Men and Boys Sexual Health in South Asia Supported by Department for International Development, UK

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Men and Boys Sexual Health in South Asia
Supported by Department for International
Development, UK
Global Symposium Engaging Men and Boys Tim
Shand Jameel Zamir
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How does International Planned Parenthood
Federation (IPPF) look at men and boys?

• Traditional family planning provider womens
  rights advocate most clients are female
• Primarily take male involvement perspective
• Expertise, experience and interest in this issue
  varies across the organisation
• Issue cuts across our strategic priorities
  Adolescents/young people AIDS Abortion
  Access Advocacy
• IPPF Policy on Men SRH
• IPPF believes that in order to address
  underlying power and gender imbalances, and their
  effects on health, it is essential to work with
  men and boys in promoting gender equality

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DFID supported research on Gender Equality
Mens Sexual Health

• Countries
• Bangladesh, India, Nepal and Pakistan
• Objectives
• To assess mens knowledge and attitude to gender
  equality and SRH needs of women and men
• To assess mens health seeking behavior relating
  to SRH and their vulnerabilities
• To explore service providers own perceptions
  about the SRH needs of men and women and
  vulnerability of men and
• To look for associations, and make
  recommendations for policy, research and
  interventions

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• Respondents and tools
• Structured questionnaires with married men (15
  -54 years)
• Semi- structured questionnaires health service
  providers
• Focus group discussions with men and women (FGD
  guidelines)
• Study location
• India (Gwalior)
• Bangladesh (Jamalpur)
• Nepal (Sunsari)
• Pakistan (Faisalabad)
• Sample size
• 1475 married men (aged15 -54) and 55 health
  service providers were interviewed

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Characteristics of men and boys

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Gender Equitable Men (GEM) Scale Items

• Masculinity and Sexuality
• Sexual Reproductive health and infection
  prevention
• Gender roles and Violence
• Domestic life and child care

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Gender Equitable Men Scale results

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Mean GEM Scale Score
Plt0.05 (t-test)
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of men currently using family planning with
their partner
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Current use of family planning methods
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Men and boys attitudes about contraception
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Source of contraceptive methods for men/boys
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STI and SRH problems and health seeking behaviour
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Sexual health problems/concerns faced by men

• Expressed anxieties decreased sexual desire, not
  being able to satisfy partner, anxiety over shape
  of penis, worries about nocturnal emissions,
  reduced quantity of sperms and masturbation
• Functionality related problems premature
  ejaculation, impotence, pain during intercourse,
  erectile dysfunction, discharge from the genitals
  
• Symptoms / infection boils and wounds in the
  genital region, itching in genital region,
  swollen testicles, burning sensation in
  urination, syphilis and TB

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Attitude towards women and masculinity

• Its impossible for men and women to truly
  understand each other
• In all societies it is inevitable that one sex
  is dominant
• When women work they are taking jobs away from
  men
• When women get rights they are taking rights
  away from men
• agreed or some what agreed

37 59 52 to 75 15 to 73 12 to 64
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of fathers who often spent time with their
children for different things
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Discussion / Outcomes

• Moderate/high level of equitable attitudes
  displayed by men and boys across all countries
• Areas where key challenges remain domestic
  violence post-child birth womens work
• Family planning use significantly associated with
  equitable norms among men
• Significant knowledge gaps remain (e.g. SRH and
  HIV) and misinformation (e.g. on masturbation)
• Men/boys have wide range of SRH problems and
  anxieties
• Barriers to access of services attitudinal (e.g.
  service providers) and structural (e.g. opening
  times)

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Recommendations

• SRH Interventions
• Comprehensive challenge social norms re.
  masculinity
• Engage the private sector and traditional
  providers
• Service provider capacity building/training
• Enabling environment for men beyond female
  spaces
• Reaching most vulnerable men/those in rural
  locations
• Policy
• Recognise/build upon existing equitable
  behaviours and desires among men in South Asia to
  do more
• Greater focus on mens SRH needs (age specific),
  misinformation and lack of health seeking
  behaviour
• Supporting greater father/parent involvement

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Recommendations

• Further research
• Addressing attitudinal barriers among men safe
  sex seen as unpleasurable sex
• Reaching most vulnerable men and boys,
  particularly men who have sex with men/different
  sexual orientations
• Reaching unmarried males, particularly young men

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Acknowledgements

• Abhijit Das
• Anjali Sen
• Armin Neogi
• Ataur Rahman
• Ajay Singh
• Giridhari Sharma
• Helee
• Iffat Chaudary
• Ishita
• Moulasha
• Manodeep
• Nirmal
• Ravi Verma
• Shahana

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THANK YOU

• jzamir_at_ippfsar.org
• tshand_at_ippf.org
• www.ippf.org

A world where women, men and young people
everywhere have control over their bodies where
gender and sexuality are no longer a source of
inequality or stigma Sexual Rights An IPPF
Declaration