Focus on men's needs with male health clinics

How does your facility address the specific needs of young men, including information on their role in preventing pregnancy and sexually transmitted diseases (STDs)?

If your male-targeted services consist of a couple of brochures on STDs and a bowl of condoms, perhaps a more focused approach will better serve your male population and bring increased utilization of your facility's programs.

William Rogers II, MD, MPH, and Basil Vareldzis, MD, MPH, can attest to the benefits when men's clinics are in force. The two physicians, who are affiliated respectively with student health centers at San Francisco (CA) State Uni versity and the Blacksburg, VA-based Virginia Polytechnic Institute and State University, recently presented information on planning and operating such services at the Baltimore-based American College Health Association's annual meeting. While those services are located in university student health facilities, many of the ideas can be used in other types of clinics.

San Francisco State's men's clinic has been in operation since 1996. Virginia Tech putting the finishing touches on a needs assessment to shape the direction of its first clinic slated to begin this fall. Results from Virginia Tech's needs assessment reveal that college-age males want such services, and a program evaluation survey conducted by San Francisco State shows that such services are put to good use.

Prevention of STDs, HIV/AIDS, and pregnancy are major issues of interest to young men at Virginia Tech, says Vareldzis. For San Francisco State, survey results affirm that once young men learn of the men's clinic, the services are used - and used again, says Kamal Harb, MPH, a university health services health educator who works with the men's clinic. About 45% of students who used the men's health clinic returned up to five times, and all said it addressed their major health concerns.

Snips, snails, and STD screenings

Just what does a men's clinic entail? "My goal from the start was to make it as multidisciplinary as possible," Rogers says. "We draw on all the ancillary services that are available at the clinic and make fair use of our sports medicine consultant and our podiatrist."

The San Francisco State clinic addresses such issues as immunizations; screenings for STDs, cholesterol, and tuberculosis; testicular cancer self-exams; and evaluation of fitness for recreational sports recreation. Visual acuity testing also is included, with glaucoma screening offered for high-risk individuals.

San Francisco State's men's clinic operates two half-days per week and is staffed by Rogers, Harb, and a male student in the school's nursing program. Initial intake is performed by the nurse, then Rogers does a 45-minute physical exam. The session is closed with Harb reinforcing issues discussed during the physical evaluation. Each patient visit is very thorough, usually lasting 1.5 hours, Rogers says.

College males ask about STDs

STDs are a big concern for male university students, Harb says. He fields many questions about how they are contracted and their signs and symptoms. The Student Health Service operates an anonymous HIV testing program, and students are referred to it directly, Rogers says.

Rogers discusses pregnancy prevention and condom use. He asks students if they feel ready for fatherhood if they aren't being careful, then reinforces the importance of condom use during the counseling session.

While Virginia Tech's student population is about 60% male, only about 40% to 45% of the students who come to its health services are men, Vareldzis says. That finding led student health services officials to take a look at developing a men's clinic. The needs assessment conducted by student health services has included comments from male and female students about what components are needed for a successful clinic.

Another valuable source of information has been a men's growth group, "Men Alive," facilitated by Vareldzis through the school's counseling center. The summer semester marks the third time the group has been offered. It's designed to give young men a "safe space" to discuss important health and lifestyle issues, such as relationships with men and women, expression of emotions, addictions, sexuality, dating, and intimacy.

"[Young] males interact by going out and getting drunk, or they go to a football or basketball game and root for the team, but they don't really ever talk about intimate things with each other," Vareldzis says. "We are creating a space where they can do that."

Groups usually are limited to eight to 10 students, and each semester's group has filled within a few days, he says. Advertisements in the student newspaper and on the campus radio station have been used, as well as fliers distributed through health and peer educators. Word of mouth from former participants has been a strong source of recommendation as well.

The men's clinic will open this fall, with tentative plans to have two physicians seeing patients for two hours per week, Vareldzis notes. That staffing level will be maintained for 15 weeks to assess the utilization, with the goal of having at least 50 students come through in the first semester.

Banners and fliers have been developed, and health educators have pulled together all available brochures on such issues as STDs, testicular self exams, and high blood pressure into a men's clinic package, he says. By gathering available information into one integrated unit, the student health service can easily market the clinic's services, he says.