Sexual health and older adults: Suggestions for social science research

The body of evidence on older adults’ sexual health is beginning to grow. However, it remains an under-researched area particularly within the social sciences. This letter to the editor outlines four considerations for those who carry out social science research in this area: 1. defining the age category ‘older adults’; 2. being clear about the types of sex under research; 3. capturing a range of diverse voices; and 4. considering the use of qualitative research methods to explore the topic in-depth. These suggestions are aimed at helping researchers to avoid some of the pitfalls of research in this area, as well as improving the evidence base in order to advance recognition of the issues and drive change in service provision

Phenomenology and the dance culture: Women's perception of ecstasy use, clubbing and the body.

In-depth interviews were conducted with women who use ecstasy for recreation, mainly in the context of the dance event. The aim was to discover the meaning of ecstasy use, and its surrounding culture, for women in the late 1990s. A further endeavour involved disclosing how the body was experienced at the dance event and what this meant to the women.Existential phenomenological analysis led to the following key conclusions. The dance event is experienced as a social space that allows women to be themselves and find a strong sense of belonging. There may be apparent dependence upon the experiences surrounding ecstasy. But, the journey of ecstasy use allows alterations in attitude, and transitions in life, to be experienced, which the women view positively. The women use ecstasy for pleasure, believe themselves to be independent in their use, and do not view their actions as deviant.These findings are important to scholarly literature on female drug users because they redress the gender balance by presenting the specific experiences of women. They also have implications for social policy and health service provision, in the sense that this description of a social world enables understanding, enhances communication and, thus, betters education

Older women, intimate partner violence and mental health: a consideration of the particular issues for health and health care practice

Aims and objectives: The purpose of this meta-synthesis was to explore qualitative evidence in older women with a history of Intimate partner violence (IPV) and their accounts and experiences of mental health. Background Intimate partner violence significantly impacts the health and wellbeing of women who experience it. However, women who experience intimate partner violence do not form a homogenous group and the effect on older women has not been adequately distinguished. While there is a growing body of evidence to address this deficit, studies to date have tended to concentrate on older women’s experiences of intimate partner violence in totality and as such mental health issues have been subsumed as a part of the whole. Design: Meta ethnographic synthesis of qualitative evidence. Methods: A systematic search of PUBMED, Cumulative Index to Nursing and Allied Health Literature (CINAHL), COCHRANE , Medline and PsycInfo, Sci was completed. The search included articles published up until the end of December 2015. Results: The review identified that intimate partner violence exerts a significant impact on the mental health of older women. Iintimate partner violence for women in later life is inherently complex, especially where the boundaries of violence and vulnerability have been blurred historically both within the intimate partner violence discourse and through provision and practice. Conclusions: This paper adds to the developing knowledge and understanding of intimate partner violence for older women as a part of the growing body of evidence of the impact of IPV on the health and wellbeing of those who experience abuse more generally. When age and gender intersect with IPV, there are specific implications and health professionals and service providers need to be aware of these. Relevance to Clinical Practice: Nurses and health care professionals are professionally accountable for the effective management and support of women who have experienced abuse. It is therefore crucial that they are able to understand and identify the possible complexity of presentations of abuse and this includes older women

Older adults’ experiences of sexual difficulties: Qualitative findings from the English Longitudinal Study on Ageing (ELSA)

There is a growing body of evidence demonstrating that sexual activity is important to the quality of life of older adults, and that it can be influenced by physical, psychological, and social factors. However, older adults’ experiences of sexual difficulties remain relatively unexplored. This article draws on qualitative data collected as part of the English Longitudinal Study of Ageing (ELSA). Participants answered a Sexual Relationships and Activities Questionnaire (SRA-Q), which included an open comment box for further details, 1,084 (1/7) of which were completed. These data were analyzed using Template Analysis, and findings on the experiences of sexual difficulties are presented in this article. Sexual difficulties were contextualized within the couple relationship and could be detrimental to the relationship, particularly if the partner would not seek professional help. Participants reported that sexual difficulties could also have a negative impact on psychological well-being, described mainly as frustration, depression, and sadness. For some participants the supportive nature of their relationship buffered these impacts. Few had sought professional help; those who had reported helpful and unhelpful experiences. These findings add to the limited evidence base and have implications for health care in the context of global aging and a growing recognition of older adults’ sexual rights

Socio-cultural influences upon knowledge of sexually transmitted infections: a qualitative study with heterosexual middle-aged adults in Scotland

There has been a recent global increase in sexually transmitted infections (STIs) including HIV among adults aged over 45. Limited evidence exists regarding middle-aged adults’ knowledge of STIs other than HIV. This qualitative study sought to understand middle-aged adults’ knowledge of STIs within a socio-cultural context. Individual interviews, based on a life-course approach, were conducted with 31 recently sexually active heterosexual men and women. Participants were aged between 45 and 65 and of mixed relationship status (14 were single, 17 in a relationship). Thematic analysis identified four key findings, including: “engagement with STI-related knowledge”; “general knowledge of STIs”; “learning about STIs from children”; and “limited application of knowledge”. The findings allow insight into a neglected area, and indicate that socio-cultural factors influence middle-aged adults’ STI-related knowledge acquisition throughout the life course. These are important implications for the prevention of STIs, particularly in addressing the on-going stigmatisation of STIs in older age groups

Let's talk about sex – what do older men and women say about their sexual relations and sexual activities? A qualitative analysis of ELSA Wave 6 data

In 2012/2013 the English Longitudinal Study of Ageing (ELSA) included a comprehensive Sexual Relationships and Activities questionnaire (SRA-Q). A total of 7,079 men and women aged 50 to >90, primarily heterosexual and in a coupled relationship, completed the SRA-Q answering a series of questions about their attitudes to sexual relationships, their own sexual activities, problems and concerns with sexual functioning, and quality of intimate relationships. The questions aimed to gain insights into the ways in which sexual relations and activities related to health, well-being and other lifestyle factors as people grow older. The primary mode of data collection was a tick box response to a series of questions. However, at the end of the questionnaire an open comment box was provided, which asked respondents whether there was anything else that they would like to say. 1,084 respondents provided additional information and these comments created a unique qualitative dataset. The analysis of this data then illustrated how people’s health, relationships, experiences and perceptions of ageing, along with sexual satisfaction, impact on sexual relationships and activities

The impact of experiences of ageism on sexual activity and interest in later life

Experiences of ageism are associated with poorer health outcomes. Sexual activity and interest are areas in life where the impact of ageism may also be evident as popular culture often depicts the older body as asexual, undesirable or sexually impotent. We explore the possible links between experiences of ageism and sexual activity/interest in later life using data from a study of Australians aged 60+. We explored characteristics of those who were more likely to have experienced ageism (measured using the Ageism survey) and the relationships between experiences of ageism and measures of sexual interest/activity in later life (n=1,817). Experiences of ageism were greater among those without a partner, unemployed participants, those with lower incomes, and poorer self-rated health. Adjusting for these differences, experiences of ageism were more likely to be reported by those who had not had sex in the past two years and were not sure about their hopes/plans for sex in the future. Those who reported their sexual interest had increased or decreased since 60 also reported greater levels of ageism experience, as did those who wanted to have sex more frequently in the future. Ageism appears to impact sexual activity and interest in different ways. It is critical that social policy aims to reverse attitudes that reinforce the view of the ageist asexual and unattractive older body or person

The perspectives of psychosexual therapists towards using play therapy techniques in sex and relationship therapy: A qualitative study

Play therapy is an intervention traditionally used with children that is beginning to be used with adults. One area of use is within the psychosexual context; however, there is an absence of empirical research in this area. This qualitative study explored therapists’ perspectives on using play therapy techniques in psychosexual therapy. The 16 participants were either qualified or trainee psychosexual therapists. Data were collected through focus group interviews and analysed thematically. Four interlinking themes were identified: (1) playfulness already used but not recognised as play therapy; (2) delivery and receiving of play techniques; (3) attachment; and (4) well-being and social skills. Overall, participants believed there were benefits to using play therapy in the psychosexual context but that the therapeutic environment should be conducive to its use. Recommendations for practice include views about whether or not play therapy can be further developed and refined for use within the psychosexual context

Successful aging, change in sexual interest and sexual satisfaction in couples from four European countries

Although the importance of sexuality and physical intimacy for well-being of older adults has been recognized, the role of sexuality in successful aging (SA) has been largely neglected. Building on our previous work, here we further validated a three-dimensional model of SA and examined its associations with sexual satisfaction and change in sexual interest among older heterosexual couples (aged 60–75 years). Participants were recruited in a probability-based survey, which was carried out in 2016–2017 in four European countries. Using structural equation modeling of the Actor–Partner Interdependence, we observed significant relationships between SA and sexual satisfaction for both male and female partners across countries. Among women, their retrospectively assessed change in sexual interest over the past 10 years was consistently associated with sexual satisfaction. Partner effects were gender-specific: male partners’ SA was significantly related to their female partners’ change in sexual interest, which in turn was linked to male partners’ sexual satisfaction. The findings point to substantial ties between successful aging and sexuality in older European couples. Taking into account the prevalent stereotypes about old age and sexuality, this study’s findings can assist professionals working with aging couples

How important is sex in later life? The views of older people

Stereotypes of an asexual old age remain pervasive, shaping not only popular images of older people, but also research and policy agendas. However, older people's own attitudes towards the role and value of sex in later life remain relatively unexplored. This paper draws on both quantitative and qualitative data to examine how sex is prioritised in middle age and later life. Data collection methods involved completion of two quality of life measures (WHOQOL-100 and WHOQOL Importance Scale), followed by semi-structured interviews. In total the sample comprised 69 individuals recruited from the age/sex register of a general practice in Sheffield in the UK. This paper will focus upon the accounts of 21 men and 23 women aged 50-92 years. Ratings of the importance of sex to participants were gathered from the WHOQOL Importance Scale; the in-depth interviews enabled the basis for this prioritisation to be explored. Analysis identified the following key themes. Participants who did not consider sex to be of any importance to them neither had a current sexual partner, nor felt that they would have another sexual partner in their lifetime. Indeed, all participants who had a current sexual partner attributed at least some importance to sex, with many rating sex as 'very' or 'extremely' important. However, experiencing barriers to being sexually active led them to place less importance on sex; this was particularly apparent when health problems and widowhood were experienced. Age was seen as facilitating coping when sex became less frequent, or stopped altogether. This was explained in terms of sexual desire decreasing with age (for some male participants), the cessation of sex being easier to cope with in a relationship of long duration and the expectation that sex will become less possible with 'normal ageing'. The discussion considers the implications of these findings for this developing field.Older people Ageing Sexuality Sex UK