Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex

Abstract

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.

Emotional intimacy and sexual well-being in aging European couples: a cross-cultural mediation analysis

“…A number of studies have highlighted the importance of emotional intimacy for aging individuals' sexuality (Laumann et al 2006;Sandberg 2013;Müller et al 2014;Fileborn et al 2017). In a longitudinal population-based study of aging German men and women, participants in the highest age group (74 years), prioritized "affection" over sexual activity.…”

“…In a longitudinal population-based study of aging German men and women, participants in the highest age group (74 years), prioritized "affection" over sexual activity. In the Australian Sex, Age, and Me study (Fileborn et al 2017), qualitative interviews with individuals aged 60 and older revealed that both men and women considered intimacy and bonding a central component of their sexual lives.…”

“…Secondly, studies have suggested that for many older adults, physical closeness and intimacy may be more important than sexual activity per se (Sandberg 2013;Müller et al 2014;Lee et al 2016;Fileborn et al 2017;Freak-Poli et al 2017). Based on findings from a large study of midlife and older adults' definitions of sexual wellness, Symes et al (2018) concluded that conceptualizing and measuring sexual wellness in this population requires a multidimensional approach that includes psychological, social, and attitudinal aspects in addition to sexual function and activity-related ones.…”

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

“…Such work could be supported by, for example, ensuring that older Australians are explicitly addressed in sexual health policy, and we reiterate recent calls for such action here . Some participants in our study viewed sexual health as irrelevant to them, even if they were in relatively ‘high‐risk’ relationships , and this likely acts as a significant barrier to discussing sex with their HCP.…”

“…This suggests there may be gendered barriers to discussing sex with a HCP, and this warrants further examination, particularly to determine the implications this presents for sexual health campaigns and HCP education. For example, some female participants reported receiving stigmatising responses from male sexual partners in attempting to discuss safer sex practices with them . It is unclear whether or to what extent such highly gendered experiences may in turn shape older women's willingness to discuss sex with HCPs, although several women discussed stigma and embarrassment as a barrier which suggests there may be a connection here; that is, older women's reluctance to discuss sex with HCPs may be situated within broader social norms and attitudes towards older women's sexuality, and stereotypical assumptions about who is ‘likely’ to contract an STI.…”