Sexual Behaviors, Condom Use, and Sexual Health of Americans Over 50: Implications for Sexual Health Promotion for Older Adults

Abstract

Introduction In the contemporary U.S., men and women are living longer and healthier lives. As such, many people spend greater portions of their lives as sexually active individuals. Yet, little is known about the myriad of ways that older adults experience their sexual lives. Aim This study sought to assess the context and frequency of sexual behaviors, condom use, sexual pleasure, and sexual experience of men and women over age 50. Methods Information regarding the sexual experiences of a nationally representative sample of men and women over age 50 within the past year was examined. Main Outcome Measures Sexual behavior over the past year was assessed in relation to several situational and contextual characteristics (e.g., event location, type of partner, health status, condom use). Participants were also asked about their experience (i.e., pleasure, arousal, pain, lubrication/erectile difficulties, and orgasm) during their most recent partnered sexual event. Bivariate or ordinal logistic regression models were used to investigate the relationship of age, health and partner status to sexual frequency and experience. Results Although sizable proportions (20–30%) of both men and women remained sexually active well into their 80s age was related to a lower likelihood of solo and most partnered sexual behaviors. When controlling for age, relationship status, and health remained significant predictors of select sexual behaviors. The participant’s evaluation of their most recent sexual experience in terms of arousal, erectile difficulty, and orgasm all declined with age. Health status was related to men’s evaluation of the experience. Relationship status was the most consistent predictor of women’s evaluation of the experience. Condom use rates remained low for participants across age groups. Conclusion Many older adults continue be sexually active well into advanced age (80+). Thus, providers need to be attentive to the diverse sexual health needs of older adults.

The known unknowns of HPV natural history

“…an average decline in new sexual exposures with increasing age, as has been reported previously (54). It seems unlikely that the relatively higher HPV incidence in older seropositive versus younger seropositive women reflects a uniquely high sexual risk among the older seropositives.…”

“…The benefit of vaccination in a sexually active woman is uncertain (20), and on a population level, HPV vaccination with increasing time since sexual debut (correlated with aging) rapidly loses cost-effectiveness (73). This loss of costeffectiveness is driven by a combination of reduced frequency of new sexual exposures with age and the lack of efficacy of vaccine in women already infected with vaccine-associated HPV types (54,74,75). The argument that on an individual level nearly all women will benefit from HPV vaccination, since less than 1% of women have evidence of prior infection to all four vaccine types, is overly simplistic (76).…”

Barriers and facilitators to HIV testing in people age 50 and above: a systematic review

“…32 Although this is not unique to older people, relationship transitions -common in older age -may increase the likelihood of meeting new partners after an established relationship. 33 Studies indicate condom use among older people is low, 34 which may be due to a lack of confidence in negotiating condom use when starting a new relationship, or because postmenopausal women no longer worry about pregnancy. 28 Additionally, availability of drugs such as sildenafil mean erectile dysfunction may no longer be a barrier to sex for older men.…”

Vulnerabilidade de idosos a infecções sexualmente transmissíveis

“…(3) In the context of sexuality, researchers have demonstrated that the elderly continue to be sexually active, even after 80 years of age. (4) A study conducted in northeastern Brazil also demonstrated that in this country, many elderly people maintain an active sex life with desires and pleasures and often continue to have sex in an unsafe manner. (5) This may be because the elderly do not perceive themselves as vulnerable to sexually transmitted infections (STIs) and HIV/AIDS, (6) a perception that can be contested by global data on the distribution of these diseases by age group.…”