A reproductive health intervention combining a highly explicit half-hour slide-tape program with a personal health consultation was provided to male patients aged 15-18 at a large health maintenance organization. A test of the consultation's impact against a control group provides no support for the argument that highly explicit instruction in contraception encourages early initiation of intercourse. In fact, the consultation may have reduced pressure to become sexually active among young men who had never had sexual intercourse. There is also some evidence that the consultation helped improve the effectiveness of contraceptive practice among the men who were sexually active at follow-up; those exposed to the consultation were more likely than those who were not to report that their last intercourse was protected by the pill and that their main method of contraception in the previous year was the pill. Compared with those in the control group, patients who received the health consultation scored higher on measures of fertility knowledge and knowledge of the prevention of sexually transmitted diseases, including AIDS. Furthermore, the young men who had the consultation were more likely to have practiced testicular self-examination. In many cases, however, the positive effects of the consultation were stronger or were only statistically significant among those who had not been sexually active at the time of the baseline survey.
PIP: This case-control study examined the effects of a reproductive health intervention directed to 15-18 year old adolescent male members of a US health maintenance organization. The intervention combined an explicit slide-tape program with a personal health consultation designed to improve contraceptive practice and knowledge of fertility, prevent sexually transmitted diseases, increase the practice of testicular self-examination, and ameliorate coercive sexual attitudes. Comparison with controls revealed that the intervention did not encourage early initiation of intercourse but may, in fact, have reduced pressure to become sexually active. There was some evidence at follow-up that the intervention improved the effectiveness of contraceptive practice among the men who were sexually active. Cases scored higher than controls on measures of knowledge in the subjects covered by the intervention. The intervention had the greatest impact on young men who were not sexually active at the time of the baseline survey. This implies that additional efforts should be directed to young men who are already sexually active and use contraceptives in an inconsistent manner (or not at all). The breadth of the topics covered in the intervention and the use of audiovisual materials are possible reasons for its success.