What role does religion play in men's contraceptive behavior? A secondary data analysis of 2011-2013 NSFG data. Public

Abstract

Background: Over half of all pregnancies in the United States are unintended. Nonuse of contraceptives is responsible for more than half of births that result from unintended pregnancies. However, men's contribution to that nonuse is understudied. Although religion has been a factor associated with non-use of contraception among younger women, the relationship between religion and men's contraceptive behavior is less understood. Dominant or traditional masculinity ideology is associated with decreased condom use in young men as well as more frequent religious service attendance among adult men. This study examined the relationship between individual-level religiosity, men's non-use of contraception, and masculinity ideology using data from the 2011-2013 National Survey of Family Growth (NSFG).

Methods: Logistic regression models were tested with current religious service attendance as the exposure, recent non-use of contraception as the outcome, and masculinity ideology as a mediator, controlling for other demographic covariates.

Results: Just over one fifth (21.6%) of men in the U.S. of reproductive age who are at risk for facilitating unintended pregnancy are not using contraception. Rates of non-use of contraception were higher among those with more frequent religious service attendance. Masculinity ideology itself was associated with non-use of contraception, and was a partial mediator in the relationship between non-use of contraception and religious service attendance. Other factors that were associated with non-use of contraception in the multivariate models included marital status, number of pregnancies fathered, age, and race/ethnicity.

Conclusions: Among U.S. men ages 15-44, masculinity ideology mediates the relationship between non-use of contraception with those with stronger adherence to dominant masculinity having higher odds for non-use than men with lower adherence to dominant masculinity. Odds ratios of non-use of contraception also vary by marital status, number of pregnancies fathered, age, and race/ethnicity, but not by religious service attendance. It is recommended that further cross-sectional and sub-population research be conducted to further assess these findings. The curriculum of sexual education in schools and reproductive health interventions in communities should include information regarding the influence of masculinity ideology

Table of Contents

I. Introduction. 1

Introduction and Rationale. 1

Problem Statement. 1

Purpose Statement. 2

Research Questions. 2

Significance Statement. 2

Definition of Terms. 3

II. Literature Review. 5

Non-use of contraception. 6

Religion and Contraception. 9

Masculinity ideology and contraception. 14

Summary. 17

Figure 1: Religious Attendance and Non-use of Contraception Conceptual Diagram. 18

III. Methodology. 19

Introduction. 19

Population and Sample. 19

Analysis. 22

Ethical Considerations. 23

Limitations and Delimitations. 23

IV. Results. 25

Introduction. 25

Findings. 25

Characteristics of the study population. 25

Tetrachoric correlation analysis. 27

Bivariate analysis. 28

Figure 2: Non-use of contraception by religious attendance among men ages 15-44 at risk for facilitating unintended pregnancy, NSFG 2011-2013. 29

Figure 3: Non-use of contraception by masculinity ideology among men ages 15-44 at risk for facilitating unintended pregnancy, NSFG 2011-2013. 30

Three way associations. 30

Regression Models. 32

Other Findings. 34

V. Discussion. 36

Conclusion and Recommendations. 39

References. 41

Appendix. 45

Table 1: Items selected for masculinity ideology scale from 2011-2013 NSFG and comparative item from MRNI-R (Levant et al., 2007). 45

Table 2: Sample Demographics of men ages 15-44 at risk for facilitating unintended pregnancy (n=2,980), NSFG 2011-2013. 46

Table 3: Pairwise estimates of tetrachoric correlations of covariates by non-use of contraception and religious attendance among men ages 15-44 at risk for facilitating unintended pregnancy (n=2,980), NSFG, 2011-2013. 48

Table 4: Proportion of noncontraceptors among men ages 15-44 at risk for facilitating unintended pregnancy (n=2,980), by religious attendance and select demographic covariates, NSFG, 2011-2013. 50

Table 5: Crude odds ratios (ORs) for non-contraception among men ages 15-44 at risk for facilitating unintended pregnancy (n=2,980), by measures of religiosity and masculinity ideology NSFG 2011-2013. 52

Table 6: Adjusted odds ratios (AORs) for non-contraception among men ages 15-44 at risk for facilitating unintended pregnancy (n=2,980), NSFG 2011-2013. 53

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Gender Studies
Mot-clé	Men's reproductive health Masculinity ideology Unplanned pregnancy Religion and sex Contraception behavior National Survey of Family Growth
Committee Chair / Thesis Advisor	Yount, Kathryn, Emory University
Committee Members	Rochat, Roger, Emory University
Partnering Agencies	CDC

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