Male involvement in family planning: perceptions among HIV-affected men and women in Nyanza Province, Kenya

Sara J. Newmann, University of California, San Francisco
Mellissa Withers, University of California, Los Angeles
Elizabeth A. Harrington, Oregon Health & Science University
Zachary Kwena, Kenyan Medical Research Institute, Nairobi
Maricianah Onono, Kenyan Medical Research Institute, Nairobi
Elizabeth A. Bukusi, Kenyan Medical Research Institute, Nairobi
Daniel Grossman, Ibis Reproductive Health
Craig R. Cohen, University of California, San Francisco
Shari L. Dworkin, University of California, San Francisco

BACKGROUND: In Kenya, there is a large unmet need for family planning (FP), especially among HIV-infected couples. Gendered power differentials influence reproductive decision-making in sub-Saharan Africa. Understanding the influence of male involvement in family planning (FP) is critical to design effective family planning programs. OBJECTIVES: To explore perceptions of male FP involvement and how gendered-power differentials influence reproductive behavior among HIV-affected Kenyan couples. METHODS: Individual, in-depth interviews were conducted among 40 HIV-affected, married couples in Nyanza Province. RESULTS: Approval of male involvement in FP was high. Perceived benefits included: improved couple communication and decreased women’s covert FP use. Perceptions of male disapproval of FP were related to gender role expectations, large family preferences, FP association with female promiscuity, beliefs that God determines fertility, fear of child death and side effects. CONCLUSIONS: FP interventions should simultaneously consider gendered-power imbalances in couple relationships and engage men by understanding their views and easing their fears related to FP.