A study on the knowledge and practice of contraception among men in the United Arab Emirates

Emergency Contraception Knowledge, Attitudes, and Barriers Among Men: A Cross-Sectional Study

Background Emergency contraception (EC) plays a pivotal role in the prevention of unintended pregnancies following unprotected sexual intercourse. Men's awareness regarding emergency contraception is pivotal for informed decision-making and for enhancing reproductive health in this context. This study investigated Syrian men's awareness and perspectives on emergency contraception to inform diverse reproductive health initiatives. Methods We conducted a cross-sectional study in Syria, from June 2022 and April 2023. Our study included male participants aged 18 years or older who held Syrian nationality and volunteered to participate. The data collection involved administering a questionnaire comprising three sections (knowledge, attitude, and barrier assessment), encompassing a total of 30 questions. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY). Results Most participants were aged 18-25 (65.7%) and single (75.4%) and held a university degree (79.3%). The knowledge of emergency contraception was low (36.1%), with the Internet and social media (77.5%) being the primary sources of information. While 89% held positive attitudes toward emergency contraception, only 37.3% supported nonprescription availability. Age, income, and desire for children were associated with knowledge, attitudes, and the use of emergency contraception. Men aged 26-35 exhibited the highest positive attitude (8.11±1.83). Those desiring no children showed higher attitude scores (7.42±2.04). Income was positively associated with knowledge (adjusted odds ratio {AOR}=1.75 and confidence interval {CI}=1.02-2.99) and emergency contraception use (AOR=2.87 and CI=1.27-6.48). Conclusion This study underscores the knowledge gap regarding emergency contraception in Syrian men. Despite positive attitudes, awareness remains limited, particularly among those of childbearing age. Targeted education and improved accessibility to emergency contraception can enhance its use among men, particularly in those with low socioeconomic status and younger age groups.

Scoping review of sexual and reproductive healthcare for men in the MENA (Middle East and North Africa) region: a handful of paradoxes?

Background

No study appraised the knowledge gaps and factors impacting men’s sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task.

Methods

We searched PubMed and Web of Science (WoS) electronic databases for original articles on men’s SRH published from MENA. Data was extracted from the selected articles and mapped out employing the WHO framework for operationalising SRH. Analyses and data synthesis identified the factors impacting on men’s experiences of and access to SRH.

Results

A total of 98 articles met the inclusion criteria and were included in the analysis. The majority of studies focused on HIV and other sexually transmissible infections (67%); followed by comprehensive education and information (10%); contraception counselling/provision (9%); sexual function and psychosexual counselling (5%); fertility care (8%); and gender-based violence prevention, support/care (1%). There were no studies on antenatal/intrapartum/postnatal care and on safe abortion care (0% for both). Conceptually, there was lack of knowledge of the different domains of men’s SRH, with negative attitudes, and many misconceptions; as well as a deficiency of health system policies, strategies and interventions for SRH.

Conclusion

Men’s SRH is not sufficiently prioritized. We observed five ‘paradoxes’: strong focus on HIV/AIDS, when MENA has low prevalence of HIV; weak focus on both fertility and sexual dysfunctions, despite their high prevalence in MENA; no publications on men’s involvement in sexual gender-based violence, despite its frequency across MENA; no studies of men’s involvement in antenatal/intrapartum/postnatal care, despite the international literature valuing such involvement; and, many studies identifying lack of SRH knowledge, but no publications on policies and strategies addressing such shortcoming. These ‘mismatches’ suggest the necessity for efforts to enhance the education of the general population and healthcare workers, as well as improvements across MENA health systems, with future research examining their effects on men’s SRH.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14716-2.

Knowledge, attitudes, and perception patterns of contraception methods: Cross-sectional study among Saudi males

Purpose:

The aim of this study is to assess the knowledge, attitude, and perception pattern of contraception and family planning among males in Saudi Arabia.

Methods:

A cross-sectional study was conducted using a self-administered questionnaire. Study sample were Saudi males who presented to the urology clinics in one tertiary center. Beside demographic data, we evaluate the responders’ knowledge about types of contraceptive methods, usage of one or more methods, reasons for using contraceptives, knowledge of contraception complications, awareness of religious opinion on contraception, the ideal number of children, and birth interval between them. Statistical analysis was performed using the Chi-square and Fisher's exact tests. A value of P < 0.05 was considered statistically significant.

Results:

Two hundred and forty-three subjects filled the questioner. The participants’ mean age was 42.7 years (range, 19–81); 227 (93.4%) were married. The majority of the participants were aware of the concept of contraception (79%). However, only 54% of the cohort reported using at least one type of contraception. A high percentage of the participants wanted a limited number of children with longer birth intervals. Many factors are responsible for increasing awareness and practice of contraception, additionally; there is limited knowledge and practice regarding male contraception, particularly vasectomy. Withdrawal technique and oral contraceptive pills for females were the most commonly used contraceptive methods for Saudi family planning. The most common reason for using birth control methods was having a lot of children. More than two-thirds of males believed that birth control methods are not prohibited by Islamic law.

Conclusions:

Younger age, shorter duration of marriage, governmental employee, less number of children, higher education degree, and higher monthly income had higher impact on contraception awareness and utilization. Couples still prefer noninvasive methods for contraception. Despite the relatively low use of contraceptive methods, particularly the male methods, the majority of the participants know about contraception. Efforts to advocate and promote the effective use of reproductive and sexual health services among newly married couples are warranted.

A. Ahmed A. Men's knowledge, attitude, and barriers towards emergency contraception: A facility based cross-sectional study at King Saud University Medical City

BACKGROUND

Male partners have a considerable role in influencing women's contraceptive decision making to reduce the chance of unintended pregnancy. Most studies are focused on women's knowledge and barriers for emergency contraception (EC) use. There is limited research on this topic from the male perspective. This study aimed to gather baseline data on men's knowledge, attitudes and barriers about EC.

METHODS

Descriptive analytic cross-sectional study was conducted from Dec 2019 -May 2020 at the King Khalid University Hospital (KKUH); a teaching facility with general and subspecialty medical services in King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. Data were collected using a structured pretested questionnaire and analyzed using SPSS version 23.0. Descriptive statistics and Chi square tests were used. Multivariate logistic regression analysis was used to find significant predictors for EC awareness and use. A p value < 0.05 was considered statistically significant.

RESULTS

A total of 461 participants completed the questionnaire (response rate 86%). The majority (82%) of the participants were unaware of EC; with only 18% having some knowledge. Knowledgeable men had positive attitudes (73.5%) about EC as compared to non- knowledgeable ones (55.0%). Factors found to be associated with less knowledge of EC were cultural [0.46, 95%CI 0.22. 0.96] and religious unacceptability [OR 0.51, 95%CI 0.29, 0.89)]. Higher level of education [OR 1.83, 95%CI 0.94, 3.53] was associated with more knowledge regarding EC. The study showed that correct information about using contraceptives within 3 days of unprotected sex [OR 4.96, 95%CI 1.81, 13.60]; availability without prescription [OR 5.06, 95%CI 1.68, 15.30], EC advertisement [OR 4.84, 95%CI 0.96, 24.27] and receipt of information from family/friends [OR 18.50, 95%CI 5.19, 65.93] were factors that contributed to men using EC.

CONCLUSION

The current knowledge of EC among men is limited. Social determinants affect these levels of knowledge, as well as the usage of EC. Factors that were associated with the use of ECPs were correct knowledge, advertisement, availability and receipt of information from family/friends. The findings highlight the need to educate men on this important topic to avoid unintended pregnancy, keeping in view cultural and social values. Future qualitative studies are needed to understand the male perspective.

Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates

OBJECTIVES

This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE).

METHODS

This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection.

RESULTS

The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis.

CONCLUSION

Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.

Perception and practice of contraception among male soldiers in Sobi barracks, Ilorin, Nigeria

BACKGROUND

There is a popular belief among the general population that Nigerian soldiers tend to have large families but this has not been substantiated with evidence-based research. The Nigerian military health authority implements female-targetted contraception strategies, with less focus on their husbands; who are the dominant fertility determinants.

OBJECTIVE

To determine the perception and practice of contraception among male soldiers of Sobi Cantonment, Ilorin, Nigeria, with a view to instituting male-targeted contraceptive/family planning strategies.

METHODOLOGY

A cross-sectional survey of 334 male soldiers using multistage sampling technique and pre-tested interviewer administered questionnaires.

RESULTS

The respondents' approval of contraception (73.6%) and willingness to discuss it with their spouses/partners (71.6%) were high. Fear of wives/partner's sexual promiscuity (55.7%), cultural and religious beliefs (43.2%), fear of the side effects of contraceptives (29.5%) and the desire for more children (21.6%) were reported reasons for the non-approval of contraception. The prevalence of contraceptive use among the respondents was low (12.3%). There was a significant relationship between the respondents' educational level and contraceptive use (p< 0.05).

CONCLUSION

The study revealed a high approval and willingness to discuss contraception with their spouses/partners but low contraceptive use.

Space, agency, and withdrawal: birth control choices of women in Turkey

Withdrawal (WD) is not a reliable method for preventing unwanted pregnancies, yet it is still a very popular form of birth control in many societies, including Turkey. We look at the relationship between women's agency and physical space in relation to birth control choices of women in Turkey. Agency in our context refers to a woman's ability to resist domination and subordination to the patriarchal beliefs valuing her reproductivity over her pleasure. Our analysis of the Turkish Demographic Health Survey (TDHS) suggests that (a) the available space in the household for possible private encounters between husband and wife, and (b) the women's capacity to insert her agency into her life choices are closely correlated with WD choices. Women with better social and physical resources prefer WD less.

Muslim women's reflections on the acceptability of vaginal microbicidal products to prevent HIV infection

This paper examines South African Muslim women's opinions of the acceptability of microbicidal products to prevent HIV infection if these were to become available in the future. In the context of the HIV pandemic, prophylactic methods such as male circumcision, vaccines and microbicidal preparations are increasingly thought of as ways to reduce the incidence of infection. We examine the extent to which participants' religious beliefs and the implications of religious norms and ideals might influence decision-making concerning hypothetical acceptability to use a microbicide. We conducted qualitative interviews with 29 Muslim women residing in South Africa, a country with one of the highest HIV prevalence rates in the world. Four themes emerged from the data, namely, (1) participants' questioning of the need for microbicides; (2) reasons they gave in favour of microbicide use; (3) the juxtaposition of microbicide use and religious ethics; and (4) the role of religious authorities in decision-making regarding microbicide use. The juxtaposition of microbicide use and religious ethics was further informed by three sub-themes, namely, the life-promoting nature of both Islam and microbicide use, the possibility that microbicide use could encourage sexual risk-taking among male partners, and that the use of these products contradicted womens' notions of ethical agency and ideals about marriage. These themes and sub-themes are analysed in the context of gender relations among South African Muslims. The study findings are significant in light of recent data showing the effectiveness of a microbicidal preparation in reducing the risk of HIV infection in South Africa. We also show that the acceptability of microbicidal products is to a certain extent linked to a variety of religious persuasions and ideals. When microbicides become available in the future, proponents of their use will need to consider religious reasoning of potential users, including that of Muslim women.

Determinants of choosing withdrawal over modern contraceptive methods in Turkey

OBJECTIVES

The determinants of the use of withdrawal in Turkey are examined using a multinomial logistic model.

METHODS

Data were drawn from a nation-wide population-based cross-sectional study, the Turkish Demographic Health Surveys that took place in 1998 and 2003. Detailed interviews were conducted with 8576 women aged 15-49 and analysed using SPSS.

RESULTS

Contextual, cultural and demographic characteristics define women's choice of withdrawal over modern methods. Socio-economic status, education, employment status, and past fertility behaviour are among key determinants. First-ever used contraception method has a very strong impact on later choices. Urban women, the more educated, those with better socioeconomic status, and those living in less crowded households resort less to withdrawal. Experience and empowerment positively linked to modern contraceptive use among women in Turkey.

CONCLUSIONS

The use of contraceptive methods in Turkey differs greatly. Empowerment of women in terms of better socioeconomic status, better education, modern and liberal attitudes towards women and family planning seem to reduce withdrawal use as the main method of contraception. The results suggest the need for education (particularly targeting young women and couples), information and provision of modern contraceptive services particularly for disadvantaged groups.

Contraceptive awareness among men in Bangladesh

OBJECTIVE

A considerable gap exists between contraceptive awareness and use. Traditional approaches to measuring awareness are inadequate to properly understand the linkages between awareness and use. The objective of this study was to examine the degree of men's modern contraceptive awareness in Bangladesh and the associated determinants and further testing of a hypothesis that current contraceptive use confers a high degree of method awareness.

METHODS

This study used the couple data set from the Bangladesh Demographic and Health Survey (1999-2000). A two-level, multinomial logistic regression was used with the degree of contraceptive awareness as the dependent variable. The degree of awareness was measured by the reported number of modern contraceptive methods known among men aged 15-59 years. Men's responses on method awareness were classified according to those reported spontaneously and probed.

RESULTS

Nearly 100% of the study participants reported having heard of at least one method and about half reported awareness of at least eight different methods of contraception. Multinomial logistic regression analyses showed that older and educated men were more likely to have reported a high degree of awareness. The findings confirmed our hypothesis that current contraceptive use is likely to confer a high degree of modern method awareness among men (p<0.001), after controlling for other important characteristics.

CONCLUSIONS

Men who had a low degree of contraceptive awareness seem not properly informed of the wide range of contraceptive options. It is imperative that family planning intervention strategies in Bangladesh should focus on the degree and functional knowledge of contraceptive methods to improve the uptake of especially male-based modern methods.

Male hormonal contraception: concept proven, product in sight?

Current male hormonal contraceptive (MHC) regimens act at various levels within the hypothalamic pituitary testicular axis, principally to induce the withdrawal of the pituitary gonadotrophins and in turn intratesticular androgen production and spermatogenesis. Azoospermia or severe oligozoospermia result from the inhibition of spermatogonial maturation and sperm release (spermiation). All regimens include an androgen to maintain virilization, while in many the suppression of gonadotrophins/spermatogenesis is augmented by the addition of another anti-gonadotrophic agent (progestin, GnRH antagonist). The suppression of sperm concentration to 1 x 10(6)/ml appears to provide comparable contraceptive efficacy to female hormonal methods, but the confidence intervals around these estimates remain relatively large, reflecting the limited number of exposure years reported. Also, inconsistencies in the rapidity and depth of spermatogenic suppression, potential for secondary escape of sperm into the ejaculate and onset of fertility return not readily explainable by analysis of subject serum hormone levels, germ cell number or intratesticular steroidogenesis, are apparent. As such, a better understanding of the endocrine and genetic regulation of spermatogenesis is necessary and may allow for new treatment paradigms. The development of an effective, consumer-friendly male contraceptive remains challenging, as it requires strong translational cooperation not only between basic scientists and clinicians but also between public and private sectors. At present, a prototype MHC product using a long-acting injectable testosterone and depot progestin is well advanced.

Attitudes of married individuals towards oral contraceptives: a qualitative study in Istanbul, Turkey

OBJECTIVE

To determine positive and negative attitudes of married Turkish women and men regarding the use of oral contraceptives (OCs).

METHODS

Twenty focus group discussions were conducted during the period October 1998-March 1999 in Umraniye, which is one of the densely populated districts of Istanbul.

RESULTS

Most of the negative attitudes relating to OCs stemmed from concerns over side effects, particularly in the male focus groups. Health care professionals' behaviour, lack of concern or bias, and their reluctance to prescribe also limited the uptake of OCs. The female groups had very positive attitudes towards OCs compared to those of the male groups. It was identified that although OCs are largely provided free of charge in Turkey, beliefs and attitudes towards them are the important factors which affect the uptake of the method.

CONCLUSION

Special efforts may be needed to educate these groups and also to teach the health professionals about family planning counselling.