6C 3 Male Reproductive Health Project 2009-2013: Program Implementation, Research Results and Implications for STD Service Delivery

Thursday, June 12, 2014: 9:50 AM
Grand Ballroom A/B/C/D1
David M. Johnson, MPH1, Sarah Salomon, MPH2, Lee Warner, PhD, MPH3, Alfonso Carlon, BA4 and David Fine, PhD2, 1Office of Population Affairs, U.S. DHHS Office of Population Affairs, Office of Family Planning, Rockville, MD, 2Cardea Services, Seattle, WA, 3Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, 4Cardea Services, Austin, TX

Background:  While >90% of U.S. family planning (FP) clinic clients are women, men also benefit from reproductive health (RH) services, e.g. chlamydia/gonorrhea (CT/GC) testing. The Male Reproductive Health Research Project(2009-13) implemented interventions to increase male clients and services at FP clinics.  We assessed impacts of clinic, staff, and community interventions on male RH client volume and CT/GC-related services.    

Methods:  Beginning 2009, three FP agencies implemented interventions at six experimental (E) clinics, including: restructuring clinic environments; male client recruitment through outreach and clinic in-reach; and training on male clinical services. Agencies identified 9 comparison (C) clinics not implementing innovations. We accessed clinic client information systems (IS) documenting male FP visits. Records included demographics, program characteristics, and STI services and test results. In univariate and multivariate analyses, we evaluated client volume and services by demographic, program, timeframe (pre=2007-09/post=2010-12), and condition variables.

Results:  Relative to the 3 C agencies (n=3,683/1,584/8,322), the 3 E agencies (n=3,503/5,054/12,389) showed significant increases in male FP visits following interventions, 2010-12 (agency pre-post volume changes: C=17%/18%/26%; E=35%/99%/109%, respectively; all p-values<0.05). E site CT testing increased significantly during intervention (e.g. CT testing, E agency: pre/post-intervention=35%/42%; C agency: pre/post=37%/33%; p<0.05). E and C annual %CT+ in males aged <30 years ranged from 6.9%-16.6%. %GC+ was modest (<1.5%). E and C sites had comparable female patient volume and STI service trends 2009-2012.   

Conclusions:  Interventions were practical; E sites successfully implemented innovations. E sites significantly increased male FP patients and STI services. Young adult male FP clients represent a high risk group for CT. Increasing male access did not reduce female FP patients or services. Administrative IS can be used to monitor program innovations, but expanding IS measures is challenging, e.g. documenting sexual risk behaviors. Future work is needed on system models for scaling-up innovations, impact evaluations, and monitoring program management effectiveness.