Young men play an important role in informing young women’s decisions about contraceptive use and in preventing unintended teen pregnancy and sexually transmitted infections (STIs). Programming that focuses specifically on male involvement in teen pregnancy prevention can highlight how decisions to have sex and use contraception are made by two consenting individuals. Involving young men in sexual health programming can also relieve the burden on females to singlehandedly prevent unintended pregnancy.

Incorporating content about gender norms into programming for young men can be an effective way to foster equitable relationships and reduce risky sexual behaviors. Research finds that harmful gender norms and gender-based power imbalances are linked to poor sexual and reproductive health outcomes and low rates of condom use, sexual risk behaviors, and intimate partner violence. Additionally, incorporating program content related to gender and power into sexual health programming is linked to more gender-equitable relationships, reduced teen pregnancy, and reduced incidence of STIs.

Child Trends partnered with Promundo and the Latin American Youth Center (LAYC) to implement and evaluate Manhood 2.0, an innovative teen pregnancy prevention program designed specifically for young men. Child Trends interviewed 14 young men almost two years after their participation in an evaluation of Manhood 2.0 to understand what program content had resonated long-term, and how (if at all) they had incorporated program content into their lives. This brief provides data on how Black and Latino young men receive male-focused pregnancy prevention programming, two years later, and what implications these data have for future programming with these populations.


Key Findings Summary

  • Young men felt that Manhood 2.0 had increased and sustained their confidence in discussing birth control use with partners.
  • With increased confidence in discussing female birth control methods, young men still viewed themselves in a supportive role for females’ ultimate decisions related to family planning.
  • Young men felt that Manhood 2.0 had increased their understanding of the nuances of sexual consent and the importance of obtaining sexual consent.
  • Through Manhood 2.0, young men had expanded their definition of a “real man” and continued to challenge traditional ideas about masculinity and gender roles.
  • Young men highlighted racism, early fatherhood, and a lack of role models as among the biggest issues they face and areas of need for additional support.
  • Since the program ended, young men had not found a formal safe space like Manhood 2.0 to talk with other young men; however, the program had enabled them to create those spaces for themselves, informally, years later.

Developing a pregnancy prevention program for Black and Latino young men

Few pregnancy prevention programs are designed for males and even fewer programs focus on young men of color in an uplifting way. This matters because birth rates for Black and Latino teens are 50 percent higher than the national average, and 75 percent of teen pregnancies are unintended. Additionally, 80 percent of young, unmarried Black men and 78 percent of young, unmarried Latino men believe it is important to prevent pregnancy at this young age. However, Black and Latino men often face barriers to accessing reproductive health care services and have historically been excluded from reproductive health efforts. Developing and evaluating programs and conceptual models that support young Black and Latino men in making informed decisions about having sex and using contraception can play a key role in reducing unintended teen pregnancy in the United States.

Promundo and the University of Pittsburgh developed Manhood 2.0, which encourages young men—through reflective discussions—to question and challenge inequitable gender norms, reduce intimate partner violence, improve contraceptive use, and prevent unintended teen pregnancy. This program was informed by input from young Black and Latino men in Washington, DC. [1] In 2017 and 2018, Child Trends conducted a rigorous evaluation of Manhood 2.0 in Washington, DC with a sample of Black and Latino young men. At the end of the evaluation, Child Trends conducted focus groups with 27 of the 56 young men (48%) who completed Manhood 2.0 to understand what they had learned from the program and how they felt about the program content and delivery. This brief describes the experiences of the 14 young men (25%) who participated in the 2020 long-term follow-up.


Findings from Long-Term Follow-Up with Former Manhood 2.0 Participants

In 2020, Child Trends conducted interviews with nine young men and two focus groups with an additional five young men (N=14) who had participated in at least 50 percent of Manhood 2.0 sessions in 2017 and 2018. Participants described the lessons and knowledge they gained from Manhood 2.0, aspects of the program they had incorporated into their lives, and additional services and supports that future programs could incorporate to help support young men—particularly Black and Latino young men. Most participants (71%) were Black, 18 years old, and had completed the Manhood 2.0 program 1.5 to 2 years prior. These participants had significantly higher attendance in the Manhood 2.0 program than those who did not participate in focus groups or interviews. Half of participants reported visiting a health care provider for sexual or reproductive health services in the past year, half were in a current relationship, 50 percent had ever had sexual intercourse, and 43 percent were sexually active in the last three months. Almost all sexually experienced young men reported ever having a pregnancy scare. See the appendix for detailed information on the study methods and participant characteristics. This brief presents the most salient themes emerging from the long-term follow-up study.

“[Manhood 2.0] helped me a lot with being able to openly have conversations about prevention.” Manhood 2.0 increased and sustained young men’s confidence in discussing birth control use with partners, years later.

In the 2018 immediate follow-up focus groups, Manhood 2.0 participants discussed how they had gained a broader understanding of the various forms of birth control methods as a result of the program, and how this knowledge had increased their confidence in talking with potential partners about using birth control. In the 2020 long-term follow-up interviews and focus groups, we asked the young men to discuss any opportunities they had had to use this knowledge with previous or existing partners. One participant said, “[Manhood 2.0] helped me a lot with just being able to openly have conversations about prevention.” Most young men had not been directly involved in birth control decision making with a partner, largely because they had not been sexually active or in a serious relationship since completing the program. However, overall, the young men—regardless of relationship status or sexual activity—noted that they would still feel confident discussing birth control use with potential partners, if they needed or wanted to. For example, one young man said, “If [my girlfriend] was bringing up the idea that she wanted to be on birth control, I would be able to have a conversation with her and have knowledge about it.” Another participant stated:

“[Manhood 2.0] helps you understand … it’s more than a condom for birth control methods. And so, I guess that can make me feel confident. I know this type of information, and I can use it to help me and the relationship too.”

Participants also reported that Manhood 2.0 had provided a collective space to ask questions and discuss various birth control methods. One young man described how participating in open discussions in the program with facilitators and other young men helped him see birth control as a “discussable topic” between partners, rather than solely a female’s responsibility. Another participant said, “Before the program, I didn’t know much about female birth control … but once I got into Manhood … I was able to see that there’s a lot of other different methods that we can use as well. And they helped me understand and be able to have that conversation.” Overall, these findings indicate that participants have sustained comfort and confidence discussing birth control use with partners up to two years after participation.

“Young men] should support females’ decisions.” Young men view themselves in a supportive role for females’ decisions related to family planning.

In the long-term follow-up interviews and focus groups, we explored what young men saw as their role in pregnancy prevention and in decisions about birth control use. Several young men reported that they should be equally responsible for preventing pregnancy and mentioned ways they could support their partners in making decisions about contraceptive use—for example, by contributing knowledge about the pros and cons of birth control. One participant said, “I feel like [young men] should take the time to think about, learn the positives and negatives of birth control, and then they just speak with their partner about it … I think they should really discuss it together.”

For men who had been directly involved in decision making with a partner, the side effects of birth control played a large role in conversations and thinking around birth control use. One participant said, “[Previous partners] who used birth control … they really told me that it’s good for some physical aspects, but for things like emotional and mental stability, it sort of varies by person.” He reiterated the importance of discussing birth control, given that women may have had negative experiences with it in the past.

A couple of young men mentioned encouraging their partners to stop taking birth control, citing concern for their partner’s well-being. One young man explained how his partner had experienced negative side effects from the pill, so she switched to the shot. However, “so far, that has not been the brightest option either. So right now, I just told her that we’re just going to stop using birth control, period.” When speaking hypothetically, another participant said, “I mean, me personally, I wouldn’t really want her to [use birth control] because, like I said, it does come with side effects too, that you know might affect you sometimes a little bit in the long run.” Even though some men expressed concerns about side effects, some described how the program helped shift their negative perceptions of birth control in a positive direction. For example, a participant said, “I thought birth control was a way to— … I thought that harmed women or something, but the program taught us how it benefits and how it helps.”

Given the complexities of these decisions, young men emphasized the importance of being understanding and respectful of women’s birth control decisions, saying that “[young men] should support females’ decision even if they don’t use birth control. They should support it even if they do use birth control. Either way, support it all the way—no matter what circumstance.” This aligns with the immediate follow-up focus groups, where young men largely agreed that birth control decisions are ultimately up to women.

Young men also emphasized that decisions about having children should be made equally. One participant remarked, “Both the male and the female should be in the right position in life to be able to make a decision on whether to have a baby or not. That’s when they should both equally consult one another.” While young men agreed that both partners should be involved in the decision-making process and have a mutual understanding about the implications of having children, they ultimately felt that it was a woman’s decision. One participant explained how women of color have particularly difficult interactions with the health care system during pregnancy and childbirth—“where doctors don’t understand pain, they don’t believe that when women say that things are not right, it’s not right. And so, with that kind of stress and pressure, I rely on the woman to make her decision …”

“I didn’t really see [sexual consent] as a big deal until Manhood 2.0.” Manhood 2.0 made a lasting impact on how young men define sexual consent and view the importance of obtaining consent.

Young men who participated in Manhood 2.0 gained a more nuanced and deeper understanding of sexual consent, which stuck with them up to two years after the program ended. Young men reported that the program had taught them to be aware of any discomfort before engaging in sex and that sexual consent needs to be obtained while sober. For example, one young man explained that if someone is “saying they want to do it, but they look uncomfortable, that’s their sign that you shouldn’t pressure them into doing something they don’t want to do.” Young men also discussed how, before participating in the program, they had not been aware that consent could be revoked midway through sex, and that Manhood 2.0 had taught them that “you need to constantly be affirming the consent is still there at all times.” The program had also helped them understand that men pressuring women into providing consent does not qualify as consent. For example, a participant said, “If they said, ‘no,’ and you continuously, continue to ask them, and they say ‘yes.’ I didn’t really see that as a big deal until when I really got into Manhood 2.0 because one thing they told me like, ‘Trust me. If they want to do it, they’ll say it and you don’t have to keep pressing them.” He continued: “Sometimes a female don’t want to do things but guys are very good at like seducing their minds so they just do it.”

Since half the participants had never had sex, many of the young men discussed how consent plays out primarily for other young men. Participants discussed how sexual consent may be “ignored” or “rushed,” and that young people do not usually think about consent before sex happens; instead, they just “go with the flow.” Similarly, young men discussed how, even though they define consent as a verbal “yes” or “no,” sexual consent can be nonverbal and confusing. One participant explained his views: “I feel like sometimes consent can be physically shown because if a guy and a female just keep looking at each other and they just kiss … I mean nobody verbally said it, but you know they physically said it, and that’s why I feel like consent can be physically and verbally dependent.” The participant continued to say that, even if he were to kiss before verbal consent, he would ask his partner, “Are you sure this is what you want to do?” noting that other men typically don’t do this.

“It’s okay to not be okay.” Manhood 2.0 influenced the young men’s definition of a “real man” and helped them further challenge traditional ideas around masculinity and gender roles.

Young men who participated in the 2018 immediate follow-up focus groups reported that Manhood 2.0 had shifted their views on gender norms, specifically around allowing themselves to express emotions. Similarly, in 2020, many participants reported that Manhood 2.0 had helped them see that “it’s okay to not be okay”—and that expressing emotion doesn’t make you less of a man. At least one third of participants mentioned that young men struggle to communicate their feelings. As one young man said, “if there is one issue that I would like to solve about men, it’s how we communicate how we feel.” Having a safe space to talk to other young men, like Manhood 2.0, was important for participants who felt that they did not have anyone they could turn to: “There was nobody I could talk to. I just had to keep it in, and that messed with my head …” Even participants who felt they had someone to turn to mentioned that “[men] are not raised to be able to have those kind of conversations” and benefited from learning, through Manhood 2.0, how to communicate feelings and express their emotions.

Young men also delved more deeply into what they feel society expects of them, including the pressure to provide financial stability and sacrifice for their families. The young men discussed how they are expected to “step up more than the female” and have the added pressure to “pay all the bills.” These pressures and responsibilities around what “men are supposed to do” resulted in several participants wanting more equitable relationships, in which “both people go to work, providing for one another.” As a result of Manhood 2.0, young men also learned that they do not have to be “the dominant figure of the house” and that “the man has to help somehow in the family … in the house”—and that not just the woman should serve in this role. Overall, Manhood 2.0 guided the young men in understanding how gender plays a role in society and in relationships; years later, this continues to be reinforced through their everyday lives.

“It’s so easy for a Black man to get locked up or imprisoned.” Racism, early fatherhood, and lack of positive role models are some of the biggest issues that young men of color face today.

Similar to the immediate follow-up focus groups, interview and focus group participants in 2020 identified racism, discrimination, and stereotyping as the biggest issues they face as young men of color. One participant explained that “young Black males like myself are being accused of stealing or committing a crime that they didn’t do, and they’re getting killed over it for no apparent reason.” The young men reported that, because of pervasive racism and stereotyping, they have to “watch the way” they carry themselves because “it’s so easy for a Black man to get locked up or be imprisoned.”

New issues, such as the challenge of being a young father and the lack of positive role models, also emerged in the long-term follow-up interviews and focus groups. Although only one young man had a child, several participants discussed the challenges of being a young father—notably the financial strain and educational sacrifices. Participants felt that young fathers often “don’t have enough money to provide for the kid.” The young men also discussed how some of the issues around being a young father are compounded by being a young Black man. One young man discussed how, as a young Black father, “you are already down a couple points because you’re Black and have a kid. [Society] don’t think that you’re going to be there [for the kid].”

Several participants also mentioned the lack of positive role models for young men of color as one of the biggest issues they face. One participant explained: “[young men of color] don’t have that father figure that’s been there to really mentor them.” Young men also wanted to learn more about how to “deal with society.” For example, one participant explained how “in school they’ll teach you how to read, how to write, but when you go to the real world, they’re not showing you how to do taxes or other stuff that a grown man is supposed to do.” Another participant expanded on this, saying that young men of color lack representation in successful careers. Overall, the young men felt that more successful role models who looked like them would be critical for helping them “find what they want to be when they get older, what path they want to take, what life they want to live.” One participant highlighted how young men of color “have the mindset to go far,” but that they “need people that can push us forward, that we can listen to, that will really be a strength that can help a lot of Black men in the community.”

“Not everyone has a place.” Even though participants had not found another safe space like Manhood 2.0 since the program ended, the program had made them more comfortable creating those spaces themselves.

When asked what had resonated most from Manhood 2.0, the young men reiterated the importance of facilitators who fostered a feeling of togetherness, provided a judgement-free space, and taught the young men that they “have other people there to talk to.” The young men frequently mentioned how Manhood 2.0 was unique because participants felt they could “say anything and not have to worry about anybody judging” and could be themselves around the facilitators and “laugh” and “joke around with them.” This sense of comfort—along with a reflective, discussion-based format—encouraged strong bonds between participants and made the young men feel that Manhood 2.0 was a safe space where “you can share anything.”

Young men noted, however, that it can be difficult to have conversations about masculinity, relationships, and sex outside of a program setting, and that Manhood 2.0 “holds a lot of value” because “not everyone has a place where you can go into like, ‘man, I need to talk.’” Most participants reported that, since Manhood 2.0 had ended, they had not yet found another safe space in which they could express their emotions and discuss what it means to be a man. Other participants felt they had friends, partners, or family members they could talk to, but mentioned that it can be difficult to carve out a time or space for those conversations. One participant explained: “When you’re hanging with your friends, you’re not going to talk about consent in the middle of a game.” He continued, “It’s better to have that sort of opportunity to talk, not only with other males, but males who lived through the times that you have and get their opinions on things.”

Even though participants had not found other formal spaces like Manhood 2.0, several young men discussed how the program had made them more comfortable reaching out to friends or family for support. One young man said that, while he didn’t talk “specifically [about] being a man,” he was able to seek support from his girlfriend and mother and express how he was feeling. Another participant mentioned that Manhood 2.0 had taught him how “constructive conversations are supposed to go”; because of that lesson, he is “more able to have those kinds of conversations with my friends back at school.” Overall, the young men felt more comfortable talking about their emotions and sensitive topics since participating in Manhood 2.0.


Discussion

Both the content and the delivery of Manhood 2.0 continued to influence this sample of program participants years after the program ended. For example, program participants recalled detailed knowledge about sexual consent and indicated that they still felt comfortable communicating with potential partners about birth control, even years later. The discussion-based format with nonjudgmental, relatable facilitators prepared young men not only for future conversations on family planning and sexual consent with their partners, but also for conversations with other young men, friends, and family members on sensitive topics. Some data suggest that the skill-building and discussion-based components of the curriculum, in combination with knowledge building, might help enforce equitable romantic relationships.

The young men who participated in Manhood 2.0 take seriously their role in supporting partners in their contraceptive decisions. This is especially important as more of these young people enter into romantic and sexual relationships. In the two-year follow-up, the young men continued to note their increased awareness of birth control methods, which made it easier for them to discuss contraceptive options with partners. However, despite this additional knowledge and awareness of birth control, young men continued to respect women’s autonomy over their bodies and noted that decision making around birth control and pregnancy was ultimately the female’s decision because it involved her body.

Appendix. Focus Group and Interview Study Methods

For information on the Manhood 2.0 program, study eligibility and recruitment, and the full sample participant characteristics, please see our previously published brief.


Recruitment

Program facilitators served as liaisons for Child Trends and reached out to the 41 previous Manhood 2.0 participants who had attended at least 50 percent of the program sessions. We focused recruitment efforts on those who had attended at least 50 percent of program sessions because we felt they might be better able to speak to the effects of the program. Program facilitators used contact information obtained from the study to invite the young men to participate in a long-term follow-up interview or focus group. Participants were contacted via a mix of calls, text messages, and emails. Those who expressed interest were tracked in an Excel document. Program facilitators scheduled a time for the interview/focus group and informed the Child Trends evaluation team of the number of expected participants and the date and time of each focus group or interview. Program facilitators sent participants several reminder messages leading up to the interview/focus group date. In total, Child Trends conducted nine interviews and two focus groups with 14 young men.


Data collection

The Child Trends research team created interview and focus group protocols that were approved by Child Trend’s institutional review board. The protocols included questions about what young men had learned during the program, which program topics had resonated with them the most, and their experiences after participating in the program. Participants were sent an electronic consent form, which they read with the facilitator before the focus group/interview. The participants then provided verbal consent before the start of focus group/interview and agreed to have the discussions audio recorded. Focus group facilitators started the focus groups/interviews by asking general questions, such as what participants had been up to since the Manhood 2.0 program ended. As discussions proceeded, facilitators asked participants specific questions relating to their experience in the program and after the program, and the knowledge they had gained from program sessions. Depending on the size of the group and depth of conversation, focus group/interview discussions ran from 45 to 90 minutes. At the end of the focus group/interview, participants were asked to fill out an 18-item, online demographic survey sent to them via text and/or email. Participants were then sent an electronic $50 Amazon gift card for their participation, regardless of whether they had completed the focus group/interview or the demographic survey. Interviews and focus groups were held from January to March 2020.


Data analysis

After each focus group and interview, the study team transcribed the audio recording of the discussion prior to data analysis. The study team reviewed the transcripts for completeness and de-identified the transcripts before entry into the Dedoose software. To analyze the focus group findings, the study team used the focus group protocol as a guide to create a codebook containing approximately 40 codes. Two researchers coded two transcripts together, reconciled any discrepancies through consensus, and independently coded the remaining transcripts. After coding the 11 transcripts, the two coders, along with another study team member, identified commonalities across groups; through extensive discussion, they agreed on the larger themes presented in this brief.


Participant characteristics

The study team collected demographic characteristics from the focus group/interview participants. The demographic characteristics, neighborhood violence and drugs, and sexual behaviors of these participants can be found in Table 1 below. The average age of focus group/interview participants was 18 (range from 16 to 19), and the majority (71%) were Black. Half of participants had some college education, technical school, or more, while over one third (36%) had less than a high school education. Several participants reported neighborhood violence, such as a fight or violent robbery, and over one third of participants (36%) reported people selling or using drugs in their neighborhood. Only one participant (7%) had a child. Half of participants reported visiting a health care provider for sexual or reproductive health services in the past year, half were sexually experienced, and 43 percent were sexually active in the past three months. One third of sexually active participants (33%) had had sex without any method of birth control, and two thirds (67%) had had sex without a condom in the past three months. Also, 86 percent of sexually active participants had experienced a pregnancy scare.

Footnote

[1] Manhood 2.0 has maintained a focus on serving structurally disadvantaged young men. Promundo, in partnership with LAYC, conducted initial focus groups with young Black and Latino men to inform the Manhood 2.0 curriculum and adaption. They also developed a youth advisory board to test and advise the team on the relevance of curriculum activities for the target populations.