• Summary
• Credits

1. Focus on Men
2. Contraceptive Use
• Married Men: Majority Do Not Use Contraceptive
• Many Unmarried Sexually Active Men Use Condoms
• Men and Women Differ in Reported Contraceptive Use
• Groups of Married Men Differ Widely in Contraceptive Use
• Some Nonusers Say They Intend To Use Contraception in the Future
3. Contraceptive Awareness and Approval
4. Fertility Preferences
5. Young Men

• Figures
• Tables
• Side-bars
• Bibliography

• Men overreport, and women under-report, condom use
• Why many men do not intend to use family planning
• Radio and TV messages reach more men than women
• Most men want to have more children than women do
• Sexually active young unmarried men at risk for HIV/AIDS

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In surveys men tend to overreport contraceptive use, and women to underreport it, particularly condom use (7, 16). In societies that associate family planning with modernity, men may overreport contraceptive use to avoid appearing traditional (7). Men also may tell survey takers that they use contraception in order to be perceived as good caretakers, especially if they think that the interviewers are associated with a family planning program (29). Conversely, some married women may hesitate to report condom use, particularly in cultures that do not encourage open discussion about sexuality or where condoms are associated with extramarital sex (7, 16).

Nevertheless, researchers tend to agree that women give more accurate responses than men to survey questions about contraceptive use (7, 16, 20). Most contraceptive methods are female-controlled, and thus women are more likely to know about their actual use. Some women use OCs, IUDs, and injectables without their partners’ knowledge. Also, women usually are more motivated than men to know if they are being protected against pregnancy because they, not men, face the risk of unintended pregnancy.

In 41 of 46 surveyed countries, married men reported higher levels of current contraceptive use than married women.⁵ Differences are particularly great in sub-Saharan Africa. In 15 of 25 sub-Saharan countries surveyed, married men’s reports of contraceptive use are at least 10 percentage points higher than married women’s, and as much as 27 percentage points higher in Burkina Faso (see Figure 4).

Also, in 24 of 36 countries with surveys of both unmarried sexually active men and women, more unmarried sexually active men than unmarried sexually active women report current contraceptive use. The differences are smaller than differences between married men and women, however.

Differences largely due to condom use. Much of the difference between men’s and women’s reports about contraception is due to differences in condom use. In 42 of 46 countries with surveys of married men—all except Albania, Bolivia, Egypt and Morocco—married men report higher levels of condom use than married women do. Also, in 36 of 46 countries more married men than married women report depending on periodic abstinence and, in 19 countries, on withdrawal.

One reason that married men report more condom use than married women is that some married men use condoms in sexual relations outside marriage (while few married women are presumed to have sex outside marriage). Some men are in polygynous marriages, particularly in sub-Saharan Africa (7, 16, 21). In the DHS, respondents can report current use of only one contraceptive method; the questionnaire for the men’s surveys does not ask about contraceptive use with each wife or sex partner. Therefore men may report use of a particular contraceptive method but may in fact use two or more methods, depending on the partner. In a recent analysis of DHS data, differences in contraceptive use between polygynous and monogamous couples were not statistically significant when the husband in a polygynous marriage reported use of a method that agreed with the reports of any of his wives (7).

In 2000, countries were given the option of using a new DHS questionnaire in which men are asked about use of contraception at last sexual intercourse for up to three partners during the past 12 months (see for example, Haiti 2000 DHS (33) and Rwanda 2000 DHS (34)). In the RHS men have been asked this question since the mid-1990s, in addition to questions about current use (31).

Discrepancies in reported contraceptive use between men and women persist even between monogamous husbands and wives who are faithful to each other (7, 45). Several reasons may account for these continued discrepancies. For example, one partner may be unaware that the other partner has stopped using a method, or one partner may be using contraception without the other’s knowledge. Partners may have different judgments as to what qualifies as “current” contraceptive use, or they may have different understandings of what constitutes a certain contraceptive method (for example, one partner may define periodic abstinence as sporadic abstinence during the postpartum period or during a woman’s menses while the other defines it accurately as deliberate abstinence during a woman’s fertile period). Furthermore, respondents may give socially expected responses, either overstating or concealing contraceptive practice depending on the context (7, 9, 16, 45).

Married men differ in their levels of current contraceptive use according to their demographic and socioeconomic characteristics, including educational attainment, urban or rural residence, age, and number of children born. Such differences resemble the differences in contraceptive use among groups of women, with some exceptions.

Education affects contraceptive use. The more schooling that men have, the more likely they are to use contraception (1, 12, 28, 36). In all 46 countries surveyed since 1990 except Mauritania, married men’s contraceptive use consistently increases with their level of education (see Table A).

Urban or rural residence. In all surveyed countries except Rwanda, contraceptive use is consistently higher among married men in urban areas than in rural areas. In 10 of 46 countries contraceptive use among married men in urban areas is at least 20 percentage points higher than among rural men. The smallest differences are in the Dominican Republic, Jamaica, and Rwanda, where married men in rural areas are almost as likely as men in urban areas to use contraception (see Table A).

Age. Among married men the use of contraception generally peaks between ages 30 and 49 (see Table A). Among married women contraceptive use peaks in a more narrow age range—between the ages of 30 and 39.

Number of children. In general, as among married women, married men without any children are less likely to use contraception than men who have children. But the patterns among men are not as clear as among married women (see the companion report on surveys of women) (52). In 34 of 45 countries surveyed, the level of contraceptive use is highest among men who have two or three children. In over half of surveyed countries at least 30% of married men with four or more children report using contraception (see Table A).

Surveys ask married men who are not currently using contraception whether they intend to use it in the future—either in the next 12 months or later. In 32 of 43 surveyed countries, at least 30% of such men say they intend to use contraception in the future. The percentage varies widely among surveyed countries, from 12% in Mauritania and Senegal to over 60% in Bangladesh, Cape Verde, Malawi, Nepal, Uganda, Zambia, and Zimbabwe (see Table 3).

Most men who say they do not intend to use contraception explain that they want to have more children or that their wives are at little risk of pregnancy (either because they and/or their wives are infertile or because their wives are postmenopausal). In 21 of 41 countries—17 in sub-Saharan Africa plus the Dominican Republic, Mauritania, Morocco, and Pakistan—the main reason that men give is wanting more children. In 14 countries—most outside sub-Saharan Africa—the main reason is that their partners are unlikely to become pregnant (see Table 4).

Another main reason that men report is opposition to family planning itself, either for religious reasons or other reasons. Also, in sub-Saharan Africa and a few countries elsewhere, some men say they do not intend to use contraception because they know little about it or where to obtain it. Men are less likely than women to mention concerns about health or side effects of contraceptive methods as an important reason to avoid using family planning (see the companion report on surveys of women) (52).

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