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Background: The Male Reproductive Health Project (2008-2013) is implementing empirically-based interventions to increase male FP clients and testing for sexually transmitted infections (STI) at 12 FP clinics in the U.S.
Objectives: Assess impact of implementing staff, clinic and community interventions on male FP client census, STI services and outcomes at four FP clinics, 2004-2010.
Methods: In 2009, project interventions included: outreach via FP clinics' female clients and with agencies serving men, clinic efficiency assessments, FP staff training, and modifying clinic environments. For FP client visit records (2004-2010) from 2 grantees—Montana (n=2,891) and San Diego (n=7,008)—HIV and chlamydia (CT) testing and CT positivity (CT+) were analyzed by client characteristics and intervention period (pre:2004-2008; post:2009-2010). Multivariate models developed.
Results: Montana—95% white. Male visits increased 90% (pre-intervention: mean=438 visits/y; post-intervention: mean=833 visits/y). HIV testing increased 79% (pre: 24% visits/y tested; post: 43% visits/y tested). CT testing increased 37% (pre-intervention: 54% visits/y tested; post-intervention: 74% visits/y tested). CT testing predicted by: intervention (AOR=1.51), racial/ethnic minority (AOR=2.08), new client (AOR 5.12), clinic (Billings: AOR=0.44). CT+=13.6%. Young age related to CT+ (age< 20y AOR=2.44). San Diego—67% Hispanic. Male visits increased 58% (pre-intervention: mean=1,115/y; post-intervention: mean=1,823/y). HIV testing increased 90% (pre: 21% visits/y tested; post: 40% visits/y tested). CT testing increased 45% (pre: 29% visits/y tested; post: 42% visits/y). CT testing predicted by: new client (AOR=2.74), age<30 (AOR=0.80), intervention (AOR= 1.46). CT+=6.3%. CT+ predictors: age <20y (AOR=3.13), black race (AOR=1.91), new client (AOR=1.88), clinic (Beach: AOR=0.44).
Conclusions: Interventions significantly increased male FP client census and HIV/CT testing. Young and racial minority males had increased CT risk. Results support using local data to inform male STI services.
Implications for Programs, Policy, and Research: FP agencies can expand mission and services to males. Results led clinics to shift future testing to younger males. The project model can inform STI service policies at local/state levels.