Abstract
OBJECTIVES: Peers and intimate partners can influence contraceptive decision-making and use. We aimed to explore the male-partner role in contraceptive decision-making, and describe ideal male-partner roles and how they relate to contraceptive use, specifically uptake of long-acting reversible contraception (LARC). STUDY DESIGN: We used a phenomenological approach to explore cis-hetero partner involvement in contraceptive decision-making and conducted semi-structured in-depth interviews with 30 cisgender women and 30 cisgender men in heterosexual relationships who presented to Salt Lake City family planning clinics. Participants, stratified by sex assigned at birth and current contraceptive method (LARC vs non-LARC), described the male-partner's role in the most recent contraceptive decision and discussed how ideal-partner involvement could look in contraceptive decision-making. We iteratively developed a codebook and identified dominant themes using a constant content and comparative analysis. RESULTS: We did not identify thematic differences by LARC vs non-LARC users. Participants universally considered that contraceptive responsibility falls on women. At the time of the interviews, both men and women indicated a strong desire to prevent pregnancy, and felt that men's actual contributions to decision-making were limited. Themes around gendered-differences of contraceptive knowledge, responsibility and risk, and sexual priorities emerged, as well as inadequate knowledge and contraception options for men. In analyzing discussion around ideal partner support, participants suggested emotional, financial, and logistical support options and placed high importance on interpersonal communication. CONCLUSIONS: The decision to use a method of LARC did not influence sentiments around male-partner involvement or stated desire for partner involvement. Limited contraceptive knowledge and male options restrict the contraceptive decision-making role and contraceptive engagement for men, although participants suggested other supportive options. IMPLICATIONS: This work suggests the desire of both men and women for men to participate in contraceptive decision-making, but their role remains limited. Future interventions focused on comprehensive contraceptive education and modeling of communication strategies for men are tangible steps to support men in this role.