Each year, more than half of all US pregnancies and 20 million sexually transmitted infections (STIs) are found to be unintended, both of which are associated with the number of people availing family planning services. Yesterday, as a part of June’s Men’s Health Month, Centers for Disease Control and Prevention (CDC) and HHS Office of Population Affairs reveled that more men in the US are visiting family planning offices to avail the services of the Title X family planning program.
The percentage of men visiting clinics to avail family planning services soared from 4.5% in 2003 to 8.8% in 2014, nearly double the last figure. Although the number is still small but a significant increase can be seen.
Wanda Barfield MD, MPH, Director of CDC’s Division of Reproductive Health, thinks that this trend is very ‘encouraging’. Dr Bafield says, “Men have family planning needs that not only have implications for their sexual and reproductive health, but also can have an impact on their overall health”.
The Title X family planning program, under the Department of Human Services’ Office of Population Affairs (OPA), was established in 1970 with the aim of providing cost-effective family planning and preventive healthcare services with priority to men and women coming from low-income households. CDC also suggests that family planning services can be expanded through providing more counseling and healthcare services to men.
Susan Moskosky, Acting Director of OPA, said that the agency is actively working to increase the number of men who avail Title X services. The agency has been working on training programs and funding multiple projects over the past 15 years to “improve outreach and appropriate male-centered service delivery”.
Nearly half of the men availing these Title X services were young adults aged 20-29 with a major portion being non-Hispanic white men. However, according to a CDC press release, the percentages of men from different states vary from 1% or less in Mississipi, Tennesse, and Alabama to 27.2% in the District of Columbia.
Additionally, sex without contraception has a conception probability of 3-5 % with the probability of acquiring an infection depending on multiple factors such as number of partners, condom use and exposure to a partner who is infected. The math is simple — according to epidemiological studies, greater family planning service usage results in greater contraception usage which leads to lesser unintended pregnancies and incidences of STIs (where male condoms are used).
Unintended pregnancies can result in physically, economically, and psychologically adverse events. In 2011, out of a total of 6.1 million pregnancies, 2.8 million were unintentional. Every 3 out of 10 such pregnancies ended in an abortion which is an increasingly political issue.
However, moral ambiguity is not the only consequence of abortion.
Abortion costs can also differ according to location, timing and facility. Planned Parenthood rounds the costs for medication abortion between $300-800 and $300-950 for an aspiration abortion (in the first 12 weeks). The total public expenditure on unintended pregnancies for the year 2010 was $21 billion in state and federal funds.
Increased family planning is positively correlated to smaller family sizes, longer gaps between children, increased opportunities for preconceptional concealing, and fewer infant, child, and maternal deaths, all of which provide social, economic and health benefits. As a result, CDC has previously identified family planning as one of the 10 great public health achievements in the United States.
The use of increased family planning services can also help avoid any sexually transmitted infections (STIs) and diseases in men. According to CDC estimates, more than half of people in United States will have an STD or STI in their life time.
The 2014 CDC surveillance report shows that STIs, especially syphilis, are on the rise among males in the US, who account for more than 90% of all primary and secondary syphilis cases.
Gays and bisexual men account for 83% of syphilis cases (where sex of the partner is known). Syphilis infection also puts a person at an increased risk of HIV infection. Nearly half of men who have sex with men (MSM) having syphilis, also have HIV.
Dr Sonia Singh, from CDC’s National Center for HIV, STD, and TB Prevention, says that HIV prevention among men who have sex with other men (MSM) is a top priority at CDC.
The financial costs of STIS are considerable — STIs can cost the US up to 19.7 million dollars in new infections. Furthermore, these infections can cost the US healthcare system a whopping $15.6 billion each year.
Future signs are encouraging though – US male contraceptive use has seen an increase in previous years. According to Guttmacher Institute, male use of condoms has increased to 93% in 2010 from a mere 52% in 1982. In addition, 7% of men aged 15-44 in the US have had a vasectomy with the proportion increasing with age.