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Young Kenyans are blaming a lack of male involvement in family planning for the rising number of unintended pregnancies and new HIV infections among them.
A 2014 report by the African Population and Health Research Center revealed that 43 per cent of pregnancies in Kenya are unplanned. Young people aged 15 to 24 constitute 60 per cent of the population and nearly half (47 per cent) of pregnancies among this age group are unintended.
If young people are not getting access to sexual and reproductive health information and services, this means more than half of the population is at an increased risk of getting infected with HIV or having unplanned pregnancies.
Condom use and education
Some young men argue that they find involvement in sexual and reproductive health issues unnecessary and time-consuming, and that their contraception options boil down to two choices: vasectomy or condoms.
“Vasectomy is not a choice for the youth, and why should I queue in health facilities to get condoms which I can buy easily from across the counter?” says Charles Nyaga, a newly married young man from Embu County in the eastern region of Kenya.
But a Nairobi-based HIV testing counsellor, George Abungu says there is more to condom-use as a family planning method than just buying them from shops. He says that records from his clients show that incorrect use of condoms contributes a lot to new HIV infections and unplanned pregnancies among young people.
One main benefit of going to a clinic is the opportunity for screening of sexually transmitted infections (STIs), including HIV testing and counselling. And in relation to family planning, those who test positive can receive early treatment since untreated STIs can cause infertility in both men and women. Early detection and treatment of HIV can also help prevent mother to child transmission of the disease.
Abungu calls on young men to take an active interest in sexual and reproductive health issues. “The youth are more sexually active than the general population and are more at risk of HIV infections; they should be taught how to use condoms correctly as a family planning method and as an HIV prevention measure,” he says.
Sexual violence and HIV
Sheila Cherina, 27, a mother of three, discloses that due to the high cost of living, her intention was to bring up only one child. "All along my boyfriend and I were relying on my safe days, and sometimes withdrawal, which was very difficult to maintain,” she says.
She adds that this was after the methods prescribed to her at the local health facility had serious side effects. When the health workers advised her to bring along her sexual partner, her boyfriend retorted that family planning was a women’s issue.
She says: “We needed counselling because sometimes he would come to my house drunk and my pleas that my days were unsafe would fall on deaf ears. He would sexually abuse me; that’s how I got my two other children.” Sheila eventually ended the relationship for fear of having a fourth baby or contracting HIV.
Nelson Otuoma, coordinator at the National Empowerment Network of People living with HIV/AIDS Kenya (NEPHAK) attributes the rising of unplanned pregnancies and new HIV infections to gender based violence and sexual abuse.
He says that if the young men were educated in a sexual and reproductive health set-up, they would understand the dangers involved in forced sex. “Unfortunately very few men will accept to go along with their sexual partners to such facilities, though the youth are highly active sexually,” he says. “In cases of condom bursts or getting in contact with infected body fluids, they don’t know the measures to take.”
But young men say that family planning facilities are unfriendly to the youth and they feel awkward even about the thought of walking in there. They accuse the health workers of being unprofessional and rude to men who attend the clinics.
Oscar Kiprutum, 24, a youth leader in Nandi Hills and a university student, recalls the day he and his girlfriend visited one family planning facility in need of information. He claims the nurses treated him with indignity and disrespect. He remembers one nurse asking them why they wanted the family planning information at their age or whether they were indulging in ‘illegitimate’ sex.
“I felt very insulted because that was really not her business,” he says. From that time, Oscar says, they resorted to buying condoms or emergency contraceptive pills from local shops.
George Gitari, 35, from Nyeri County in the central region of Kenya, disagrees that family planning is a women’s issue, saying he prides himself on going to sexual and reproductive health facilities with his wife. He calls other married youths to emulate him. “Family planning calls for concerted efforts from both parties,” he says, adding that he and his wife sought medical advice on the best family planning method for her.
Margaret Maina, 25, a youth leader in a Nairobi church, echoes George’s sentiment: “Before a couple indulges in sex, the two should be aware of what family planning method they are using. If it’s a regular sexual partner, the two should attend a family planning health facility for counselling to be advised what would work best for them,” she says.
Margaret calls upon young women to encourage their male sexual partners to use sexual and reproductive health services, so that the issue of whether to get pregnant or not doesn’t remain the woman’s burden alone. “Like all other health care issues, women should make their male sexual partners ‘contraceptive buddies’ so the issue of family planning is shared,” she says.
Lucy Maroncha lives in Kenya lives and is a member of Key Correspondents, a citizen journalism network reporting for action on HIV. The network is supported by the International HIV/AIDS Alliance.