Julie Fennell

Men Bring Condoms, Women Take Pills Men’s and Women’s Roles in Contraceptive Decision Making

The most popular form of reversible contraception in the United States is the female-controlled hormonal birth control pill. Consequently, scholars and lay people have typically assumed that women take primary responsibility for contraceptive decision making in relationships. Although many studies have shown that men exert strong influence in couple’s contraceptive decisions in developing countries, very few studies have considered the gendered dynamic of contraceptive decision making in developed societies. This study uses in-depth interviews with 30 American opposite-sex couples to show that contraceptive responsibility in long-term relationships in the United States often conforms to a gendered division of labor, with women primarily in charge. A substantial minority of men in this study were highly committed contraceptors. However, the social framing of contraception as being primarily in women’s “sphere,” and the technological constraints on their participation, made even these men reluctant to discuss contraception with their women partners.

Better than nothing or savvy risk-reduction practice? The importance of withdrawal.

This commentary discusses the causes and consequences of the family planning fields lack of enthusiasm for withdrawal use despite its comparative effectiveness. It also includes possible ways to improve measurement and understanding of withdrawal use and how to discuss it with contraceptive clients after the review of new data on the prevalence and practices of withdrawal.

And Isn't that the point?: pleasure and contraceptive decisions.

OBJECTIVE Previous survey research indicates that women and men experience reduced sexual pleasure when using condoms, especially compared to nonbarrier family planning methods. This study seeks to explore those experiences of reduced pleasure in-depth and how they affect contraceptive method decisions and use. STUDY DESIGN In-depth interviews with 30 men and 30 women between the ages of 18 and 36 years in the United States about their contraceptive decisions and use were analyzed. RESULTS Both men and women complained about the way that condoms interfered with their sexual pleasure. Several women (and no men) complained that condoms actually hurt them, and the majority of couples had at least one member who reported disliking condoms. For hormonal methods and intrauterine devices, general side effects were usually one of the most important reasons that women continued or discontinued methods, but few sexual side effects were reported. CONCLUSIONS Interfering with sexual pleasure appears to be the most important reason that both men and women do not use condoms, and public health practitioners should recognize the limitations of condoms as a contraceptive technology. Despite problems with general side effects, most women (and men) prefer hormonal methods to condoms. IMPLICATIONS This study provides in-depth descriptions showing that young adult men and women in the United States use condoms less because condoms interfere with their sexual pleasure. Although women often say they experience general negative side effects from hormonal birth control, they usually perceive few sexual side effects from hormonal birth control. Since young heterosexual adults usually perceive themselves to be at much greater risk for pregnancy than sexually transmitted infections, they mostly perceive hormonal birth control to be a greatly superior contraceptive option compared to condoms.

Providing for women's pleasure in the next generation of condoms.

In March 2013, the Gates Foundation released its latest “Grand Challenge in Global Health”: a call for proposals regarding the development of more appealing, pleasurable, and user friendly male condoms.1 Given their universal recognition, practicality, low cost, and unique ability to prevent both pregnancy and STIs, condoms are a valuable and often underutilized tool in promoting global health. Though condoms often receive less attention than biomedical prevention technologies such as male circumcision or pre- and post-exposure prophylaxis (PrEP and PEP), they have saved thousands, if not millions, of lives over the course of the AIDS pandemic. Moreover, if condoms transferred more heat and sensation, were easier to apply correctly, broke less often, were reusable, and/or were more readily available, they could curb even more STI/HIV transmissions and unintended pregnancies worldwide.

Letters to the EditorProviding for Women's Pleasure in the Next Generation of Condoms

In March 2013, the Gates Foundation released its latest “Grand Challenge in Global Health”: a call for proposals regarding the development of more appealing, pleasurable, and user friendly male condoms.1 Given their universal recognition, practicality, low cost, and unique ability to prevent both pregnancy and STIs, condoms are a valuable and often underutilized tool in promoting global health. Though condoms often receive less attention than biomedical prevention technologies such as male circumcision or pre- and post-exposure prophylaxis (PrEP and PEP), they have saved thousands, if not millions, of lives over the course of the AIDS pandemic. Moreover, if condoms transferred more heat and sensation, were easier to apply correctly, broke less often, were reusable, and/or were more readily available, they could curb even more STI/HIV transmissions and unintended pregnancies worldwide.

Calculating contraceptive decisions while intoxicated

BACKGROUND Experimental research in laboratory conditions indicates that intoxication makes unprotected sex more favorable to subjects, while event-level research indicates little causal effect of intoxication on condom use. Little work has addressed the effect of intoxication on hormonal contraceptive use. STUDY DESIGN This study analyzes in-depth interviews with 30 men and 30 women between the ages of 18 and 30 years on the East Coast of the United States about their contraceptive decisions and use. RESULTS Respondents believed that frequent intoxication discouraged condom use and consistent contraceptive pill-taking. Their accounts suggested that intoxication discouraged calculated contraceptive decision-making, and consequently, they mostly reverted to their standard contraceptive habits. People who were consistent contraceptors sober were usually consistent contraceptors while intoxicated, and people who were inconsistent contraceptors sober were usually inconsistent contraceptors while intoxicated. This pattern applied to both condom use and hormonal contraceptive use.

The children of converts: Beyond the first generation of contemporary Pagans

Very little is known about the adult religious retention of children and adolescents in New Religious Movements (NRMs). The current study seeks to examine the factors that determine the success of one NRM, contemporary Paganism, at retaining the children of its first generation of converts. Using a small convenience internet sample (n=183), we found that 45% of our sample continued to practice Paganism as adults, and a further 25% remained spiritually Pagan. We find that children and adolescents who were very religious Pagans are much more likely to remain members of the religion as adults, controlling for age, gender and sexual orientation. We also find that children who grew up in more specifically defined Pagan paths, such as Wicca or Druidism, are more likely to remain Pagan and in those paths, than children who were raised in more vaguely defined ways such as ‘eclectic Pagan’.