Bring in the men: One clinic’s tale

Monday evenings and Friday afternoons, there’s a different look to the facility that normally houses the family planning clinic operated by the department of population and family health at Columbia University’s Mailman School of Public Health and New York Presbyterian Hospital. The space is transformed into the Young Men’s Clinic, New York City’s sole facility specifically focused on meeting men’s sexual and reproductive health concerns.

Medical, counseling, and health education services are provided at more than 2,500 visits each year at the facility, which is operated by the Center for Community Health and Education in the Mail-man School of Public Health, Columbia University, and the New York Presbyterian Hospital. The clinic operates with funding from the federal Office of Population Affairs and other sources, according to clinic director Bruce Armstrong, DSW.

Two-thirds of clinic clients are between 20 and 29 years old, and 90% are Latino, says Armstrong. To reach these young men, the clinic markets its services through an array of interventions designed to increase men’s awareness of the need for and availability of "male-friendly" health care.

Educate while they wait

Waiting room groups in the family planning clinics encourage, enable, and support women’s motivation and capacity to engage their sexual partners in health services, says Armstrong. During women’s wait times, a Young Men’s Clinic social worker leads group discussions, enlivened by PowerPoint slides developed by Columbia University public health students. Following the presentations, women are encouraged to make clinic appointments for their partners. Since such groups were implemented in 2000, the proportion of male patients referred to the clinic by family planning patients increased from about 25% in 1999 to 53% in 2001, says Armstrong.

Public health students also have developed slides for use during men’s waiting time at their clinic and lead discussions on such basic health information as "What is a hernia?" and "Should a man be circumcised?"

To further add to the male-friendly setting, the Young Men’s Clinic waiting area features a "Wall of Fame" filled with framed photos (some personally signed) of Secretary of State Colin Powell, former Surgeon General David Satcher, neighborhood politicians, and other prominent men of color. Such attention to detail has paid off; self-administered patient forms show that 90% of revisit patients were "very satisfied" with their prior clinic visit.

To reach area young men, the clinic has collaborated with New York City-based EngenderHealth in developing cartoons to broadcast clinic services while promoting a range of male involvement behaviors, says Armstrong. The cartoons are printed on posters and posted in strategic locations throughout the neighborhood, such as corner lampposts, grocery stores, telephone booths, playgrounds, and barbershops.

The cartoons portray men involved in caring behaviors such as holding a child, accompanying a partner to her clinic appointment, having an annual exam, getting screened for sexually transmitted diseases, and talking about emergency contraception. Each cartoon ends with the man entering the clinic.

Sharpen the skills set

The clinic has developed a training protocol for all staff working at the facility to ensure that each young male is thoroughly engaged in an assessment of their sexual, reproductive, and psychosocial needs, and to increase the competency of the next generation of health professionals who will address men’s health, says Armstrong. The protocol, "An Empowerment Approach to Working with Young Men," focuses on such issues as increasing condom use, improving partner communication, and increasing compliance with preventive physical exams and testicular self-exams.

"Our goal is to improve men’s health, including sexual and reproductive health, by increasing their access to culturally competent, developmentally appropriate, and gender-sensitive health care," he says.

Where Do Men Rate on the Sexual Health Scale?

  • Nine in 10 men have heard of HIV, AIDS, gonorrhea, and syphilis, but far fewer know about genital warts and are aware that chlamydia can infect men.
  • Half of men who use condoms do so for birth control, not for protection against sexually transmitted diseases.
  • Reported rates of chlamydia and gonorrhea reach 500-600 per 100,000 men in their early 20s, levels that are much higher than those of men in their 30s or older.
  • More than one in 10 men who had AIDS diagnosed in 1999 were exposed to HIV through heterosexual activity.

Source: Alan Guttmacher Institute. In Their Own Right: Addressing the Sexual and Reproductive Health Needs of American Men. New York City; 2002.