Online Program

Assessing interventions to increase use of reproductive health (RH) and sexually transmitted infection (STI) services by male clients at family planning (FP) clinics

Monday, November 4, 2013 : 9:10 a.m. - 9:30 a.m.

Lee Warner, PhD, Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA
David Johnson, MPH, US Department of Health and Human Services, Office of Population Affairs, Rockville, MD
Sarah Salomon, MPH, Cardea Services, Seattle, WA
David Fine, PhD, Cardea Services, Seattle, WA
Background: 92% of U.S. family planning (FP) clinic clients are women, but men also benefit from RH services. The DHHS/OPA-funded Male Reproductive Health Project (2009-13) is implementing empirically-based interventions to increase male FP clinic clients and STI services.

Objective: Assess impacts of clinic and community interventions on male FP client census and services.

Methods: Project interventions (2010-11) at 2 Family Health Center (FHC) FP clinics (San Diego, CA) included: outreach via female clinic clients; efficiency assessments; staff training on male services; and modifying clinic environments. We compared service provision at 2 intervention clinics to 6 comparison clinics where innovations were not introduced. Chlamydia and gonorrhea (CT/GC) testing was analyzed by client characteristics, timeframe (pre-intervention=2007-2008; post=2010-2011) and condition. Multivariate models were developed.

Results: Male RH client visits (n=16,007; 50%:50% E:C) were mostly Hispanic (69%) and aged <30 (55%). Intervention clinics increased male visits by 99% (pre-intervention: mean=671 visits/clinic/year; post-intervention: mean=1,336 visits/year/clinic, p<0.01); comparison clinics increased male visits 4% (325 to 339 visits/year/clinic). At intervention clinics, male CT/GC testing increased 31% (pre-/post-intervention=32%/42%, p<0.01); comparison clinics' CT/GC testing was stable (pre/post=32%/33%). Controlling for demographic and visit characteristics, testing was higher at experimental sites (AOR=1.23, 95%CI=1.12-1.34) and post-intervention (AOR=1.29, 95%CI=1.18-1.40). Female FP visits decreased comparably by condition (experimental: pre/post=72,862/54,161, -26%; comparison: pre/post=47,213/34,103, -28%).

Conclusions: Intervention clinics increased male FP client volume and proportion of males tested for CT/GC versus clinics that did not change practices. Increasing the number of male clients or male services did not differentially reduce female FP visits or CT/GC screening.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related research

Learning Objectives:
Describe key elements of the project intervention; Summarize intervention effects; Discuss how these project results were used by clinic managers to modify their service protocols, e.g. HIV/STI screening decisions for male clients

Keyword(s): Service Delivery, Male Reproductive Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: during the past 20 years--as an epidemiologist, senior health scientist, and currently Associate Director for Science with the Division of Reproductive Health, CDC, Atlanta--I have studied STD/HIV prevention interventions, contraceptive care, circumcision, vasectomy and other reproductive health issues in community and public health field settings. My publishing history includes being author or coauthor of approximately 45 publications and book chapters.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.