More than half of married men in Kenya would be willing to try a new male contraceptive immediately it is available, according to a new study.
At least 23 different male contraceptives are in varying stages of development around the world.
They include pills, injectables, implants, gels and patches placed on different parts of the body.
Most come with trivial side effects but some can cause testes to shrink by half, mood swings, decreased or increased sex drive and no fluids at orgasm, among others.
Researchers explained all these details to 2,182 Kenyan men and their 1,756 female partners.
At least 52 per cent of the men said they were open to try a novel male contraceptive in the first year of availability. Their primary concern was not the side effects but the method of application.
More than half of women in the study (58 per cent) said they would trust that their men were using contraception, and the remainder said they would continue with their female contraception.
The research, titled 'Assessment of demand for male contraceptives: A multi-country study,' was conducted in 2021 and 2022 by researchers from India, South Africa and Turkey.
“Our findings indicate a very high level of interest in novel male contraceptives among men across all surveyed countries, particularly among those who are not currently using any modern method of contraception. This suggests a significant market gap and a substantial potential for a novel male contraceptive method to meet this unfulfilled demand,” the authors said.
Their paper was published on August 19 in the Andrology journal.
Reproductive health advocates in Kenya questioned the genuineness of the high interest, noting it is already "very difficult" to get men to support female birth control, let alone a male one.
The study was conducted in several countries among a total of 12,435 sexually active heterosexual men aged 18-60 years, and 9,122 of their female partners.
The countries are Kenya, Bangladesh, Vietnam, Nigeria, DR Congo, Côte d'Ivoire and United States.
Data in Kenya was gathered by trained survey investigators who asked men the following question, 'How long after a male product to avoid pregnancy were approved would you want to wait before you start using it?'
Male respondents selected one from the following answers: use right away, 1–3 months, 4–6 months, within 7–12 months, 1–2 years, 3–5 years, more than five years, or never.
In Kenya, 52 per cent of respondents would use within the first year. Only 18 per cent of Kenyan men said they would never use a male contraception.
The interest was highest in Vietnam (98 per cent), United States (78 per cent) and 76 per cent both in Nigeria and Bangladesh.
Currently, condoms and vasectomy are the only contraceptions available to men.
Respondents were also presented with application methods, side effects, and how long each probable method works.
“The form of administration with time of use has by far the strongest impact on their probability of trying a novel male method,” the researchers noted.
“Men across all countries prefer less invasive forms of contraceptive administration.”
For Kenyans, the most popular male contraception is a gel applied on the shoulder.
The second choice is a pill, followed by a patch that you attach on the body.
The most unpopular contraception for Kenyan men are implants inserted through surgical cuts in the scrotum, or through the hole where you urinate.
The men attached consideration on effects on testes size, and sexual drive were important, but not overly so.
Also for Kenya, side effects such as mood swings, effect on ejaculation, energy and weight gain were ranked least in importance.
The findings of this study challenge some long-held assumptions about male contraception, particularly the belief that fear of side effects is the main barrier to adoption.
With traditional family planning methods largely placing the responsibility on women, the introduction of a widely accepted male contraceptive could help distribute the burden more evenly.
Experts said that as the development of male contraceptives continues, the insights from this study will be invaluable in designing products that meet the needs and preferences of men.
Nelly Munyasia, the executive director at Reproductive Health Network Kenya, said new male contraception would be welcome.
However, she said a lot of groundwork must be done to increase acceptability.
"Even having men as allies for female contraception is difficult because our society is very religious. We have been engaging Maasai morans in nomadic communities to engage them as champions for women use of contraception," she said.
"Contraception use is considered the responsibility of women."
She said part of the work would be to fight myths and misconceptions about birth control.
Daniel Odeke, a youth advocate with the Network for Adolescent and Youth of Africa said he knows many men looking forward to such a contraception.
Naya Kenya is a sexual and reproductive health rights lobby for young people.
"Many men are willing to use a male method, provided it does not take away what makes them men. Vasectomy was seen as taking away what makes them men. Condom was taking away the pleasure," Odeke said.
"In my opinion, the gel and patches are good options. The challenge would be access, cost and availability."
He called on health providers to help fight misinformation about male contraception.
Odeke also called for advocacy to deal with cultural norms.
"There’s view that these modern contraceptives are coming to fight our culture. We have looked at sexual and reproductive health rights as a tool coming to fight our culture," he said.
"Even our cultures have science. We need to integrate the science of SRHR to our culture. As long as we fit science in our cultural normal will be acceptable."
A new hormonal male contraception is unlikely to be available before 2030, according to various medical resources.
One of the reasons it has taken so long to develop a male hormonal contraceptive is, unlike females who produce an egg a month, men produce millions of sperms every day. Sperm counts must be low enough to reliably prevent pregnancy.
If available, Kenyans would still fight the norms that make it difficult for men to be involved in family planning.
The National Council for Population and Development in a policy brief advised the Gender Directorate and the National Gender Commission should develop a strategy for challenging the gender stereotypes that work against efforts to improve male involvement in family planning and reproductive health.
It also advised the Ministry of Health to make health facilities male-friendly.
"The Ministry of Health should step up efforts by employing additional male service providers, reducing waiting times, encouraging service providers to be friendly to men, increasing service privacy, using male volunteers in community outreach services, and ensuring that there is an adequate mix of both male and female contraceptive methods in all health facilities," the brief said.
