Female condom study explores role of peer support in sustaining use. Women's forum.

PIP: The AIDS Control and Prevention (AIDSCAP) Project's Women's Initiative, together with the US Agency for International Development, supported a study of the use of female condoms. 96 women in 10 focus groups in Nairobi and Sao Paulo participated in a discussion group about their experiences with the female condom designed to determine how the female condom affects women's ability to negotiate safer sex and to identify reasons for continued use and nonuse of the device. The study design allowed participants to help each other devise strategies for negotiating the use of the female condom with their partners and to sustain that use through peer support. Most of the women reported that use of the condom gave them the courage to discuss sex with their husbands and boyfriends. They remained, however, wary about occasionally denying their partners sexual intercourse. The study's design, women's networks, and men's perspective on the female condom are discussed. 55 men in six focus groups reported preferring the female condom over the tight and uncomfortable male condom, and planned to use them if made available.^ieng

IUSSP activities. Committee on Anthropological Demography. Report: Seminar on Fertility and the Male Life Cycle in the Era of Fertility Decline, Zacatecas, Mexico, 13-16 November 1995.

PIP: This article gives an overview of a conference on Fertility and the Male Life Cycle held in Mexico on November 13-16, 1995. The seminars, organized by anthropological demographers, were based on the view that differences in men's life course events affect how many children are produced, when children are produced, and the kind of support given to children. Little research has focused on male fertility. Two overview papers addressed the issues of men's changing sexual and reproductive intentions as a response to economic changes (Jane Guyer) and theories of male fertility trends in industrialized countries (David Coleman). Other papers were presented on the following topics: changes in male fertility, sexuality and the male life cycle, polygyny and fertility, men's notions of sexuality and reproductive health, masculinity and reproduction, and future research directions. Laurent Toulemon and Evelyne Lapierre-Adamcyk and Katarina Pohl presented papers on gender differences in fertility. Philip Setel presented an analysis of the social construction of parenthood among Coastal Boiken in Papua New Guinea. Paul Miret discussed men's role in the sharp decline in Spanish fertility. Nosa Orobaton contrasted African men's changing roles over the life course. Differences in fertility among polygynous populations in Africa and in China were analyzed by Ann Blanc and Anastasia Gage, and James Lee and Wang Feng. Other papers were prepared by Juan Gillermo Figueroa Perea, John Anarfi and Clara Korkor, Frances L. Goldscheider et al., Benno de Keijzer, and Mario Humberto Ruz, Ondina Fachel Leal and Jandyra M.G. Fachel, and Kamran Asdar Ali. Seminar papers were expected to be published in several collections.^ieng

Mexican agencies reach teenagers.

PIP: The Gente Joven project of the Mexican Foundation for Family Planning (MEXFAM) trains young volunteers in 19 cities to spread messages about sexually transmitted diseases and population growth to their peers. They also distribute condoms and spermicides. It also uses films and materials to spread its messages. The project would like to influence young men's behavior, but the Latin image of machismo poses a big challenge. It would like to become more responsible toward pregnancy prevention. About 50% of adolescents have sexual intercourse, but few use contraceptives resulting in a high adolescent pregnancy rate. Many of these pregnant teenagers choose not to marry. Adolescent pregnancy leads to girls leaving school, few marketable skills, and rearing children alone. Besides women who began childbearing as a teenager have 1.5 times more children than other women. Male involvement in pregnancy prevention should improve these statistics. As late as 1973, the Health Code banned promotion and sales of contraceptives, but by 1992 about 50% of women of reproductive age use contraceptives. The Center for the Orientation of Adolescents has organized 8 Young Men's Clubs in Mexico City to involve male teenagers more in family planning and to develop self-confidence. It uses a holistic approach to their development through discussions with their peers. A MEXFAM study shows that young men are not close with their fathers who tend to exude a machismo attitude, thus the young men do not have a role model for responsible sexual behavior. MEXFAM's work is cut out for them, however, since the same study indicates that 50% of the young men believe it is fine to have 1 girlfriend and 33% think women should earn more than men. A teenager volunteer reports, however, that more boys have been coming to him for contraception and information than girls in 1992 while in other years girls outnumbered the boys.^ieng

Making vasectomy attractive.

PIP: In 1989, Pro-Pater, a private, nonprofit family planning organization in Brazil, used attractive ads with the message Vasectomy, An Act of Love to promote vasectomy. The number of vasectomies performed/day at Pro-Pater clinics increased from 11 to 20 during the publicity campaign and fell after the ads stopped but continued at higher levels. Word of mouth communication among friends, neighbors, and relatives who had vasectomies maintained these high levels. This type of communication reduced the fear that often involves vasectomies because men hear from men they know and trust that vasectomies are harmless and do not deprive them of potency. In Sao Paulo, the percentage of men familiar with vasectomies and how they are performed increased after the campaign, but in Salvador, knowledge did not increase even though the number of vasectomies in Pro-Pater clinics increased. Organizations in Colombia and Guatemala have also been effective in educating men about vasectomies. These successes were especially relevant in Latin American where machismo has been an obstacle of family planning programs. The no-scalpel technique 1st introduced in China in 1974 reduces the fear of vasectomy and has fewer complications than the conventional technique. Further trained physicians can perform the no-scalpel technique in about 10 minutes compared with 15 minutes for the conventional technique. In 1987 during a 1-day festival in Thailand, physicians averaged 57 no-scalpel vasectomies/day compared with only 33 for conventional vasectomies. This technique has not spread to Guatemala, Brazil, Colombia, the US, and some countries in Asia and Africa. Extensive research does not indicate that vasectomy has an increased risk of testicular cancer, prostate cancer, and myocardial infarction. Physicians are working on ways to improve vasectomy.^ieng

Caribbean male: macho and insensitive?

PIP: 185, 50, and 104 men aged 15-44 years were interviewed, respectively, in Barbados, St. Lucia, and Grenada in three attitudinal studies designed to get an objective look at male attitudes in the region on family planning and human sexuality. Qualitative information was obtained on fertility and contraceptive use, attitudes toward premarital sex, fidelity and relationships, and influences upon male behavior. Men wanted an average of 2.5 children in Barbados, 4 in St. Lucia, and 3.5 in Grenada. Monogamy was not paramount, with 56% of Grenadian men reporting having overlapping sexual relations. There was also a substantial tolerance for illegitimacy, especially among married men and men with post-secondary education. In St. Lucia, relationships are conducted on the man's terms. For example, men may have sexual relationships with multiple women, but it is unacceptable for women to have other men. Most men, however, agreed that fathers should have a say in the upbringing of their children and should visit and support them financially even if the parents do not live together. Many respondents had unstable relationships with their fathers, and a large proportion had not lived with them. 63% of respondents knew their fathers had outside women. Men were aware and supportive of family planning, and generally try to use contraception. 78% of men interviewed in Grenada and 75% of men interviewed in St. Lucia endorse birth control, while 52% of the respondents in St. Lucia practice family planning. Younger, relatively inexperienced men were most typically in need of more knowledge and greater practice of family planning. Family planning programs should be targeted accordingly.^ieng

Focus groups reveal consumer ambivalence.

PIP: According to qualitative research, Salvadoreans are ambivalent about the use of contraceptives. Since complete responsibility for management of the CSM project was accepted by the Association Demografica Salvadorena (ADS), the agency which operates the contraceptive social marketing project in El Salvador, in November 1980, the need for decisions in such areas as product price increases, introduction of new condom brands, promotion of the vaginal foaming tablet, and assessment of product sales performance had arisen. The ICSMP funded market research, completed during 1983, was intended to provide the data on which such decisions by ADS could be based. The qualitative research involved 8 focus groups, comprised of men and women, aged 18-45, contraceptive users and nonusers, from the middle and lower socioeconomic strata of the city of San Salvador and other suburban areas. In each group a moderator led discussion of family planning and probed respondents for specific attitudes, knowledge, and behavior regarding the use of contraceptives. To assess attitudes at a more emotional level, moderators asked respondents to "draw" their ideas on certain issues. A marked discrepancy was revealed between respondents' intellectual responses to the issues raised in group discussion, as opposed to their feelings expressed in the drawings. Intellectually, participants responded very positively to family planning practice, but when they were asked to draw their perceptions, ambivalent feelings emerged. Drawings of both the user and the nonuser convey primarily negative aspects for either choice. The user is tense and moody toward her children; the nonuser loses her attractiveness and "dies." Figures also show drawings of some of the attitudes of single and married male participants. 1 drawing shows an incomplete and a complete circle, symbolizing a sterilized man (incomplete) and a nonsterilized man (complete). Another picture depicts a chained man who has lost his freedom (sterilized) versus a world of abundance and strength enjoyed by a nonsterilized man. The results of the projective drawings are only a small part of the total market research effort in El Salvador, yet they seem to indicate that the development of a CSM project communications strategy is critically important to product sales and continued product use. New advertising messages will need to be carefully tested and much communication expertise will be required to develop a message that will contribute to resolving consumer ambivalences toward product use.^ieng

Social class and family size as determinants of attributed machismo, femininity, and family planning: a field study in two South American communities.

PIP: A study was conducted to determine the way in which stereotypes of machismo and femininity are associated with family size and perceptions of family planning. A total of 144 adults, male and female, from a lower class and an upper middle class urban area in Colombia were asked to respond to photographs of Colombian families varying in size and state of completeness. The study illustrated the critical role of sex-role identity and sex-role organization as variables having an effect on fertility. The lower-class respondents described parents in the photographs as significantly more macho or feminine because of their children than the upper-middle-class subjects did. Future research should attempt to measure when this drive to sex-role identity is strongest, i.e., when men and women are most driven to reproduce in order to "prove" themselves. Both lower- and upper-middle-class male groups considered male dominance in marriage to be directly linked with family size. Perceptions of the use of family planning decreased linearly with family size for both social groups, although the lower-class females attributed more family planning to spouses of large families than upper-middle-class females. It is suggested that further research deal with the ways in which constructs of machismo and male dominance vary between the sexes and among socioeconomic groups and the ways in which they impact on fertility.^ieng