Dimensions of Psychological Well-being Predict Consistent Condom Use among Older Adults Living with HIV

Golub, Sarit A.; Botsko, Michael; Gamarel, Kristi E.; Parsons, Jeffrey T.; Brennan, Mark; Karpiak, Stephen E.

doi:10.1007/s12126-011-9113-4

Cited by 15 publications

(9 citation statements)

References 47 publications

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“…In the Research on Older Adults with HIV (ROAH) study, more than one-third of sexually active older adults with HIV reported engaging in condomless sex, and 18% reported condomless sex with a serodiscordant partner (Golub et al, 2011; Golub et al, 2010; Karpiak & Brennan, 2009). In a longitudinal analysis, using data also from the Women’s Interagency HIV Study (WIHS), we found that 22–25% of women living with HIV, regardless of viral suppression, exhibited moderate to high levels of condomless sex after 13 years (Taylor et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“The Pleasure Is Better as I’ve Gotten Older”: Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV

Taylor

Munoz-Plaza²,

Goparaju

et al. 2016

Arch Sex Behav

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There is limited research examining the sexual health and wellbeing of older women living with HIV (OWLH). Most studies focus on sexual dysfunction, leaving aside the richer context of sexuality and sexual health, including the effect of age-related psychosocial and interpersonal changes on sexual health behaviors. Guided by the integrative biopsychosocial model and the sexual health model, this study explored the importance of sex and sexuality among OWLH to identify their sexual health and HIV prevention needs for program planning. A purposive sample (n=50) of OWLH was selected from a parent study (n=2,052). We conducted 8 focus groups and 41 in-depth interviews with 50 African American and Latina OWLH aged 50–69 years old in three U.S. cities. The triangulation approach was used to synthesize the data. Six salient themes emerged: sexual pleasure changes due to age, sexual freedom as women age, the role of relationships in sexual pleasure, changes in sexual ability and sexual health needs, sexual risk behaviors, and ageist assumptions about older women’s sexuality. We found that sexual pleasure and the need for intimacy continue to be important for OWLH, but that changing sexual abilities and sexual health needs, such as the reduction of sexual desire, as well as increased painful intercourse due to menopause-associated vaginal drying, were persistent barriers to sexual fulfillment and satisfaction. Particular interpersonal dynamics, including low perceptions of the risk of HIV transmission as related to gender, viral suppression and habitual condomless sex with long term partners without HIV transmission have resulted in abandoning safer sex practices with serodiscordant partners. These findings suggest that HIV prevention for OWLH should focus on how sexual function and satisfaction intersect with sexual risk. HIV prevention for OWLH should promote ways to maintain satisfying and safe sex lives among aging women.

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Section: Discussionmentioning

confidence: 99%

“The Pleasure Is Better as I’ve Gotten Older”: Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV

Taylor

Munoz-Plaza²,

Goparaju

et al. 2016

Arch Sex Behav

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“…Older adults with HIV are particularly isolated from supportive social networks and are less likely to disclose their status due to the double stigma of AIDS and ageism, both of which lead to stress and poorer mental health outcomes [70–74]. To compensate for these changes, many older adults use alcohol, tobacco, and/or illicit drugs which are factors for sexual risk [14, 75–77]. These changing psychosocial and intrapersonal factors highlight the need to understand the context of sexual behavior among older women with HIV.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Trends in Sexual Behaviors with Advancing Age and Menopause Among Women With and Without HIV-1 Infection

et al. 2014

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We assessed changes in self-reported sexual activity (SA) over 13 years among HIV-infected and uninfected women. The impact of aging and menopause on SA and unprotected anal or vaginal intercourse (UAVI) was examined among women in the Women’s Interagency HIV Study (WIHS), stratifying by HIV status and detectable viral load among HIV-infected women. Generalized mixed linear models were fitted for each outcome, adjusted for relevant covariates. HIV-uninfected women evidenced higher levels of SA and UAVI than HIV-infected. The odds of SA declined by 62–64 % per decade of age. The odds of SA in a 6-month interval for women aged 40–57 declined by 18–22 % post-menopause (controlling for age). Among HIV+/detectable women only, the odds of any UAVI decreased by 17 % per decade of age; the odds of UAVI were unchanged pre-menopause, and then decreased by 28 % post-menopause. Elucidating the factors accounting for ongoing unprotected sex among older women should inform interventions.

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“…Another study in South Africa demonstrated that lack of HIV disclosure to partner, and alcohol use at last sex were correlated with unprotected intercourse. 2 Other variables found to be associated with more condom use in this population include higher education level, 4 economic stability, 5 psychological well-being, 6 and relationship characteristics such as HIV status of partner, length of relationship, and desire for children. 5 However, there is limited literature on whether or not the determinants of condom use differ between male and female HIV-infected individuals.…”

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confidence: 89%

Gender Differences in Determinants of Condom Use Among HIV Clients in Uganda

Walusaga

Kyohangirwe

Wagner

2012

AIDS Patient Care and STDs

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Little research has examined gender differences in reporting of condom use, which is the goal of our analysis. A baseline study was conducted in two urban clinics and we examined data from sexually active clients entering HIV care who enrolled in a prospective longitudinal cohort study. The primary outcome was consistent condom use and determinant variables were demographics, physical health and immune status, economic well-being, relationship characteristics, psychosocial functioning, and self-efficacy. Of 280 participants, 129 were males and 151 females, and 41.7% had at least some secondary education; 60.7% did not always use condoms. Nearly half (48.1%) of men reported always using condoms compared to 31.8% of females. In bivariate analyses, men who consistently use condoms were more likely to be working, have a primary partner who was HIV negative, to have disclosed their HIV status to their primary partner, and to have higher general self-efficacy and condom use self-efficacy compared to men who did not always use condoms. Higher general self-efficacy and condom use self-efficacy were the only variables associated with reported consistent condom use among women. In regression analysis, working in the last 7 days, general self efficacy, and condom use self-efficacy were associated with consistent condom use among men. These findings reveal low rates of consistent condom use among people living with HIV, and a gender difference with men more likely to report consistent condom use. These data suggest the need for gender sensitive prevention programs and strategies, including programs that can provide women with greater control and self-efficacy regarding use of protective methods.

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Dimensions of Psychological Well-being Predict Consistent Condom Use among Older Adults Living with HIV

Cited by 15 publications

References 47 publications

“The Pleasure Is Better as I’ve Gotten Older”: Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV

“The Pleasure Is Better as I’ve Gotten Older”: Sexual Health, Sexuality, and Sexual Risk Behaviors Among Older Women Living With HIV

Longitudinal Trends in Sexual Behaviors with Advancing Age and Menopause Among Women With and Without HIV-1 Infection

Gender Differences in Determinants of Condom Use Among HIV Clients in Uganda

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