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RHO archives : Topics : Men and Reproductive Health

Annotated Bibliography

This is page 2 of the Men and Reproductive Health Annotated Bibliography. This page contains:

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Reaching adolescent males

Also see the Annotated Bibliography for the Adolescent Reproductive Health section.

Ajuwon, A. J. et al. "Sexual Coercion Among Adolescents in Ibadan, Nigeria: The Perspectives of Males." Paper presented at WHO Afro Regional meeting in Pretoria, South Africa (27–29 September 2000).
This paper summarizes findings from a study in Nigeria that identifies reproductive health behaviors that adolescents perceive as coercive. The most frequently mentioned were rape, unwanted touch, mockery, forceful exposure to pornographic film, and incest. They concurred that perpetrators of sexual coercion are not strangers to their victims, but tend to be boyfriends, fellow students, neighbors, and parents. Participants in the study (15–19 years old) agreed that typically males are the perpetrators and females the main victims. The study recommends that interventions targeting boys should focus on helping them appreciate the consequences of their actions and provide them with the skills that enable them to take responsible actions in resolving conflicts in their relationship with girls.

Ampofo, A.A.. Aben wo ha: Socialisation of Boys and Girls and Behavioral Outcomes: Sexual Identity and Practices [abstract]. Paper presented at WHO Afro Regional meeting in Pretoria, South Africa, (27–29 September 2000).
The paper reviews existing literature on what is known about boys' knowledge about sexual matters, the source of their knowledge and mode of transmission; attitudes about their own sexuality, and the role of sex in their lives, including their attitudes to females and views on gender roles and relations.

Armstrong, B. et al. Involving men in reproductive health: The young men's clinic. American Journal of Public Health 89(6):902–905 (1999).
This article describes the population served by and the services offered through the Young Men's Clinic in New York City. The clinic was started in 1986 and serves about 1,200 men aged 14 to 34 each year. Services provided include physical examinations, treatment for acute illness, and the management of chronic illness, as well as dealing with issues related to reproductive health and psychosocial problems. A review of clinic data from 1995 revealed that two-thirds of clients had ever been sexually active, three-quarters had ever used birth control, and 69 percent had used birth control at their last sexual encounter. Although most Young Men's Clinic patients had been sexually active for several years prior to their first clinic visit, the predominant reason given for first visits was routine health care needs such as physical examinations. Over one quarter (26%) of the young men who presented for a routine physical examination were also treated for an STI. The findings of this study suggest that young men have a need for and are eager to access reproductive health clinics, especially when the needs they consider important (for example, for sports and school physicals) are addressed as well.

Barker, G. Boys, Men and HIV/AIDS. UNAIDS Briefing Paper (second draft). Instituto Promundo, Rio de Janeiro, Brazil, 18 January 2000.
The author provides a broad but comprehensive overview of missed opportunities to engage boys and men in sexual and reproductive health, and makes several recommendations for working with men. His thesis is that engaging men as partners in health and gender equity will lead to slowing the spread of HIV while improving the lives of the men, their families, and their partners. Acknowledging that men, like women, are a diverse group, and addressing the fact that some men engage in multiple sexual relations, including sex with other men, are key elements of Barker's recommendations for slowing the spread of HIV/AIDS and addressing men's health needs. The paper analyses how the socialization of boys contributes to men's risky behaviors. Recommendations for working with adolescent boys wherever boys hang out (such as at schools, workplaces, and military facilities) and lessons learned in working with men, such as providing men with STI treatment and general health care, and engaging satisfied clients to reach other men contribute to the wealth of information found in this paper. The report also describes some of the projects that work with men.

Barker, G. "Listening to Boys: Some Reflections on Adolescent Boys and Gender Equity." Paper presented at the AWID Conference Panel "Male Involvement in Sexual and Reproductive Health: Hindrance or Help to Gender Equity?" (November 12, 1999).
This presentation offers insights on adolescent boys and their socialization from the voices of boys themselves and considers the implications of what we know about adolescent boys for working with them to promote gender equity, including greater involvement in reproductive health. The author concludes that promoting gender equity during adolescence may be more effective than later on; evidence suggests that young men frequently are more willing than adult men to consider alternative views about their roles in reproductive health and are in the process of forming their values—values that often shape lifelong patterns. The paper describes the gender-specific health needs and concerns of boys. The author concludes that male socialization has direct consequences for young men's health, including their risk-taking behaviors such as substance use, violence, and unsafe sexual practices. Insights from boys who are identified as having a "gender equity" perspective found that their perspective was shaped by interactions with a relative or family friend or someone in their social circle who either modeled or supported nontraditional gender stereotypes.

Centerwall, E. Sexuality Education for Adolescent Boys. Swedish Association for Sex Education. Sweden (1995).
The Swedish Association Sex Education (RFSU) published this booklet, which advocates for sexuality education for adolescent boys. An underlining theme is the fact that men's sexual patterns have to change given current trends to provide women equal opportunity in all aspects of life. Furthermore, men must take on the responsibility of providing information to boys. The text addresses the socialization of young boys by suggesting that parents may hinder adolescent boys' formation of self-identity, and friends give inaccurate information about sexual matters. It underlines the role adult men play in generating self-esteem in young men when they provide guidance and closeness. Nordic sexuality educators are taught to address all matters related to sexuality with a gender and rights perspective. For instance, masturbation is acknowledged and accepted; pornography is discussed in terms of its exploitation of women and the fact that the pictures do not represent real life; and homosexuality is presented in the context of the right to affirm one's sexual identity. .

Erulkar, A.S., and Mensch, B.S. "Gender Differences in Dating Experiences and Sexual Behaviour Among Adolescents in Kenya." Paper presented at the 23rd Population Conference of the International Union for the Scientific Study of Population, Beijing (11–17 October 1997).
This study addresses the sexual initiation of adolescents in Kenya. The authors present information about adolescents' attitudes about gender roles (boys have more traditional attitudes than girls); their sexual activity (most young people who engaged in any kind of sexual act also reported engaging in penetrative sex); the role that peer pressure and attitudes about gender play in adolescent sexuality as well as coercion and forced sex. The study finds that peer pressure is an important factor encouraging premarital activity among boys. It also reports that boys who coerce girls into sexual relations scored significantly lower on the gender-role scale than boys who did not exhibit such behavior. Although the study failed to find more conclusive correlations between gender attitudes and sexual behavior, it is progressive in its multi-faceted approach to adolescent sexual activity and its conviction that adolescent sexuality should be studied within the context of adolescents' lives.

Irvin, A. Taking Steps of Courage: Teaching Adolescents about Sexuality and Gender in Nigeria and Cameroun. New York: International Women's Health Coalition (2000). Available in English, French, and Portuguese at: www.iwhc.org/index.cfm?fuseaction=page&pageID=71.
This report discusses sexuality education approaches for adolescents, particularly the application of gender-sensitive approaches. It includes program examples as well as a list of related resources.

Lundgren, R. Research Protocols to Study Sexual and Reproductive Health of Male Adolescents and Young Adults in Latin America. PAHO, Division of Health Promotion and Protection/family Health and Population Program, January 2000. Available at: www.paho.org/English/HPP/HPF/ADOL/protocol.htm).
The author proposes an ambitious study on various aspects of male adolescents along with the tools required to undertake it. She discusses the gaps in knowledge about this population, and lists the objectives of her study, which include understanding the significance masculinity holds for youth, identifying socialization patterns that lead to the construction of distinct forms of masculinity, understanding how the meanings of masculinity are manifested in sexual and reproductive heath attitudes and behaviors, and determining where boys and young men obtain information on reproductive and sexual health. The author identifies aspects about male adolescents that need further research. The tools she plans to use, focus group guides, individual interview guides, a survey, and the Informed Consent form she developed are annexed to the paper.

Nnko, S.E.A. "Risk Behaviours of Male Adolescents in Tanzania: Motives and Patterns of Their Sexual Relationship ." Paper presented at the WHO/UNAIDS Afro Regional Meeting in Pretoria, South Africa (2729 September 2000).
The paper presents a review of various research experiences on male adolescents in Sub-Saharan Africa, with a focus on Tanzania. The overview provides extensive data on the prevalence of HIV/AIDS: 1.6 percent among males aged between 15 to 19, and 8.1 percent among males between the ages of 20 and 24. Furthermore, it finds that only 5 percent of male pupils who are sexually active ever used a condom. In Tanzania, researchers question the sugar daddy theory, in which young girls are believed to be likely to have sex with middle aged men; instead, they found that 18- to 25-year-old out-of-school males are the older men that are more likely to seduce young girls. Sexual coercion, the threat or use of force by young men, plays a significant role in sexual encounters among adolescents in Tanzania. The study makes the following recommendations for programs that work with male adolescents: work with young men in school and out of school; design interventions that "fit into existing adolescents' (sub)culture as much as possible," rather than appealing to monogamy or abstinence; promote condom use among adolescents; and work through peer educators.

Pathfinder. Promoting reproductive health for young adults through social marketing and mass media: a review of trends and practices. Focus on Young Adults, Research Series (16 July 1997).
This paper provides guidance for working with young men in all aspects of sexual and reproductive health while providing detailed information on key elements of social marketing programs. It analyzes strategies used by successful programs and reports on aspects that contributed to their success. The paper summarizes the analytical literature; describes key elements of project design, implementation, and evaluation; and defines critical research questions that enhance the effectiveness of interventions. It defines social marketing as a process that combines techniques used in commercial advertising, market research, and the social sciences to achieve such objectives as increased use of health-related products (condoms), increased access to health services, and changes in health behavior and practices (abstinence or reducing the number of sexual partners). Other topics addressed are audience segmentation, behavioral change, mass media, peer and other forms of interpersonal education, involvement of youth and gatekeepers, training, advocacy, monitoring and management and evaluation tools. A table that summarizes ongoing social marketing young adult reproductive health lists these projects by region and illustrates they key activities.

Senderowitz, J. A Review of Program Approaches to Adolescent Reproductive Health. USAID: Poptech assignment number 2000.176. (June 2000). Available at: www.poptechproject.com/library/review06_00.htm).
This publication provides in-depth information on program issues related to adolescent reproductive health in developed and developing countries. The paper classifies approaches to adolescent reproductive health under three objectives and describes the strategies used to achieve them: (1) fostering an enabling environment; (2) improving knowledge skills, attitudes, and self-efficacy; and (3) improving health-seeking and safer sex practices. The review includes information about the benefits young men derive from a specific program, and approaches used to attract male adolescents. The bulk of the review provides information on successful strategies such as working in partnership with youth organizations, including schools, community-based organizations, and NGOs that work with young people; youth development projects; peer programs; using mass media; building linkages with employers; and using new technologies, a strategy found to be particularly successful in reaching young men.

Social Marketing for Adolescent Sexual Health (SMASH). "Results of Operation Research in Botswana, Cameroon, Guinea, South Africa." Measure Communication Reports (June 2000). Available online at www.prb.org.
This document evaluates social marketing campaigns undertaken in Botswana, Cameroon, Guinea, and South Africa under the guidance of PSI and with funding from USAID. It describes the projects, summarizes the lessons learned, and considers their implication on future programs. The evaluation found that the programs tended to have a greater effect on young women than on young men, suggesting that social marketing program should take into account differences in male and female concerns. Other lessons learned include (1) Changing behavior may require intensive program efforts of at least two to three years; (2) Social marketing programs targeting youth are most effective if they include a carefully designed mix of mass media promotion and interpersonal communication; (3) The promotion of condoms for STI or HIV/AIDS prevention requires careful communication strategies to reduce the stigmas associated with condom use; (4) Youth involvement in program design is beneficial, but guidance and facilitation may be necessary to keep adolescents focused on critical issues; (5) Social marketing programs targeting youth should have measurable objectives and clearly identified assumptions about behavior change; (6) Evaluation is needed to measure the impact of program activities; (7) Greater collaboration among NGOs is needed to advocate successful policy change.

Varga, C. A. "The Forgotten Fifty Percent: A Review of Sexual and Reproductive Health Literature on Boys and Young Men in Sub-Saharan Africa." Paper presented at the WHO Afro Regional Meeting in Pretoria, South Africa, (27–29 September 2000).
This literature review begins by making the case for male involvement given boys' early initiation in sexual relations, the need to treat both men and women to curtail STIs and prevent HIV/AIDS, and the fact that the condom, a method for men, is the only one that protects against HIV infection. The author takes a thematic approach in reviewing studies on African men in sexual and reproductive health, and uses his findings to advocate for further research on boys and young men in sub-Saharan Africa. African men's knowledge, attitudes, and practices (KAP) in sexual and reproductive health are beginning to be collected in surveys, such as DHS, but the author points out that these tend to focus on adult and married men and thus little is known about the KAP of young unmarried men. Similarly, studies on youth that examine their sexual and reproductive KAP, condom use, and knowledge about HIV/AIDS do not focus specifically on males. Furthermore, studies reveal that youth understand the general mechanics of HIV infection but do not clearly understand the mechanics surrounding HIV such as the difference between HIV and AIDS, the concept of a "window period" in HIV testing, the connection between STI and HIV infection, the relationship between blood contact and infection, and assessing the risk posed by a potential partner. The author concludes that masculinity and the issues associated with it are not clearly understood in sub-Saharan Africa and thus requires further research.

World Health Organization (WHO). Boys in the Picture. Geneva: WHO (2000). Available at: www.who.int/child-adolescent-health/publications/ADH/WHO_FCH_CAH_00.8.htm.
This publication is an advocacy piece for increasing interest in programming for young boys. It makes a case for promoting gender equity to benefit not only boys, but young girls and the whole of society as well.

WHO. What About Boys? Geneva: WHO (2000). Available at: www.who.int/child-adolescent-health/New_Publications/ADH/WHO_FCH_CAH_00.7.pdf.
This literature on the health and development of adolescent boys highlights program and research implications for program design related to male adolescents in the areas of:

  • Adolescent Boys, Socialisation, and Overall Health and Development
  • Mental Health, Suicide, and Substance Use
  • Sexuality, Reproductive Health, and Fatherhood
  • Accidents, Injuries, and Violence

WHO. Working with Boys, Program Experiences. Geneva: WHO (1999). Available at: www.who.int/child-adolescent-health/New_Publications/ADH/WHO_FCH_CAH_00.10.htm. This is a report of a workshop on adolescent boys that was carried out in May 1999. Among the workshop results was recognizing the need to develop systematic methods that use a gender approach. The workshop also determined that there is a need for a stronger evidence base to address the needs of young boys more adequately.

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Men's reproductive health concerns

Best, K. Male circumcision and HIV risk.Network 18(3) (Spring 1998) Available at: www.reproline.jhu.edu/english/6read/6issues/6network/v18-3/nt1832a.ht ml.
This is a report on male circumcision and HIV risk. Studies in developing countries suggest that men who have been circumcised are at lower risk of HIV infection than men who have not been circumcised. U.S. studies have found no such connection.

Bortolotti, A. et al. The epidemiology of erectile dysfunction and its risk factors. International Journal of Andrology 20:323–334 (1997).
This review article summarizes the data regarding incidence of erectile dysfunction. Data are extremely limited, especially for populations outside the United States. Proven and potential risk factors—including age, diabetes, smoking, alcohol consumption, various chronic diseases, and use of certain medications—are discussed.

Eschen, A. et al. "Male Sexuality in Colombia: Implications for New Reproductive Health Services for Men." Paper presented at the American Public Health Association Annual Meeting (November 1999).
This presentation reports on findings from a qualitative study in Columbia done by the Center for Multidisciplinary Research for Development (CIMDER) in association with AVSC International. Its purpose was to understand men's, women's, and providers' knowledge, attitudes, and needs for sexual and reproductive health services for men. It was conducted in the five largest cities of Colombia using 60 focus groups, 720 surveys of service users and non-users, 45 interviews with health care staff from 21 service delivery institutions, and 5 life histories of couples. The study groups included male and female adolescents (ages 14–18), young adults (ages 19–35), and adults (over 35). The study found that men surveyed defined their masculinity according to three themes: virility, responsibility, and reciprocity. Forty-six percent of the men and about 36 percent of women surveyed thought that men were sexually responsible. The predominant feeling, however, was that men fit the macho stereotype; they are sexually hyperactive, selfish in terms of their own pleasure rather than the woman's, they lack tenderness, and they are promiscuous. The study also found that men want more than just information about health. Men also wanted to know how to communicate with children and partners as well as foster new ideas about being gender-sensitive in a changing society. Men also showed concern about sexual risks related to their behavior, either through alcohol or going to sex workers.

Hawkes, S. Why include men? Establishing sexual health clinics for men in rural Bangladesh. Health Policy and Planning 13(2):121–130 (1998).
This article describes the rationale for and experience of establishing STI clinics for men through the Matlab clinic in rural Bangladesh. Recommendations include assessing the acceptability of and need for services in the community, assessing men's health seeking behavior and understanding their concerns, training male health workers to provide services, and using both formal and informal mechanisms to "advertise" services. Though the services were designed to address STIs, the clinic found that a large percentage of men also presented with psychosexual complaints, thereby necessitating additional training for staff in responding to these issues.

Johns Hopkins University Center for Communication Programs. Helping Involve Men (HIM) CD-ROM (1999). To request a copy, contact the JHUCCP at popline@jhuccp.org.
This resource provides easy access to important and programmatic literature on men's participation in reproductive health. HIM contains 11,000 pages of journal articles, technical reports, and books. These essential documents will help program officers, NGOs, health workers, and decision makers design programs and services to increase and encourage men's participation in reproductive health activities. The HIM CD-ROM is being distributed at no cost to policy makers and program planners worldwide. It is available free of charge, with preference given to requests from developing countries.

Pinnock, C. et al. Older men's concerns about their urological health: a qualitative study. Australia and New Zealand Journal of Public Health 22(3):368–373 (1998).
Participants in focus groups identified common urological concerns of older men, including urinary symptoms, prostate cancer, and sexual function. There were many misconceptions about these issues. For some men, urinary concerns were exacerbated by working conditions in which toilets were not readily accessible. Men also identified barriers to taking action on potential health problems, including stoicism and poor relationships with doctors.

Ravi, K., Verma, G., Rangaiyan, S. et al. Cultural perceptions and categorization of male sexual health problems by practitioners and men in a Mumbai slum population. Available at: www.hsph.harvard.edu/Organizations/healthnet/SAsia/suchana/0804/rh05 2.html).
This paper presents data comparing practitioners' and community male's cultural perceptions and categorizing of sexual health problems in a Mumbai slum population. An opportunistic sample of 44 practitioners and 56 community men were contacted in the initial qualitative phase of data collection. Each respondent was asked, "what are all sexual health problems faced by men in this community?". The answer to this question generated a large number of sexual health problems identified by both the men and the practitioners. Sexual weakness, itching around genital areas, burning sensation during urination, early ejaculation, wounds on the genitals, and white discharge were among the most frequently mentioned sexual problems. Both practitioners and the men show anxieties related to sexual weaknesses, semen loss, penile size, and impotence. Doctors were more concerned than men about sexually transmitted infections such as syphilis and gonorrhea. Men, on the other hand prioritized anxieties related to semen-loss issues, "heat," and itching problems.

Schwebke, J.R. et al. Sexually transmitted diseases in Ulaanbaatar, Mongolia. International Journal of STD and AIDS 9(6):354–358 (June 1998).
This study assessed the prevalence of STIs among 137 men and 123 women of mean ages 26 and 28 years, respectively, attending the public health STI clinic in Ulaanbaatar. Overall, study subjects were aged 15 to 62 years and mainly from urban areas. Seven percent of men and 10 percent of women consistently used condoms, and 45 percent of men and 33 percent of women reported ever having had STIs; 31.1 percent, 8.1 percent, and 8.6 percent of men and 10.3 percent, 9.9 percent, and 6.0 percent of women were infected with gonorrhea, chlamydia, and syphilis, respectively; and 19.7 percent of men had nongonococcal urethritis and 67 percent of women had trichomoniasis. Even though no patient was infected with HIV, improved control efforts are urgently needed to prevent the spread of HIV in Mongolia given the existence and communication of STIs in the country.

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Outcomes of "men and reproductive health" programs

Celentano, D.D. et al. Decreasing incidence of HIV and sexually transmitted diseases in young Thai men: evidence for success of the HIV/AIDS control and prevention program. AIDS 12(5):F29–36 (March 26, 1998).
This study sought to determine whether HIV and sexually transmitted infection (STI) incidence rates among young men in northern Thailand have declined since the establishment of the "100 percent Condom Program." Cohorts of 19–23-year-old men (n = 4,086) inducted into military service between 1991 and 1993 were followed at 6-month intervals (through May 1995) for incident HIV and STI. HIV incidence declined from a rate of 2.48 per 100 person-years during 1991–1993 to 0.55 per 100 person-years during 1993–1995. STI incidence showed an even greater decline, with a 10-fold decrease from 1991–1993 to 1993–1995. Based on these dramatic results, the authors recommend expansion of similar prevention activities to other areas in Thailand and in countries experiencing major epidemics of heterosexually transmitted HIV infections.

Danforth, N. and Green, C. Involving Men in Reproductive Health: A Review of USAID-Funded Activities. Arlington: Population Technical Assistance Project (1997).
This report catalogues USAID-funded projects that seek to expand the provision of reproductive health services and information to include men of all ages, whether individually or as part of a sexually active couple. Projects include working with local male leaders to support family planning and MCH activities, training providers to serve couples, advocacy, operations and social science research, STI/HIV/AIDS education and services, and community-based distribution. Approximately 12 percent of USAID project funds are spent on men's involvement activities. The document also reports on the results of a survey of USAID and cooperating agency staff regarding their perceptions of constraints and priorities related to men's involvement. Based on the survey results, the report summarizes key obstacles to increasing men's involvement activities (lack of funding and the woman-centered nature of family planning services) and makes recommendations to USAID for improving men's involvement.

Davidson, N. Men's Sexual Health Matters. London: Healthlink Worldwide (1998).
This easily accessible handbook for health and community workers includes discussions of the rationale for working with men, effective approaches to reach men, men's sexual development and function, common sexual problems men face, and resources for groups working with men. Suggestions for activities are included throughout the text.

Drennan, M. Reproductive Health: New Perspectives on Men's Participation . Population Reports Series J, Number 46, Baltimore, Johns Hopkins University School of Public Health, Population Information Program (October 1998) Available at: www.jhuccp.org/pr/j46edsum.stm).
This issue of Population Reports provides a comprehensive look at men's participation in reproductive health. It includes a discussion of why programs are interested in men as an audience; how men influence the health of women and their families; what survey results show about men's knowledge, attitudes, and behaviors related to reproductive health; the effect of gender issues on couple communication; and lessons learned from program examples. While the primary focus of the issue is on family planning, issues such as men's roles in promoting safe motherhood, reducing STI transmission, and preventing domestic violence also are included.

FOCUS. Overview: Key Elements of Youth Friendly Reproductive Health Programs. Pathfinder International (1998) Available at: http://pf.convio.com/pf/pubs/focus/RPPS-Papers/OverviewKE.html.
This overview article summarizes the reproductive health concerns of young men and describes various approaches that are being used to meet young men's needs for reproductive health information and services. The article provides examples of programs that reach young men through youth centers, community outreach activities, peer education and counseling, male-friendly clinics, mass media, social marketing, and the workplace.

Green, C. et al. Male involvement in reproductive health, including family planning and sexual health. Technical Report 28, UNFPA, New York (1995).
This report includes a comprehensive discussion of the rationale for involving men, major program goals, and strategic issues related to planning services. In addition, the report documents key lessons learned from service delivery and information, communication, and education interventions. Throughout the text are case studies of various programs that address men's reproductive health needs.

Gupta, P.K. and Joshi, A. Leadership, Responsibility and Men's Partnership With Women to Improve Reproductive Health: A Process Documentation of Designing a 4-Day Training Module for Youth in the Jaunpur Area in Tehri Garhwal District in the Central Himalayas of Uttar Pradesh, India. Prepared for The Population Council workshop, Enhancing the Roles and Responsibilities of Men in Sexual and Reproductive Health , Kathmandu, Nepal (June 1998).
This detailed report documents the process of developing a four-day training module on gender and reproductive health for youth in rural India. The issue of gender is viewed within the larger context of social injustice, with the training geared toward generating long-term changes in attitudes and behaviors rather than on just imparting knowledge and skills. The report includes findings of qualitative research to determine beliefs and attitudes related to gender, reproductive health, and other related social issues. Also included is an outline of the workshop, including detailed descriptions of some of the exercises and techniques used, and an evaluation of the workshop's impact.

Healthlink Worldwide. Men's Sexual Health Matters. London: Healthlink Worldwide (1998).
This publication provides practical information for people who are working with men on sexual health or would like to start working with men. It looks at ways of engaging men in discussions about sexual health and sexual responsibility, and men's role in reducing the incidence of unwanted pregnancy, sexually transmitted diseases, and sexual abuse.

IPPF/RHO and AVSC (now EngenderHealth). Cinco Casos de Estudio Para el Simposio Sobre Participacion Masculina en la Salud Sexual y Reproductiva: Nuevos Paradigmas. Oaxaca, Mexico (October 1998).
This report includes four themes: fatherhood, violence, sexuality, and the social construction of masculinity. Content is focused on examples from Latin America including detailed case studies from MEXFAM (Mexico), ECOS (Brazil), CISTAC (Bolivia), Profamilia (Colombia), and Salud y Gnero (Mexico). The report includes programmatic recommendations based on discussion at the Oaxaca Symposium. English summaries of the studies are available on EngenderHealth's Men as Partners website (www.engenderhealth.org/ia/wwm/index.html).

IPPF/RHO and AVSC (now EngenderHealth). Men as Partners Initiative: Summary Report of Literature Review and Case Studies. New York (1998).
Very comprehensive look at men and reproductive health theory, research, and programs in the Americas; emphasis is on Latin America. (Available in Spanish and English.)

Johns Hopkins Center for Communication Programs. Reaching Men Worldwide: Lessons Learned From Family Planning and Communication Projects, 1986–1996. Working Paper No. 3, Johns Hopkins Center for Communication Programs/Population Communication Services/Population Information Program, Baltimore, Maryland (January 1997).
This publication reviews strategies and lessons learned about communicating with men based on 10 years of program experience. The report includes summaries of 20 projects from around the world. Topics covered include designing and implementing programs, advocating for programs, and evaluating program results.

Liow, M.L. et al. Innovative approaches to population programme management: Men and reproductive health. Innovations 4 (1996).
This volume provides a useful summary of the issues facing programs wishing to reach men with reproductive health services. Also included are descriptions of the approaches and lessons learned from programs serving men in eight countries. Examples include empowering women farmers through men in Indonesia, a men's reproductive health service delivery project in the Philippines, men-only clinics in Colombia, increasing men's involvement in family planning in Ghana, reaching men through the media in Zimbabwe, and social marketing campaigns in Pakistan, Philippines, and Viet Nam. Key to the success of all activities was the involvement of men in the design and implementation of the program activities.

Robey, B. et al. Men: Key Partners in Reproductive Health: A Report on the First Conference of French-Speaking African Countries on Men's Participation in Reproductive Health. March 30–April 3, 1998, Ouagadougou, Burkina Faso (1998).
This conference focused on identifying strategies to reach men in French-speaking African countries, with emphasis on overcoming barriers to men's participation and building on decision-making traditions in the region. The report includes a summary of research findings related to men's participation in reproductive health, a summary of obstacles to men's participation and strategies for overcoming them, country action plans from 12 countries in the region, and a list of conference resolutions and recommendations.

Rojanapithayakorn, W. et al. The 100 percent condom program in Thailand [editorial]. AIDS 10(1):1–7 (January 1996).
This nationwide "100 percent Condom Program" aims to ensure that clients of sex workers use condoms during every act of sexual intercourse. It combines a mass media campaign (radio and television) with free condom distribution at sex establishments. In addition, when clients present with STIs at government clinics, clinic workers trace the STI back to the commercial establishment and begin procedures aimed at encouraging the establishment to comply with the 100 percent condom program. At the start of the program, members of Provincial AIDS Commissions met with owners of all commercial sex establishments to discuss the current AIDS situation, how the program worked, how compliance would be monitored, what the penalties were for noncompliance, and the benefits to establishment owners. During 1989–1994, condom use in sex establishments increased from about 14 percent to more than 90 percent, and the STI rate decreased by more than 85 percent. The key factor contributing to the success of the program is that it focuses on a limited goal (i.e., use of condoms in sex establishments).

Wegner, M., et al. Men as partners in reproductive health: from issues to action. International Family Planning Perspectives 24(1):38–42 (March 1998).
This article describes the outcome of an AVSC sponsored workshop on men and reproductive health held in Mombasa. National level action plans were developed by participants at the meeting. The article details the steps needed to put these plans into action. Available in English, French, and Spanish.

Yinger, N. and Murphy, E. Illustrative indicators for programming in men and reproductive health. Washington, DC : PATH. (October 1999).
This document builds on the three "values" developed by the Gender Working Group Men and Reproductive Health Subcommittee. It provides examples of programming and indicators under three core objectives. Detailed tables illustrate the kinds of programs that could be developed to achieve these objectives as well as the kinds of indicators that could be used to measure their success.

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Men and HIV

Aggleton, P. Men's Role in HIV Prevention and Care. Thomas Coram Research Unit, Institute of Education, University of London (2000).
The author presents strategies for embracing men as part of the solution to HIV prevention. He proposes the need for new frameworks that place men alongside women in the global response to HIV and AIDS. Issues addressed in the paper are the socialization of boys, working with younger and older men, breaking the silence about sex, sexuality (including men having sex with men), and stigma. The author also takes a broader view of issues associated with the disease that need to be addressed, such as poverty, alcohol, and drug use. The paper concludes with several policy implications ranging from redefining masculinity to providing job opportunities to young men, to rendering service provision more "men sensitive and men friendly."

Foreman, M., ed. AIDS and Men: Taking Risks or Taking Responsibility? Panos Institute and Zed Books, London (1999).
This book argues that the AIDS epidemic cannot be contained until men are persuaded to reassess their traditional concepts of masculinity. It examines the relationship between men and HIV/AIDS, and suggests that one in four men world-wide have sexual and drug-taking behavior that places themselves and their partners at risk from infection by HIV. The first section of the book explores the impact of men's actions and attitudes on women, children, and other men, and looks at initiatives designed to help men protect themselves and their partners. The second section contains reports written by journalists from Asia, Africa, the Americas, and Eastern Europe that illustrate the way the epidemic affects all men.

Panos Institute. Young Men and HIV - Culture, Poverty and Sexual Risk. Briefing No. 41. London: Panos Institute (July 2001). Available at: www.panos.org.uk..
There are one and a half billion young people under the age of 25 in the world today. Their behavior, attitudes, and beliefs will shape tomorrows world. They are also very vulnerable, especially to sexually transmitted infections, including HIV. Young people experiment with sex, as with other things in their lives. Approximately 60 percent of HIV infections are found in this age group and over half of the worlds population has had unprotected sex before the age of 16. This report argues that AIDS-prevention programs must target young men as well as young women. Many young men know very little about the disease or about where to go for information. They are constrained by the desire toimpress their peers, hide their emotions, and show strength rather than weakness. But because they are still young, change is possible. There is enormous potential to slow the epidemic down. Evidence shows that young men can learn responsible sexual behavior. The full report can be downloaded as a PDF or in a text-only version from the PANOS website.

Scalway, T. "Young Men and HIV in Africa: Challenges and Opportunities." Paper presented at the UNAIDS African Development Forum (December 2000).
This paper provides a comprehensive analysis of the factors that contribute to young men (aged 15–24) driving the HIV epidemic (e.g., non-use of condoms, sex between men, low perception of HIV/AIDS risk) and the analytical tools used to understand gender and gender relations, which are key factor in understanding the spread of HIV. The author argue that young African men's exposure to global media images that idealize unobtainable lifestyles; the mixed messages they receive in school, in church, and from sexual health providers; and the fact that they are lumped together as one group—and the resulting frustration—works against efforts to stem the epidemic. The author concludes by summarizing "tried and tested methods" that have worked elsewhere: peer education, school and media interventions, sports, youth groups, and adapting indigenous traditional rituals and ceremonies by weaving in messages that promote reproductive and sexual health.

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