PART 1

CHAPTER IV

AWARENESS, KNOWLEDGE AND PERSONAL BELIEFS ABOUT FAMILY PLANNING AND ABORTION

Public awareness, information and education are essential to attaining sustained improvements in family planning and prevention of unintended pregnancy. Preventive health care approach is based on empowering people of both genders to manage their own sexual and reproductive health through access to adequate information. However, only few surveys of men have been conducted in the industrialized world to examine men’s sexual and reproductive health awareness, knowledge and personal beliefs.  

1.4.1. Awareness

This survey found that about 18% of men are not aware that a woman is able to conceive after just one unprotected intercourse. About 52% had no idea or an incorrect one, as to when in her monthly cycle it is more likely for a woman to become pregnant (Figure 1.4.1).

Almost all respondents (99%) were aware of at least one method of protection from unwanted pregnancy. Number of known methods varied from 0 to 9 (Figure 1.4.2), and on the average, respondents were aware of about 4 methods (Mean±SD = 3.94±1.78). Table 1.4.1. summarizes the awareness of men about the specific methods of birth control. Among the methods known by the majority of survey respondents were the condom (97%), withdrawal method (87%) and the IUD (83%). Most men knew where to obtain condoms (95%) and where the IUD might be inserted (73%). Only 38% of men knew about hormonal contraceptive pills and 31% knew where it is possible to buy them. Awareness about sterilization was very low: only 14% had ever heard about female sterilization and only 8% had heard about vasectomy (male sterilization). 

The friends were found to be the most important source of information about condom (66%) and withdrawal method (66%). Information about the pills was obtained mainly through written press (35%), health providers (23%), friends (18%) and sexual partners (16%). The most important sources of information about the IUDs were sexual partners (39%) and health providers (26%).  

1.4.2. Knowledge

In order to make conclusions about the level of men’s knowledge about contraceptive methods and abortion, we created a special score of knowledge that was based on the number of correct answers on related questions. The highest possible value was equal to 26 points, however the maximal score reached by the respondents was 23 and an average was 9.8 (SD=3.74). According to the score of knowledge we subdivided the sample population into three conventional groups. It was found that about one half of men (50%) had poor family planning knowledge, 47% had average knowledge, and only in 3% of men was the knowledge good (Figure 1.4.3).

A number of factors, such as age, education, place of living, and level of urbanization determined men’s knowledge about the methods of birth control. The Figures 1.4.4 demonstrates that the mean score of knowledge about family planning increased with the age of men, but still was at the level of below average. It was lower in adolescents, below 20 years of age, as compared to men older than 24 (p<0.00).

It was found also that men with a university level of education have better knowledge of family planning methods, as compared with lower educated respondents (p<0.00). The knowledge was also better in urban men as compared to rural (p<0.00). Among important determinants of the knowledge of men was the place of residence. Those men, who were living in Yerevan, Aragatsotn or Gegarkunic regions had better knowledge of family planning, as compared to inhabitants of other regions (Figure 1.4.5.).

1.4.3.  Personal Beliefs

We investigated the personal beliefs of survey respondent about the benefits and risks of specific contraceptive methods and the consequences of induced abortion. More than 21% of men had the opinion that taking pills for too long can cause female facial hair growth and 11% believe that it may result in infertility. There were men (13%) who were sure or suspected that taking the pills increased the risk of a woman getting cancer (Table 1.4.2.).

Although 60% of men believed that IUD insertion is easier as compared to abortion, still about 15% of them had contrary ideas. The majority of men (64%) were aware of possible infertility as a consequence of induced abortion, while 2% of men believed that it is not true and 33% were not sure (Figure 1.4.6).

In this study we also investigated opinions of men towards specific contraceptive methods. Those men who never heard of any of the methods were excluded from the analysis. The percentage distribution of men according to their opinions about the condoms, pills, the withdrawal method and IUDs are demonstrated in Figure 1.4.7.

The general opinion expressed by more than one half of the survey respondents was that both condoms and withdrawal are safe and reliable methods. The majority had a positive opinion in relation to ease of use of condoms, but 44% found it disturbing for sexual satisfaction. The withdrawal method was considered not to be easy to use (51%) and disturbed sexual satisfaction (70%).

About 32% of men supposed that the use of hormonal contraceptive pills is not safe, but another 11% were unaware of their safety. The majority (70%) had positive opinion in relation to ease of their use. Almost 47% considered that pills are reliable, but 17% had an opposite opinion and 36% had no idea.  The general opinions about the safety of IUDs were positive in 42% of men.  The majority considered an IUD as a reliable (60%) means of family planning. About 45% of men supposed that it is not difficult for women to have an IUD inserted, and 24% considered that IUDs might disturb sexual satisfaction.

For a comparative assessment of the attitudes to each known method of birth control we constructed a score on opinions based on the scale from 1 to 3 points  (positive opinion = 1, neutral = 2, and negative = 3). Results of the comparative analysis of the mean scores on opinions about safety and reliability of methods, as well about the ease of their use and influence on sexual relationship are summarized in Figure 1.4.8.

The general opinion of men was most positive about the safety of vaginal douching, condoms and spermicides and most negative about the safety of abortion, sterilization and hormonal contraceptives. The most reliable were considered female and male sterilization, and IUDs.  The general opinions were that pills, condoms, vaginal douching and spermicides were considered as methods, which are easy to use. The most disturbing for sexual relationship was considered withdrawal method and less disturbing – vaginal douching.