[Men want to speak out]. / Los hombres piden la palabra.

PIP: Long before the appearance of oral contraceptives, men took the lead in controlling family size, especially in the developed countries, through use of condoms and withdrawal. But women now have almost total priority in the field of family planning (FP). The risks of too many pregnancies, FP services offered through maternal child health care workers, and the networks, and the women's liberation movement have been the main factors in the predominance of women in FP. In recent years, however, organizations and expert in FP have recognized the need to incorporate men in FP programs. Men must not take part in the struggle for improved living conditions. A recent report by the International Planned Parenthood Federation states that men have not only been almost ignored in FP programs, but have been excluded in the belief that they constitute an obstacle to the efficacy of programs. Failure to involve men in FP and contraceptive decisions has led to an increase in the rate of unplanned pregnancies and ultimately to as lower quality of life for many families. Men have also been neglected in the area of contraceptive research and development. It has proven much less difficult to develop a range of contraceptive methods to control the single egg produced each month by a woman then to control the millions of sperm produced by a man. Rapid heterosexual transmission of AIDS has prompted significant efforts to motivate men to use condoms, which has had a certain demographic effect. Information campaigns have been prepared to create male awareness of condom use and to change attitudes toward FP. Research has shown that men in different countries desire access to different contraceptive methods, but that many are mistrustful of new drugs and devices that are rumored to harm users. Some men also fear that use of new male contraceptives will bring a change in the balance of social control between the sexes. Only through information campaigns, increased services for men, personal contact in community activities, and communication between partners will real incorporation of men into the process of FP be possible. Available methods requiring male participation are the condom, vasectomy, withdrawal, and rhythm. Condoms protect against sexually transmitted diseases and are safe and effective when correctly used. Vasectomy is 99% effective but is a permanent method appropriate only for couples whose families are complete. Withdrawal is an ancient method used by an estimated 35 million couples in 1986, but like the rhythm method sit has a high failure rate.^ieng