Assessing the Unmet Preconception Care Needs of Men in the United States by Race/Ethnicity and Nativity

Objective: To estimate the percentage of men in the U.S. in need of preconception care and to assess gaps in utilization of services by race/ethnicity and nativity, irrespective of intention for children, via cross-sectional analysis of 2017-2019 National Survey for Family Growth (NSFG). Methods: The need for preconception care was defined as non-sterile men who had sexual experience and were with female partner(s) who were not sterile. Thirteen preconception care services were assessed across six domains: family planning, blood pressure, HIV, STD, weight management, and smoking cessation. Multivariable weighted analyses were performed to obtain odds ratios to assess differences in preconception care utilization among participants. Results: Approximately 64% of men were estimated to need preconception care. Substantial disparities in need and service use were found across sociodemographic characteristics. Foreign-born men had significantly higher odds of not receiving three of the thirteen preconception care services, including condom use screening (aOR = 1.67; CI = 1.23-2.26), HIV advice (aOR = 1.76; CI = 1.35-2.29), and STD testing (aOR = 1.66; CI = 1.13-2.44), than U.S.-born. Hispanic men had higher odds of not receiving blood pressure (aOR = 1.39; CI = 1.09-1.79) and smoking screenings (aOR = 1.33; CI = 1.02-1.73) than White men. Black men had the highest use in six of the thirteen preconception care services. Conclusion: Gaps in preconception care utilization suggest a need to further explore potential drivers of disparities, specifically for Hispanic and foreign-born men. Additional research into the timing and quality of care received by men are needed to assess the scope, severity, and prevalence of unmet needs within medically underserved communities.