P1-S6.25 The male reproductive health project: using research-based interventions to increase male clients and STI testing at family planning clinics
Authors: Fine D , Goldenkranz S , Adamian J , Ranjan S , Pan A , Baker J , Rink E , Tran N , Johnson D , Carlon A 
Published: July 2011

Background

Women comprise >95% of US family planning (FP) clinic clients. The Male Reproductive Health Project (2008–2013) is a national research demonstration effort implementing empirically-based interventions to increase male FP clients and male testing for sexually transmitted infections (STI).

Methods

In 2009 interventions at 5 FP grantees included: male outreach via FP clinics' female clients and other agencies serving men, clinic efficiency assessments, FP staff training, and modifying clinic environments. Study population currently includes male FP client visit records (2004–2009) from 2 grantees. In separate analyses for Montana (MT) (2891 visits) and San Diego (SD) (7008 visits) grantees we analysed chlamydia (CT) testing (urine/NAAT) and positivity (CT+) by clinic, age, race/ethnicity, intervention status (pre: 2004–2008; post: 2009), insurance status, new/returning client, and federal Title X FP funding. Multivariate models developed.

Results

MT-67% of visits aged 20–29 y; 94% non-Hispanic whites. Annual visits increased 60%--pre-intervention (2004–2008) x̄ =438 visits/y; post (2009)=702 visits. CT testing increased 44% (2004–2008 x̄ =58% of visits/y tested; 2009: 78% tested). Significant (p<0.05) multivariate factors related to CT testing: intervention status (AOR=2.21), racial/ethnic minority (AOR=2.06), new client (AOR=5.59), visit's federal funding (AOR=3.04), and clinic (Billings: AOR=0.45). CT+ was 13.9%. Factors related to CT+: age<20 y (AOR=2.44, Ref:>29 y), no insurance (AOR=1.67), and federal funding (AOR=1.76). Annual female FP clients were stable (2004–2008: 5085/y; 2009: 5650). SD-43% of visits aged 20–29 y; 66% Hispanic. Annual visits increased 18%--pre-intervention x̄ =1045/y; post=1235 visits. CT testing increased 41% (pre: x̄ =29% of visits/y tested; post: 41% tested). Factors related to testing: new client (AOR=2.39) and intervention status (AO=1.76). CT+ was 6.4%. Factors related to CT+: age<20 y (AOR=3.13), black race (AOR=2.29), new client (AOR=2.47), and clinic (Beach: AOR=0.40). Annual female FP clients were stable (2004–2008: 4440/y; 2009: 4833).

Conclusions

Early data indicate FP clinic interventions significantly increased male clients and the proportion tested for CT without reducing female FP clients. Screening prioritised new male patients. Like other CT programs, young and minority males have increased infection risk. CT positivity varied by clinic, supporting use of local data to inform male STI services at FP clinics.

Abstract P1-S6.25 Table 1

Characteristics of male family planning client visits, CT testing and positivity—2004–2009†

CharacteristicNo.Percent% CT Tested% CT PositiveGrantee: Planned Parenthood of Montana28911005913.9Clinic Missoula20096963*13.6* Billings882315114.6Age (years) <203811367*17.8* 20–241217426017.3 25–29700256010.5 >2957220547.6Race/ethnicity Non-Hispanic white2730945913.7 Minority16166316.5Intervention status Pre (2004–2008)21897654*13.2 Post (2009)702247814.9Insurance No19956958*15.3* Yes (public or private)896316211.0Client status New13166077*14.8 Continuing877403511.4Federal Title X funding No18736549*11.1* Yes1018357816.1Grantee: Family Health Centers, San Diego, CA‡700810031%6.4%Clinic Logan473268317.5* Beach227632324.3Age (years) <20252425*14.6* 20–24133419329.7 25–29168624337.8 >29373653303.9Grantee: FHC, San Diego cont.Race/ethnicity Non-Hispanic white172627316.4* Non-Hispanic black33552916.4 Hispanic442868326.0Intervention status Pre (2004–2008)57738229*6.4 Post (2009)123518416.5Insurance No22583235*2.7* Yes (public or private)474968297.6Client status New19792844*9.8* Continuing502972264.3

*Statistically significant (p<0.05) univariate differences.

†Calendar Year 2010 data available March 2011.

‡All FHC San Diego clinic visits are federal Title X funded; measure excluded from this grantee's results.