Brian Trung Nguyen, MD

Unintended pregnancy (45% of US pregnancies [2]) remains a critical issue [3-6] that cannot be resolved without the investment/involvement of men. While women’s contraceptive options continue to expand, men still have only two reversible options: condoms and withdrawal, which are susceptible to user error and already unacceptable—typical failure rates approach 20% at 12 months [7]. Women shoulder the burden and inherent risks of contraception; male hormonal contraceptives (MHCs) are a promising solution.
Multiple clinical trials of investigational MHCs demonstrate efficacy and tolerability [1, 8-10]. Acceptability studies from MHC trials also demonstrate high levels of satisfaction [11-14], however generalizability of these findings is often questioned, prompting a need to re-evaluate MHC acceptability in detail.
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Los Angeles is unique for its diversity and housing of one of the only MHC clinical trial centers in the US. We are thus able to collect qualitative data from (1) a racially diverse population via focus groups and (2) men who have actual MHC experience from phase II clinical trials via in-depth interviews. Endocrinologists/Andrologists who focus on the clinical efficacy of MHCs, welcome collaboration from family planning specialists (OB/GYN) who consider the complexities involved in their patient’s decisions to use contraception.
We aim to better understand the factors contributing to men’s willingness to use MHCs, contrasting the perspectives of men who have never used MHCs to those of men with trial experience. Guided by a dyadic-modification of the Theory of Planned Behavior, we recognize that while drug characteristics (i.e. pills, injections, and topical applications) may be important to men, other relevant factors may include their reproductive history/experience, attitudes of their sexual partners, and perceptions of social networks/stigma. Findings from this qualitative research will improve male contraceptive messaging, suggest populations of need/interest, and provide pilot data for a comprehensive population survey to estimate MHC demand.