"Particularly for older men who are interested in playing a role in pregnancy prevention through sterilization, there are not many low-cost services available, even in a large city," says David Bell, medical director of the Young Men's Clinic at New York-Presbyterian Hospital's Family Planning Clinic.
The health law also requires free coverage for screening for a number of sexually transmitted diseases in women but not men. For example, HIV screening is covered annually for all sexually active women. In men, free screening is recommended for those who are at higher risk, such as men who have sex with men or with multiple partners.
Similarly, the Preventive Services Task Force, a federal panel of experts, recommends screening all sexually active women younger than 25 for chlamydia and screening at-risk women for gonorrhea. But the task force says there's not enough evidence to make such recommendations for men.
Some of the new preventive coverage requirements do address men's sexual health. For example, under CDC recommendations that become effective in December, new health plans must cover the three-shot human papillomavirus (HPV) vaccine for young men at no charge. Previously recommended for young women primarily to prevent cervical cancer, the vaccine is also associated with some cancers that affect men. It is recommended routinely for boys aged 11 or 12, and for those ages 13 to 21 who haven't been vaccinated.
It's no accident that most of the new preventive benefits are aimed at women, say experts. "Women bear a disproportionate burden when it comes to sexually transmitted diseases and preventing pregnancy," says Deborah Arrindell, vice president for health policy at the American Social Health Association, an advocacy group.
As women enter their reproductive years, they typically begin to see a primary-care practitioner, often a gynecologist, for regular checkups and to receive contraceptives. In 2009, 66 percent of women ages 18 to 44 visited a primary-care provider, compared with 52 percent of men in that age group, according to the Centers for Disease Control and Prevention's National Center for Health Statistics.