Sex and the ‘recently single’: perceptions of sexuality and HIV risk among mature women and primary care physicians

Abstract

Primary care physicians may mistakenly conclude that sexual issues are unimportant to divorced or widowed mature women, based on age and gender biases. Although research suggests that many single mature women are sexually active, physicians are often reluctant to discuss sexual matters with them. Structured and open-ended interviews explored perceptions regarding mature women's sexuality and HIV-related risk for patient-physician communication among 44 'recently single' mature women aged 45-68 and 31 primary care physicians. Age and ethnic group comparisons with the mature women suggest that younger and African-American women reported higher HIV and STI risk perception than older and White women. Many mature women (64%) believed that they were at-risk for HIV and STIs, whereas physicians considered younger patients most at-risk and that risk declined with patients' advancing age and with female status. Mature women and physicians had different expectations regarding initiation of clinical sexual health discussions, with 44% of the mature women placing the onus of responsibility on the patient, whereas 74% of physicians believed it was the role of both doctors and patients to bring up these topics. The findings are instructive to primary care physicians and healthcare policy makers, indicating that sexual health issues are relevant to mature women's continued health and well-being.

Sexual Function in Younger and Older HIV+adults in the United States and Puerto Rico

“…Heterosexual transmission continues to be the area of greatest concern for women aged 50 and older particularly among those re-entering the dating scene after divorce or widowhood. Grant & Ragsdale (2008) found that in a sample of 44 recently divorced, widowed or separated mature women, 23% (n=10) were in a new sexual relationship with a steady partner, 16% (n=7) were in new sexual relationships with non-steady partners, 7% (n=3) had ended a sexual relationship during the prior 2 weeks to a month, 36% (n=16) were single and not pursuing a new sexual relationship but would consider dating the "right person" and 16% (n=7) expressed no interest in dating or finding a new sexual partner. Smith and Christakis (2009) used the Medicare claims data to explore if widowhood was associated with an increased risk of being diagnosed with a sexually transmitted infection (STI) and also if the introduction of drugs to treat erectile dysfunction in 1998 impacted on the number of older persons being diagnosed with STI.…”

‘Becoming more of myself’: Safe sensuality, salsa and ageing

“…Due to the various ways in which youth is reinforced as beauty, ageing has been described as a process of transformation whereby women become socially invisible (Vares, 2009), and this is reflected in many ways from absence in national surveys about sex, to being excluded from roles such as TV presenting (Grant andRagsdale, 2008, Meah et al, 2011), and in advertising (Williams et al, 2007). Others have argued that this invisibility is also reflected in academic scholarship where often, '[the] only bodies of interest to the theoretical gaze are young bodies' (Dolan and Tincknell, 2012b:vii).…”

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

“…The limited research undertaken to date suggests that older people do not consistently practice safer sex (Altschuler & Rhee, 2015;Bourne & Minichiello, 2009;Dalrymple, Booth, Flowers, & Lorimer, 2016;de Visser et al, 2014;Foster, Clark, McDonnell Holstad, & Burgess, 2012;Grant & Ragsdale, 2008;Lindau et al, 2006;Reece et al, 2010;Schick et al, 2010), may lack effective condom use skills (Foster et al, 2012), and report low rates of testing for HIV and STIs (Bourne & Minichiello, 2009;Dalrymple et al, 2016;Grulich et al, 2014;Schick et al, 2010;Slinkard & Kazer, 2011).…”

“…Older people grew up in a time when discussions of sex and sexual health were largely taboo, comprehensive sexuality education was generally not available (Cook, 2012;May, 2006;Pilcher, 2005), and STIs were highly stigmatised (though this is arguably still the case in many respects) (Altschuler & Rhee, 2015;Bourne & Minichiello, 2009;Grant & Ragsdale, 2008;Idso, 2009;Nash et al, 2015;Slinkard & Kazer, 2011). Additionally, the dominant sexual and gendered sexual scripts that older people grew up with may restrain their ability to openly negotiate condom use or other safer sex practices in new sexual relationships (Altschuler & Rhee, 2015;Bateson et al, 2012;Nash et al, 2015;Zablotsky & Kennedy, 2003).…”

“…Further, safer-sex campaigns and policy are typically targeted towards younger people (Bateson et al, 2012;Bourne & Minichiello, 2009;European Expert Group on Sexuality Education, 2016;Gedin & Resnick, 2014;Kirkman, Kenny & Fox, 2013;Nash et al, 2015). Health care professionals are often reticent to discuss sex per se with older patients (Gott et al, 2004;Grant & Ragsdale, 2008;Nash et al, 2015;Nusbaum, Singh, & Pyles, 2004) and older people often wait for their health care provider to initiate discussions on sex (Lindau et al, 2006;Nash et al, 2015;Nusbaum et al, 2004;Slinkard & Kazer, 2011). These contextual factors may shape and limit the safer sex knowledge and practices of older people; however, further qualitative research is required to examine and confirm the extent to which this may occur (Bateson et al, 2012).…”