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Shahvisi offers cogent arguments for men taking primary responsibility for unwanted pregnancy (1). I do not, in this letter, aim to argue against her conclusion. However, when discussing potential counterarguments to this position, she mentions that it is claimed that perhaps women would not trust men to use long-acting reversible contraceptives (LARCs). Shahvisi does well to point out the relevant data that reveals women in longer term relationships would, in fact, trust their partners to use LARCs (2,3). Yet in discussions of casual sexual encounters, she merely asserts that ‘barrier methods are in any case preferable’(1).
I argue this is not trivially the case. The use of barrier methods is highly inconsistent, particularly in casual sex (4–8). Despite their role in preventing both sexually transmitted infections (STIs) and unwanted pregnancy, I would argue that this data shows that people’s condom preferences are not so clear cut. Preference for condom use is heterogenous and is tied to desires more abstract than seeking to prevent pregnancy, such as the desire to feel masculine or ‘clean’ (8). Additionally, condoms, the most popular barrier method, are 86% effective at preventing unwanted pregnancy in typical use (9). LARCs are more than 99% effective (10).
It is my view that defeating the argument that women would not trust men to use LARCs in casual sexual relations thus needs more work. One argument might be that, in a world where...
It is my view that defeating the argument that women would not trust men to use LARCs in casual sexual relations thus needs more work. One argument might be that, in a world where male LARCs are freely available, the trust that men are indeed using them would stem from a similar place to the trust that one’s sexual partners do not have any STIs. At present, STI status is not routinely verified (e.g., through the exchange of clinic results) before partners embark on casual sex. If at all, statements of trust, such as verbal assertions of STI status, may be proffered prior to casual sex (11,12). I argue it is plausible that, were male LARCs to become readily available, contraceptive status would be navigated in a similar fashion.
1. Shahvisi A. Towards responsible ejaculations: the moral imperative for male contraceptive responsibility. J Med Ethics [Internet]. 2020 Mar 27;medethics-2019-105800. Available from: http://jme.bmj.com/content/early/2020/03/26/medethics-2019-105800.abstract
2. Campo-Engelstein L. Raging hormones, domestic incompetence, and contraceptive indifference: narratives contributing to the perception that women do not trust men to use contraception. Cult Health Sex [Internet]. 2013 Mar 1;15(3):283–95. Available from: https://doi.org/10.1080/13691058.2012.752106
3. Glasier AF, Anakwe R, Everington D, Martin CW, Spuy Z va. der, Cheng L, et al. Would women trust their partners to use a male pill? Hum Reprod [Internet]. 2000 Mar 1;15(3):646–9. Available from: https://doi.org/10.1093/humrep/15.3.646
4. Reynolds HW, Luseno WK, Speizer IS. Consistent condom use among men with non-marital partners in four sub-Saharan African countries. AIDS Care. 2013;25(5):592–600.
5. Mulumeoderhwa M. “It’s not good to eat a candy in a wrapper”: male students’ perspectives on condom use and concurrent sexual partnerships in the eastern Democratic Republic of Congo. SAHARA J J Soc Asp HIV/AIDS Res Alliance [Internet]. 2018 Aug 27;15(1):89–102. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30149788
6. Bowleg L, Massie JS, Holt SL, Heckert A, Teti M, Tschann JM. How black heterosexual men’s narratives about sexual partner type and condom use disrupt the main and casual partner dichotomy: ‘we still get down, but we not together.’ Cult Health Sex [Internet]. 2020 Feb 10;1–18. Available from: https://doi.org/10.1080/13691058.2019.1683228
7. Fetner T, Dion M, Heath M, Andrejek N, Newell SL, Stick M. Condom use in penile-vaginal intercourse among Canadian adults: Results from the sex in Canada survey. PLoS One. 2020;15(2):e0228981.
8. Sastre F, De La Rosa M, Ibanez GE, Whitt E, Martin SS, O’Connell DJ. Condom use preferences among Latinos in Miami-Dade: emerging themes concerning men’s and women’s culturally-ascribed attitudes and behaviours. Cult Health Sex. 2015;17(6):667–81.
9. Marfatia YS, Pandya I, Mehta K. Condoms: Past, present, and future. Indian J Sex Transm Dis AIDS [Internet]. 2015;36(2):133–9. Available from: https://pubmed.ncbi.nlm.nih.gov/26692603
10. Bahamondes L, Fernandes A, Monteiro I, Bahamondes MV. Long-acting reversible contraceptive (LARCs) methods. Best Pract Res Clin Obstet Gynaecol [Internet]. 2019 Dec 20 [cited 2020 Apr 5]; Available from: https://www.sciencedirect.com/science/article/pii/S1521693419301786?via%...
11. Smith BD, Jewett A, Burt RD, Zibbell JE, Yartel AK, DiNenno E. “To share or not to share?” Serosorting by hepatitis C status in the sharing of drug injection equipment among NHBS-IDU2 participants. J Infect Dis [Internet]. 2013/10/16. 2013 Dec 15;208(12):1934–42. Available from: https://pubmed.ncbi.nlm.nih.gov/24136794
12. Pfeiffer EJ, McGregor KA, Van Der Pol B, Hardy Hansen C, Ott MA. Willingness to Disclose Sexually Transmitted Infection Status to Sex Partners Among College-Aged Men in the United States. Sex Transm Dis [Internet]. 2016 Mar;43(3):204–6. Available from: https://pubmed.ncbi.nlm.nih.gov/26859810