Young men's understanding of hormonal contraception: Knowing me, knowing you

Couples-focused contraceptive services represent an emerging and relatively unexplored area of reproductive health. In order to design programs that assist young men in supporting women's consistent and correct use of hormonal contraception, a better understanding is needed of men's knowledge, attitudes, norms and behaviors regarding pregnancy prevention. To this end, we conducted an ethnographic investigation of 149 ethnically diverse young adults (18-25 years). This presentation will focus on findings from contraceptive life-history interviews with 41 heterosexually active males. They discussed their first and up to six subsequent sexual partners, and illustrated their experiences regarding hormonal contraception use, decision-making and communication. We found wide variation in male attitudes and behaviors regarding their role in pregnancy prevention, from obsessive concern to uncaring. Similarly, their attitudes and norms varied regarding method choice and use. Some believed women should have complete control, others felt male views should be included. Several men had concerns about trusting some partners to use hormonal contraceptives effectively. The data suggested that some men's lack of knowledge about hormonal methods can adversely affect their partner's method use. We found that attitudes and practice regarding talking and deciding about contraception are influenced by a complex interplay of factors such as relationship context and expectations. These factors operate in a milieu where most partner and method choices are not fixed. Understanding the variety of young men's knowledge and roles regarding hormonal contraception will help in designing programs that address incorrect method knowledge, method communication, contraceptive switching and unintended pregnancy.