Where does reproductive health fit into the lives of adolescent males?

CONTEXT: To develop interventions to promote responsible sexual behaviors and design reproductive health services for adolescent males, we need a better understanding of the context of reproductive health in adolescent males' lives. METHODS: A total of 32 males (mean age, 15.5 years) were recruited from two urban high schools. At each school, three group sessions, consisting of both individual free-listing activities and focus group discussions, were conducted; each addressed issues related to one of three domains - masculinity, responsibility and priorities. Data from the focus groups were examined through standard content analyses. RESULTS: Participants identified school, family, future career and sports as their current life priorities; health was not a top concern. Pregnancy and sexually transmitted infections (STIs) were not seen as interrelated health concepts. STIs were considered a health issue, whereas pregnancy was perceived as a negative event that could prevent achievement of specific life goals. At times, notions regarding how a male behaves reflected traditional masculine beliefs: that violence is justified as a way to protect oneself, that having sex is part of a male's role in a relationship and that males should handle health issues by themselves. CONCLUSIONS: To meet the reproductive health needs of adolescent males, program developers should consider how other life priorities and traditional masculine beliefs may serve as barriers to care and how to ensure that services reflect the adolescent male's perspective.