FP workers must step up promotion of male attendance at FP counseling sessions. They also need to inform men that other FP methods besides condoms exist.

Men and family planning in Zambia.

This paper examines the sociodemographic factors which influence familiarity with methods of family planning among 85 males holding low paying jobs in the University of Zambia, Lusaka. The results showed that wife's education had a significant and positive effect on husband's familiarity with family planning methods. In the longer term, female education is likely to emerge as an important factor in the onset of fertility decline in Zambia.

PIP: Communication between marriage partners is one way men become familiar with family planning (FP). In this study the role of women's education in husband's familiarity with FP methods is examined among 85 low income (around 4464 kwacha average annual income) male employees of the University of Zambia. The men in the sample were all literate and most were non-Catholic. Wife's work status, husband's monthly income, husband's education, desire for more children, religious affiliation, and urban born were control variables. The findings were that the pill and the IUD were the best-known female methods. 22% knew about condoms, and 8% about vasectomy, but 70% were familiar with abstinence, which is widespread as a traditional FP method among Africans. 78% communicated with their partners about FP and 47% spoke with friends about FP. 29% considered FP a women's responsibility. 44% thought that their mothers would approve of FP use. In the regression analysis, wives' education and religion were significantly related to familiarity of FP methods (p.05). Familiarity increased with increases in wives' level of education. Wives' education was related to use of family planning, i.e., 36% of women with a primary education used FP compared with 12% of women with primary or less education. The government of Zambia encourages modern family planning for child spacing and fertility control. Successful policy implementation will depend on the extent to which women's education is recognized as important in promoting modern methods. Deterrents to modern contraceptive use are the existing laws which require married women to have their husband's permission to obtain contraceptives from clinics. Creating easier access to FP among women is likely to increase familiarity of FP among husbands and equal sharing in decision making about contraception.

Caribbean male: macho and insensitive?

PIP: 185, 50, and 104 men aged 15-44 years were interviewed, respectively, in Barbados, St. Lucia, and Grenada in three attitudinal studies designed to get an objective look at male attitudes in the region on family planning and human sexuality. Qualitative information was obtained on fertility and contraceptive use, attitudes toward premarital sex, fidelity and relationships, and influences upon male behavior. Men wanted an average of 2.5 children in Barbados, 4 in St. Lucia, and 3.5 in Grenada. Monogamy was not paramount, with 56% of Grenadian men reporting having overlapping sexual relations. There was also a substantial tolerance for illegitimacy, especially among married men and men with post-secondary education. In St. Lucia, relationships are conducted on the man's terms. For example, men may have sexual relationships with multiple women, but it is unacceptable for women to have other men. Most men, however, agreed that fathers should have a say in the upbringing of their children and should visit and support them financially even if the parents do not live together. Many respondents had unstable relationships with their fathers, and a large proportion had not lived with them. 63% of respondents knew their fathers had outside women. Men were aware and supportive of family planning, and generally try to use contraception. 78% of men interviewed in Grenada and 75% of men interviewed in St. Lucia endorse birth control, while 52% of the respondents in St. Lucia practice family planning. Younger, relatively inexperienced men were most typically in need of more knowledge and greater practice of family planning. Family planning programs should be targeted accordingly.^ieng

Family planning knowledge, attitudes, and practices of men in Zimbabwe.

The purpose of this report is to describe knowledge, attitudes, and practices in family planning among male Zimbabweans. Understanding the role of men in inhibiting or promoting contraceptive adoption could affect the design of family planning promotion programs and program success in Zimbabwe and other African countries. Data from the 1988 Male Fertility Survey, a representative sample of 711 currently married men aged 20 and over, showed that men have a major role in the decision to use family planning methods and in determining the number of children a couple should have. Male knowledge of various family planning methods was high, as was approval and ever-use of family planning. Attitudes toward family planning information, obtaining methods, couple communication, and family size were also investigated. It was concluded that men should be included in information, education, and communication programs, without delay. Program efforts should move beyond emphasis on child spacing to stress family size limitation in order to increase contraceptive prevalence, resulting in a commensurate decline in the level of fertility.

PIP: This report described knowledge, attitudes, and practices in family planning among males in Zimbabwe. Understanding the role of men in inhibiting or promoting contraceptives use could affect the design of family planning promotion programs and program success in Zimbabwe and other African countries. Data from the 1988 Male Fertility Survey, a representative sample of 711 currently married men ages 20 and over, showed that men play a major role in the decision to use family planning and in determining the number of children a couple should have. Male knowledge of various family planning methods was high, as was approval and ever-use of family planning. Attitudes toward family planning information, obtaining methods, communication between couples, and family size were also investigated. It was concluded that men should be included in IEC programs without hesitation. Program efforts should move beyond emphasis on child spacing to stress family size limitation in order to increase contraceptive prevalence, which would result in a commensurate decline in the level of fertility.

Male knowledge of and attitudes and practices towards AIDS in Zimbabwe.

This paper presents findings from a survey on knowledge of and attitudes and practices towards AIDS among currently married Zimbabwean men conducted between April and June 1988. Findings indicated that knowledge was reasonably high: 89.7% reported having heard of AIDS. The young and middle-aged groups, the most educated, and the urban men were the most knowledgeable in identifying routes of transmission. However, 22% did not know that there could be asymptomatic carriers of the virus capable of transmitting the virus and infecting others. Furthermore, 38% did not know that all those affected with AIDS eventually die as a result, and only 55% knew that there is no cure for AIDS. Behavioral change in order to avoid contracting AIDS seems relatively low given this sample's history of sexually transmitted diseases and extramarital sexual relations during the year prior to the survey. Although condom use was the lowest percentage of the behavioral change categories, a high percentage reported ever using a condom.

A direct mailing to teenage males about condom use: its impact on knowledge, attitudes and sexual behavior.

In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males 16-17 years of age. An experimental design was used to measure the impact of the mailing on teenagers' knowledge, attitudes and behavior. Approximately five weeks after the mailing, 985 members of this group and 1,033 members of the control group (who received no mailing) were interviewed by telephone. About seven months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about three-fourths of the teenagers in the experimental group had received the materials, and about two-thirds had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes toward STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to first intercourse, suggesting a possibly important early intervention.

PIP: In August 1987, a letter, informational pamphlet and order coupon for free mail-order condoms were sent to an experimental group of teenage males ages 16-17. An experimental design was used to measure the impact of the mailing on teens' knowledge, attitudes, and behavior. Approximately 5 weeks after the mailing, 985 members of this group and 1033 members of the control group (who received no mailing) were interviewed by telephone. About 7 months after the mailing, members of the experimental group who claimed they had ordered the free condoms were reinterviewed by phone. The results of the initial interviews revealed that about 3/4 of the teens in the experimental group had received the materials, and about 2/3 had read them. Moreover, males in the experimental group, particularly those who reported having received and read the pamphlet, were slightly but statistically significantly more knowledgeable about sexually transmitted diseases (STDs), pregnancy, and contraceptives. On the other hand, there were no differences between males in the experimental and control groups in attitudes towards STDs or birth control, nor were there differences in actual sexual activity or in the use of birth control. However, the experimental group was significantly more likely to have ordered condoms by mail, presumably as a result of having received the free mail-order condom offer. Many of those who ordered condoms had previously had sex and had used condoms. However, a sizeable portion of those who ordered condoms did so prior to 1st intercourse, suggesting a possibly important early intervention.