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Male reproductive health disorders among Aboriginal and Torres Strait Islander men: a hidden problem?

Michael J Adams, Veronica R Collins, Michael P Dunne, David M de Kretser and Carol A Holden
Med J Aust 2013; 198 (1): 33-38. || doi: 10.5694/mja12.10490

Summary

Objective: To better understand help-seeking behaviours and reproductive health disorders among Aboriginal and Torres Strait Islander men.

Design, setting and participants: A cross-sectional mixed-methods study conducted from 1 May 2004 to 30 April 2005 of 293 Aboriginal and Torres Strait Islander men aged 18 years and over from urban, rural and remote communities in the Northern Territory and Queensland.

Main outcome measures: Subscale of the International Index of Erectile Function, self-reported help-seeking behaviours for erectile dysfunction (ED) and prostate disease, thematic analysis of semi-structured interviews and focus groups.

Results: The prevalence of moderate-to-severe ED increased across age groups, from about 10% in younger men (under 35 years) to 28% in men aged 55–74 years. Moderate-to-severe ED was strongly associated with reporting a chronic condition (odds ratio [OR], 3.67) and residing in a remote area (OR, 2.94). Aboriginal and Torres Strait Islander men aged 40–59 years showed similar low levels of help-seeking behaviours compared with non-Indigenous men from a comparable population-based study. About half of the men with ED saw a doctor or received treatment for ED in each population. While prostate cancer rates were low in both studies, testing for prostate problems was less frequent in Aboriginal and Torres Strait Islander men (11.4%) than in non-Indigenous men (34.1%, P < 0.001), despite similar levels of concern about prostate cancer. Barriers to help-seeking included shame, culturally inappropriate services and lack of awareness.

Conclusion: This study, the first to investigate reproductive health of Aboriginal and Torres Strait Islander men, found low levels of help-seeking behaviours for reproductive health disorders, with implications for missing a predictor of chronic disease and late diagnosis of prostate disease.

  • Michael J Adams1
  • Veronica R Collins2
  • Michael P Dunne1
  • David M de Kretser2
  • Carol A Holden2

  • 1 School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD.
  • 2 Monash University, Melbourne, VIC.

Correspondence: carol.holden@monash.edu

Acknowledgements: 

We wish to thank all the men who participated in the research, and the Aboriginal and Torres Strait Islander peoples for allowing us to undertake this research study in their communities. Without their support we would not have been able to collect the valuable information recorded here. Special mention must go to Carolyn Lang, Stanley John Ridgeway, Helen Hewett and Sue Naish for their patience and involvement. We also thank Damien Jolley for his statistical advice. Andrology Australia is supported by the Australian Government Department of Health and Ageing.

Competing interests:

Andrology Australia has received financial support from Pfizer for a men’s health education workshop for practice nurses, from Bayer and Eli Lilly for a men’s health advisory forum, and from Janssen-Cilag for a general practitioner education workshop.

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