Perspectives on and willingness to use a novel male hormonal contraceptive - a qualitative study of Black males in Los Angeles, California, USA
ESC Congress Library. Nguyen B. May 11, 2018; 208249; ESC259 Disclosure(s): N/A
Dr. Brian Nguyen
Dr. Brian Nguyen
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Abstract
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Objective: Perspectives of the Black community on novel male hormonal contraceptives (MHCs) have not been explored, but are critical for the development and dissemination of a contraceptive that will effectively prevent unintended and unwanted pregnancy among a population with reported higher rates of contraceptive non-use in the United States. Design and methods: We conducted five structured focus groups with heterosexual, Black men over the age of 18, who were recruited by a community partner, Healthy African American Families II, in Los Angeles, California. Focus groups lasted approximately 60 minutes and were facilitated by an Asian American male researcher and an African American male community partner, using a preset script with open-ended probes. We explored the men's attitudes towards and willingness to use a novel MHC, with relevant examinations of their reproductive experiences and relationships. Discussions were audio-taped and transcribed verbatim. Using modified grounded theory and the constant comparative method, the research team independently coded the transcripts and came together to organize and refine overarching themes. Results: Thirty-nine men participated in the groups, with ages ranging from 18-70 (median: 33) years. Approximately half of the participants reported at least some college education, full-time employment, and having a child; 32% (12/37) reported not wanting any(more) children in the future. 40% (13/32) endorsed that men should use a novel method of male birth control; 36% (12/33) reported that they would definitely use a MHC in the future. Six themes related to Black men's MHC attitudes emerged, in order of salience: (1) concerns about safety and side effects; (2) concerns about reversibility and impact on future fertility; (3) changing contraceptive norms; (4) uncoupling of sex and procreation/parenthood; (5) context-specific variations in willingness to use a MHC; (6) preferences for MHC characteristics. Negative attitudes towards MHCs were discussed across all groups, not limited to their distrust of the medical community. However, all groups described numerous scenarios where they would use a MHC despite their concerns, recognizing changing attitudes towards personal and/or shared reproductive responsibility and gender equality, and citing age, relationship status, relationship trust, and socioeconomic status as factors contributing to their willingness to use a MHC. Men valued the sexual freedom and alleviation of pregnancy-related anxieties entailed by a novel, reversible MHC.  Conclusions: Multiple concerns about MHCs were substantiated by our discussions with Black men. However in-depth discussions reveal perceived benefits to men, their female partners, and their community, that would increase their willingness to use MHCs despite their concerns. 
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