Safer sex in later life: Qualitative interviews with older Australians on their understandings and practices of safer sex

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the U.K. and the U.S., suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study “Sex, Age & Me: a National Study of Sex and Relationships Among Australians aged 60+.” Participants were recruited through an online national survey. We consider how participants understood “safer sex,” the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented has important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and wellbeing of older cohorts

Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices.

OBJECTIVE: Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older people's knowledge of STIs and safer sexual practices. METHODS: A total of 2,137 Australians aged 60 years and older completed the survey, which included 15 questions assessing knowledge of STIs and safer sexual practices. We examined both levels of knowledge and factors associated with an overall knowledge score. RESULTS: In total, 1,652 respondents reported having sex in the past five years and answered all knowledge questions. This group had good general knowledge but poorer knowledge in areas such as the protection offered by condoms and potential transmission modes for specific STIs. Women had better knowledge than men. Men in their 60s, men with higher education levels, and men who thought they were at risk of STIs reported better knowledge than other men. Knowledge was also better among men and women who had been tested for STIs or reported 'other' sources of knowledge on STIs. CONCLUSIONS: Many older Australians lack knowledge of STIs and safer sexual practices. Implications for public health: To reverse current trends toward increasing STI diagnoses in this population, policies and education campaigns aimed at improving knowledge levels may need to be considered

Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection

Background: Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. Methods: A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n = 805, 38%). Results: Less than one in three reported a STI test in the past 5 years (n = 241, 30%) while 6% (n = 51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. Conclusions: STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients

The Importance of Sex and the Meaning of Sex and Sexual Pleasure for Men Aged 60 and Older Who Engage in Heterosexual Relationships: Findings from a Qualitative Interview Study

That many older individuals continue to engage in various forms of sexual expression well into later life is now well established in the literature. To date, however, only a small body of qualitative research has examined older men’s experiences and understandings of sex in later life. Likewise, the ways in which older men’s discussions on sex may be used as an avenue for “doing” masculinity remain underexplored. Older men are particularly interesting in this regard, as they inhabit an increasingly subordinated position in relation to hegemonic masculine ideals because of their age. To what extent might this limit or, alternatively, open up the possibilities for sexual expression and subjectivity in later life? Drawing on a subset of findings from Sex, Age, and Me: A National Study with Australian Women and Men Aged 60 and Older, data from qualitative interviews with 27 Australian men were explored in this article. The first Australian study of its kind, we argue that older men who engage in heterosexual relationships draw on a diverse and complex array of discursive positions regarding sex, relationships, and masculinity in making sense of their experiences of sex in later life. Older men are a heterogeneous group, and their experiences and understandings of sex do not simplistically follow “decline” or “success” narratives of aging. The findings of this research build upon and extend emerging research illustrating the centrality of intimacy to older men’s sexual lives, while simultaneously highlighting the ways in which the body and discursive constructions of sex intersect to shape older men’s sexual subjectivities

Learning about sex in later life: sources of education and older Australian adults

This paper examines the preferred sexuality education sources of older Australian adults in later life. Drawing on findings from qualitative interviews with 30 men and 23 women aged 60 years and older, we consider the sources that participants currently use, or would like to use, in seeking information about sex. Where relevant, we examine participants’ experiences of learning about sex in later life using different sources, and the impact these had on their sexual expression, pleasure and well-being. Preferred sources of information include the Internet, the media, health care providers, books and workshops or discussion groups. A substantial number of participants did not actively seek information on sex. For those who had, these educational endeavours could profoundly shape their sexual practices. As such, learning about sex should be viewed as a lifelong endeavour. Our findings carry important implications for the development and delivery of sexuality education for older adults

Sources of information-seeking on sexually transmitted infections and safer sex by older heterosexual Australian men and women

Sexually transmitted infections (STIs) have risen among older people in Australia and other countries. To guide future initiatives, we examined sources of information that older people use or are willing to use for knowledge about safer sex and STIs, including whether there are any gender differences. A total of 2137 Australian adults aged 60+ years completed a nationwide survey. Analyses focused on participants who were at risk of an STI (n = 686; 220 women and 466 men). Overall, information-seeking on STIs in the last year was low (18% men; 15% women). When sought, common sources included general media outlets (e.g., magazines, TV), healthcare providers (HCPs), and the Internet. HCPs were the most relied upon source among both women and men. Brochures, websites, and HCPs were rated highest as future sources; however, women indicated they were more willing than men to have information provided by brochures and websites. STI information-seeking was generally low, but there was willingness among both men and women to use a range of sources for gaining future information

Improving the sexual lives of older Australians: perspectives from a qualitative study

Objectives: To examine older Australian’s perspectives on how their sexual lives can best be supported and/or improved. Method: Fifty-three, semi-structured interviews were conducted with Australian men (n=30) and women (n=23) aged 60 and over. Results: Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including: normalising the occurrence of sex and sexual desire in later life; increasing, and improving on the quality of, cultural representations of older adults; introducing policy, educational, and practice-based changes in aged-care facilities to support the consensual sexual expression of residents; and ensuring that sexual health campaigns and education are inclusive of older people. Conclusion: Our findings present clear implications for further developing sexuality education and public health campaigns, training and education of health care professionals, and generating social and cultural change pertaining to the acceptability of the diversity of sexual expression in later life

Talking to healthcare providers about sex in later life: Findings from a qualitative study with older Australian men and women

Objective Healthcare providers (HCPs) can play an important role in supporting the sexual health of older adults; however, we know little about the experiences of older people in talking to HCPs about sex. This article examines older adults' experiences and perceptions of talking to HCPs about sex. Methods Semi-structured interviews were conducted with 30 men and 23 women aged 60 and older recruited from a national, online survey of older Australians. Data were analysed using a thematic approach. Results Most participants did not discuss sex with their HCP, and their HCP did not raise it. For those who did discuss sex with a HCP, negative and stigmatising responses were common. Positive responses could facilitate access to sexual health care. Conclusion Older people benefit when HCPs are proactive and ask about sexual health. Education in how to talk about sex with older people would also be beneficial for HCPs

The Sex, Age, and Me Study: Recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population

Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics, and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices, and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult’s understandings and practices relating to sexual health. Data collection took place in 2015, with 2,137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study’s recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area