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

Taylor, Tonya N.; Munoz-Plaza, Corrine; Goparaju, Lakshmi; Martínez, Omar; Holman, Susan; Minkoff, Howard; Karpiak, Stephen E.; Gandhi, Monica; Cohen, Mardge H.; Golub, Elizabeth T.; Levine, Alexandra M.; Adedimeji, Adebola; Gonsalves, Rebecca; Bryan, Tiffany; Connors, N; Schechter, Gabrielle; Wilson, Tracey E.

doi:10.1007/s10508-016-0751-1

Cited by 41 publications

(27 citation statements)

References 78 publications

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“…41 Condom use may be difficult for older women to negotiate for many reasons, including psychosocial concerns that affect women of all ages (relationship dynamics and trust) and concerns that older women more commonly have (men with erectile dysfunction may have difficulty with condom use, adherence to traditional ideas of sex and power in relationships). 42,43 It is important to counsel older women about specific strategies for safer sex, including strategies to encourage their partners to use condoms.…”

Section: Approach To Casementioning

confidence: 99%

Women's Sexual Health and Aging

Granville

Pregler

2018

J American Geriatrics Society

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Older women are often sexually active, but physicians caring for older women rarely address sexual concerns. Although women's desire for sex declines with age, a majority of older women rate sex as having importance in their lives. Women identify emotional intimacy as an important reason for engaging in sexual relationships. Women are less likely than men to have an available spousal or intimate partner and more likely to have a partner with sexual difficulties of their own. Up to half of sexually active older women report a distressing sexual problem, with low desire and problems related to genitourinary syndrome (vulvovaginal atrophy) being most common. Difficulty with orgasm in older women is often associated with a partner's erectile dysfunction. Sexually transmitted infections (STIs) are increasingly prevalent in older women. A minority of older women report discussing sexual issues with a physician. Most commonly, the patient initiates discussions. Physicians should ask regularly and proactively about sexual activity and function. Important interventions include offering practical advice to common chronic medical conditions and sexual problems that confront older women; treating vulvovaginal atrophy; and providing STI screening, prevention strategies, and treatment when appropriate.

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Section: Approach To Casementioning

confidence: 99%

Women's Sexual Health and Aging

Granville

Pregler

2018

J American Geriatrics Society

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“…Such pleasures are important for overall health; ii) sex is an important biological and biopsychological function, and everyone has the ability to feel sexual pleasure; iii) sexual pleasure is everyone's right; iv) all humans deserve sexual satisfaction; and v) the experience of sexual satisfaction (sexual fulfillment) is important for the emotional and physical well-being, independent of age and some health conditions. 51,52 The learning session allows the gynecologist to deal with sexual myths and mistaken beliefs about sex, and to reformulate concepts on affectivity and the sharing of sexual experiences. 53 Successful treatment of sexual complaints suggests that the enjoyment of sexuality increases after women learn that sexuality is healthy.…”

Section: Permitting (P) and Stimulating Sexual Pleasurementioning

confidence: 99%

A Model for the Management of Female Sexual Dysfunctions

Lara¹,

Scalco

Troncon

et al. 2017

Rev Bras Ginecol Obstet

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Introduction Sexual pleasure is fundamental for the maintenance of health and wellbeing, but it may be adversely affected by medical and psychosocial conditions. Many patients only feel that their health is fully restored after they resume normal sexual activities. Any discussion of sexuality in a doctor's office is typically limited, mainly because of a lack of models or protocols available to guide the discussion of the topic. Objectives To present a model designed to guide gynecologists in the management of female sexual complaints. Methods This study presents a protocol used to assess women's sexual problems. A semi-structured interview is used to assess sexual function, and the teaching, orienting and permitting (TOP) intervention model that was designed to guide gynecologists in the management of sexual complaints. Results The use of protocols may facilitate the discussion of sexual issues in gynecological settings, and has the potential to provide an effective approach to the complex aspects of sexual dysfunction in women. The TOP model has three phases: teaching the sexual response, in which the gynecologist explains the physiology of the female sexual response, and focuses on the three main phases thereof (desire, excitement and orgasm); orienting a woman toward sexual health, in which sexual education is used to provide information on the concept and healthy experience of sexuality; and permitting and stimulating sexual pleasure, which is based on the assumption that sexual pleasure is an individual right and is important for the physical and emotional well-being. Conclusion The use of protocols may provide an effective approach to deal with female sexual dysfunction in gynecological offices.

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“…An analysis of data from the US Women's Interagency HIV Study found that women living with HIV were more likely to report sexual impairment compared to women without HIV, across all age groups (Wilson et al, 2010). Qualitative data reveal the importance of sexual pleasure for older women living with HIV, with diminished libido and vaginal dryness highlighted as particularly important (Taylor et al, 2017). Data on sexual function in older women living with HIV remain limited, and mainly originate from the US or Brazil.…”

Section: Introductionmentioning

confidence: 99%

Association of HIV status with sexual function in women aged 45–60 in England: results from two national surveys

et al. 2019

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Increasing numbers of women living with HIV are reaching their midlife. We explore the association of HIV status with sexual function (SF) in women aged 45-60 using two national cross-sectional surveys: the third British National Survey of Sexual Attitudes and Lifestyles ("Natsal-3") and "PRIME", a survey of women living with HIV attending HIV clinics across England. Both studies asked the same questions about SF that take account not only sexual difficulties but also the relationship context and overall level of satisfaction, which collectively allowed an overall SF score to be derived. We undertook analyses of sexually-active women aged 45-60 from Natsal-3 (N = 1228, presumed HIV-negative given the low estimated prevalence of HIV in Britain) and PRIME (N = 386 women living with HIV). Women living with HIV were compared to Natsal-3 participants using multivariable logistic regression (adjusting for key confounders identified a priori: ethnicity, ongoing relationship status, depression and number of chronic conditions) and propensity scoring. Relative to Natsal-3 participants, women living with HIV were more likely to: have low overall SF (adjusted odds ratio (AOR) 3.75 [2.15-6.56]), report ≥1 sexual problem(s) lasting ≥3 months (AOR 2.44 [1.49-4.00]), and report almost all 8 sexual problems asked about (AORs all ≥2.30). The association between HIV status and low SF remained statistically significant when using propensity scoring ). Among women living with HIV (only), low SF was more common in those who were postmenopausal vs. Premenopausal (55.6% vs. 40.4%). This study suggests a negative association between HIV status and sexual function in women aged 45-60. We recommend routine assessment of SF in women living with HIV.

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

Cited by 41 publications

References 78 publications

Women's Sexual Health and Aging

Women's Sexual Health and Aging

A Model for the Management of Female Sexual Dysfunctions

Association of HIV status with sexual function in women aged 45–60 in England: results from two national surveys

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