MARS has experience providing sexual health education to "harder-to-reach" young males in alternative youth settings, treatment centers and juvenile departments. Use of responsible male peer role models lends credibility to program messages and provides participants with positive ideas about the people they can become.

Pre-post evaluation indicates that participants have statistically significant increases in knowledge, attitudes, self-efficacy and behavior relating to sexual/reproductive health.

MARS also provides free, confidential individual sexual health education sessions with a trained peer outreach worker. Sessions are client-centered and focus on the specific needs/interests of the individual.

Expansion of MARS to serve incarcerated young men will meet the need for male-specific sexual health resources that engage males in the effort to reduce rates of unintended pregnancies and HIV/STIs both during and after incarceration. MARS has gained national recognition at public health conferences and there is significant opportunity to replicate the MARS Program with currently underserved populations and in new locations throughout Oregon.

MARS provides educational services designed to motivate males to take an equal part in pregnancy and infection prevention. To promote male participation, institutional awareness should be raised within family planning clinics to improve access to sexual/reproductive health services for males in general, as well as those recently released from correctional institutions.

At the policy level, federal reimbursement programs for reproductive health services to males are currently limited to family planning services (e.g. contraception). However, men's sexual health needs include services that are not reimbursable under current definitions (e.g. HIV/STI screenings, testicular health). This means that well-intentioned, proactive men with limited financial resources face expensive medical costs to be responsible sexual partners.

Pre-post survey findings from the classroom sexual health curriculum evaluation show that participants have statistically significant increases in the following: 1) sexual health knowledge (STIs and birth control) and where to access free/confidential sexual health services; 2) attitudes about healthy relationships and the benefits of abstinence; 3) self-efficacy communicating with a partner about abstinence, safe sex and healthy relationships; 4) self-efficacy refusing sex; and 5) self-efficacy buying condoms.

Males who participated in an individual sexual health consultation with a peer outreach worker completed a pre- and one-month follow-up survey. Findings from this analysis show that participants have statistically significant increases in the following: 1) frequency and comfort talking to partner(s) about healthy relationships and reproductive health; 2) sexual health knowledge; 3) attitudes toward birth control, condoms and abstinence; 4) attitudes about gender roles and contraceptive use; and 5) self-efficacy buying and using condoms.

These are recognized measures for demonstrating program effectiveness in the field of prevention research.

County health departments implementing MARS have developed an intergovernmental agreement which increases opportunities to leverage funding and coordinate grant writing efforts (anticipated in effect January 2008).

Plans for further expansion/replication are in place through a partnership with Oregon Department of Education HIV Prevention Education Program to target high risk males.

Additionally, efforts may be supported through fees for MARS services.

Sources of revenue are grants from the U.S. Office of Family Planning (100% for Benton County), regional Office of Family Planning (Title X Region X) (100% for Deschutes County; 85% for Jackson County) and local foundations (15% for Jackson County).

Staffing levels vary among counties. Benton County has 1.75 FTE, 6 paid student-interns (15-20 hrs/week), and 1 volunteer. Jackson County has .05 FTE and 4 paid student-interns. Deschutes County has 3 paid student-interns (coordinator time is in-kind).

The Oregon Youth Authority is the state juvenile corrections agency. OYA incarcerates youth who cannot safely live in the community, and provides supervision and treatment opportunities to youth offenders throughout Oregon.

Locally, county juvenile departments provide a continuum of supervision and rehabilitation services to youth offenders.

The Public Health Department of Oregon State University will continue serve as the independent program evaluator.

There are compelling reasons to provide sexual and reproductive health services specifically for males: 1) MALES DON'T KNOW OR BELIEVE SERVICES ARE FOR THEM: Over the past 30 years, on average only 2-4% of Title X family planning clinic patients have been males (Department of Health and Human Services, 2003); 2) MEN WANT THE SERVICES: 90% of men want to know about ways to prevent pregnancy (EngenderedHealth FGD Findings, 2003); 3) MEN HAVE UNIQUE SEXUAL HEALTH NEEDS: Testicular cancer is the most common cancer among males age 20-35 years old (Guidelines for Male Sexual and Reproductive Health Services, 2005).

Addressing men's reproductive and sexual health needs benefits more than just the men we reach. MARS believes that if men's sexual health needs are met, the whole community will benefit. Men will gain awareness and responsibility for pregnancy and disease prevention. The incidence of unwanted pregnancies and sexually transmitted infections will be reduced, resulting in healthier and happier youth and communities.