Marcell (Arik Marcell, MD, MPH, assistant professor with the Bloomberg School’s Center for Adolescent Health and a teen health expert with the Hopkins Children’s Center) pointed to gaps in research, the absence of uniform clinical practice guidelines and care providers’ lack of knowledge as contributing factors to a health care environment in which male teens often don’t receive basic sexual and reproductive health care—services that he said should be standard in primary care settings. These include taking a sexual history, STI/HIV screening and testing, a sexual development physical assessment, including a genital exam, and discussion of the male role in contraception and STI/HIV prevention.
“I think the bottom line is there’s a major research gap,” said Marcell.
“We have little data about sexual and reproductive health services delivered to boys and young men, and the few studies that we have show gender disparities, with fewer services being provided to males,” he said, noting that the imbalance reflects the longstanding traditional emphasis on women’s health in the family planning and sexual and reproductive health arena.
Yet research shows that it’s vital to reach this population.
Studies have found that compared to teen girls male adolescents become sexually active at a younger age and engage in high-risk sexual behaviors more often, including unprotected sex and sex while drunk or on drugs.
And in a 2010 study in the Journal of Adolescent Health, based on data from the 2002 National Survey of Adolescent Males, Marcell found that fewer than 1 in 5 young men reported receiving STI/HIV counseling, a finding that indicates no improvement over a 7-year period.
And one about prostate cancer:
"The problem is that in contrast to the small benefits, a significant number of men will be harmed by the test and treatments that follow prostate cancer screening," [...] The PSA is unreliable, giving a falsely positive result 80 percent of the time. Prostate cancer is typically diagnosed in older men, and the disease usually progresses so slowly they die of something else. [...] It (a task force) cited an 11-year study of over 180,000 men. The study showed more than 1,000 need to be screened to detect 37 cancers and prevent a single prostate cancer death.