All ETDs from UAB

Advisory Committee Chair

Melonie M Walcott

Advisory Committee Members

Pauline E Jolly

Ellen Funkhouser

John E Ehiri

Mirjam C Kempf

Kui Zhang

Document Type

Dissertation

Date of Award

2013

Degree Name by School

Doctor of Public Health (DrPH) School of Public Health

Abstract

This dissertation consists of three papers designed to assess the association between gender norms and men's sexual behaviors, reproductive practices, and acceptability of male circumcision (MC). The data for this study were obtained from a cross-sectional, interviewer-administered questionnaire survey of 549 men aged 19-54 years, conducted in the western region of Jamaica between June to August 2011. In the first paper we found increased odds of reporting multiple sex partners among men with moderate (AOR =2.2; 95% CI=1.4 - 3.5) and high (AOR = 4.4; 95% CI =2.2 - 8.8) support for inequitable gender norms. Similarly, men with moderate (AOR= 1.8; 95% CI = 1.1 - 2.8) and high (AOR =2.6; 95% CI =1.6 - 4.4) support for masculinity norms were more likely to report multiple sex partners. In the second paper it was found that acceptance of MC varied by the circumcision status of men, and was more favorable for infants and sons than for self. In the multivariable model, which adjusted for age, education, religion and income, there was increased odds of accepting MC for infants/sons among uncircumcised men who accepted MC for self (AOR=8.1; 95% CI = 4.1 - 15.9), believed would experience more pleasure during sex if circumcised (AOR=4.0; 95% CI = 2.0 - 8.2), and reported having no concerns regarding MC (AOR=3.0; 95% CI = 1.8 - 4.8). The third paper revealed reduced odds for taking steps to prevent unwanted pregnancy among men with moderate (AOR = 0.5; 95% CI=0.3 - 0.8) and high (AOR =0.3;95% CI= 0.1 - 0.6) support for inequitable gender norms. Desiring large family size was associated with higher support for macho scores (AOR =2.1; 95% CI 1.3 - 3.3). Among men who had 2 or more children (41%), there was increased odds of having multiple baby mothers among men who had moderate (AOR=2.1; 95%CI=1.0 - 4.4) and high (AOR=2.4; 95%CI=1.1 - 5.6) support for masculinity norms. Overall our findings underscore the need for the inclusion of men and gender norms in sexual and reproductive health programs in Jamaica. Keywords: gender norms (inequitable and masculinity), men, multiple sex partners, male circumcision (MC), contraception, multiple baby mothers.

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