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Sex Ed for Guys

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Unfortunately, young men don't know where to turn for help. Unlike women, who need to visit a doctor to get the pill or a diaphragm, guys can get condoms without seeing a health care provider. Yet many teenage boys consider themselves too old for the pediatrician and too young for the internist. As a result, guys haven't gotten the message that they can and should take reproductive responsibility in their relationships.

Recent federal programs hope to reverse this situation. Under the umbrella of the Clinton administration's Fatherhood Initiative, the Office of Family Planning has awarded grants totaling $4.7 million to 24 community-based organizations to develop and test approaches for delivering reproductive health services to young men.

The clinic at Columbia is one recipient of such a grant. Director Bruce Armstrong, PhD, casually dressed in a cotton shirt, khaki slacks, and boat shoes, earned his doctorate in social work. In 1986, he started his program to offer sports and job-related physicals to neighborhood boys. Once the guys got in the door, Armstrong and his staff used the opportunity to educate them about other health needs: the proper way to put on a condom, the signs and symptoms of various STDs.

Today, medical director David Bell, MD, an adolescent medicine specialist, supervises 10 medical students and two doctors, furthering Armstrong's goal of training future doctors in the care of young men. They work out of a women's clinic that becomes the Young Men's Clinic on Monday evenings and Friday afternoons -- and they take advantage of being based in a place where women get care. Clinic coordinator Darren Petillo visits women while they're in the waiting room, describes the men's program and asks the women if they'll ask their boyfriends to come in. The approach works: 50% of the clinic's new male patients are referred by women, twice the rate of two years ago. "Everything we do is strategically thought out," says Armstrong.

On a recent Monday night, medical students were picking up charts, escorting patients into private rooms, interviewing them about medical problems and lifestyle concerns, and passing the charts on to the doctors. On this evening they will see 26 patients, including a 17-year-old who came for a routine physical but complained of back spasms, and a 15-year-old who needed a physical for his school basketball team.

"He describes himself as being in excellent health, but you'll still do your history," Armstrong tells the students about the young basketball player. "Find out if he has a partner he's getting close to." Another young man who lost his job recently says he'd been smoking more marijuana than usual. He ultimately sees the in-house social worker, who helps him make the connection between his pot use and the stress from losing his job.

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