American Journal of Men’s Health
sexual behavior (Chege, 2005; Ott, 2010; Smith, Fenwick,
Skinner, Merriman, & Hallett, 2011).
The high percentage of males in this study who
reported a preference toward male sexual partners is sur-
prising in light of a national rate of 4% (Purcell et al.,
2012), but is consistent with previous observations in the
study’s clinical settings (Buzi, Smith, & Haas, in press).
These findings may suggest that the clinics in this study
were effective in reaching out to males, specifically
minority young MSM, by providing free to low-cost ser-
vices and promoting safe and supportive family planning
and reproductive health facilities for young men. MSM
appear to be especially vulnerable to adverse health out-
comes—fewer reported having used any method of birth
control at last sexual intercourse or intent to use birth
control in the future—as compared with men with a
female sexual partner preference. The clinic setting,
which was perceived as serving the general population,
may also be attractive to men who have not yet publically
identified as gay.
There is a dearth of information and studies around the
overall health of affluent minority men and low-income
nonminority men, making it difficult to accurately com-
pare this sample of participants with other populations
(Master et al., 2013; Molina, Alegria, & Chen, 2012).
One health assessment, The National College Health
Assessment (NCHA), focused on college students and
stratified data by gender (American College Health
Association, 2015). Although NCHA is a college sample
of males, the age ranges of the two samples are similar.
NCHA participants had overall higher education levels
and the majority were White non-Hispanics. A compari-
son between the male participants in the NCHA and the
present study suggests that fewer NCHA participants
engaged in sexual intercourse (68.1% vs. 83.7%, respec-
tively) and more reported using a form of birth control at
last sexual encounter, as compared with the males in the
current study (51.1% vs. 37.7%, respectively).
Additionally, the proportion of young men in the
NCHA survey who reported physical altercations (8.2%)
and physical harm by their partner (1.8%) is lower than
that observed in the present study (71.2% and 18.1%,
respectively). However, more participants in the NCHA
survey reported feeling very sad any time within the past
12 months as compared with males in the present study
(54.2% vs. 46.5%, respectively). The difference between
physical and mental health reporting is consistent with
prior studies, suggesting that young minority men may
manifest depression differently than the general popula-
tion. Rather than reporting symptoms such as feeling low
energy and blue, young minority men may show signs of
depression by engaging in physical altercations (Buzi,
Weinman, & Smith, 2010; CDC, 2004; “Link Between
Relationship,” 2013). This comparison suggests young
males in the present study are affected by multiple chal-
lenges that can compromise their health.
This study’s findings also demonstrated a lack of TSE
education in young males. While the U.S. Preventive
Services Task Force has recommended against TSE,
young minority men may represent a population in which
TSE and genitourinary health education may be benefi-
cial. Considering that males often do not seek health care
early in the course of disease, and with only 22% of the
male clinic population insured, it is reasonable to educate
and screen for testicular malignancy in this population of
young men (Farrow, 2009; Kalmuss & Tatum, 2007;
Moul, 2007).
Expanding comprehensive health services could con-
tribute to lowering STI and HIV rates in low-income
areas by providing male youth-friendly family planning
and reproductive health services such as SRH education
and urologic screenings. Improving access to family
planning clinics is essential to increasing the overall
health in young minority males, as utilization of these
services decreases health outcome gaps (Guttmacher
Institute, 2015; Laski & Wong, 2010).
This study has several limitations. The survey assessed
SRH needs of young men in a single large metropolitan
area, which limited the generalizability of the findings to
a broader population. Additionally, although several of
the questions used had been extracted from validated
questionnaires, the study’s questionnaire as a whole has
not been validated. Despite these limitations, this study
improves the understanding of SRH in young men by
highlighting gaps in SRH knowledge and access to care,
and by providing insight into the comprehensive needs of
minority young males.
The results of the present study indicate that young
minority males engage in high-risk sexual behaviors,
lack SRH knowledge and risk perception, and are not
involved in their personal health. These findings are
consistent with other studies suggesting the presence of
risk behaviors among minority young males (Brindis,
2002). This study also highlights the needs of MSM to
engage in safe sex practices such as condom use and
accessing SRH services. In order to address the needs of
young males, providers should establish guidelines to
ensure consistent and thorough health monitoring in this
population of men (Marcell & Ellen, 2012). Marcell and
Ellen (2012) recommend increasing health awareness,
involving more youth-focused services, providing SRH
education, institutionalizing programs, and providing
guidance and referrals. From the results of this study, it
appears that young minority males are also affected by
violence that may further compromise other aspects of
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