Sexual behaviors differ among older adults of various sexual and gender identities, a study in Ohio found, and such diversity needs to be considered when developing HIV and sexually transmitted infection (STI) prevention interventions for this age group.
About This Study
“Differences in infection and prevention of HIV and other sexually transmitted infections among older adults in Columbus, Ohio” was published online on March 6, 2023, in PLoS One. The lead author is Ethan Morgan, Ph.D., of the College of Nursing and the Infectious Disease Institute at The Ohio State University in Columbus, Ohio.
Key Research Findings
The aim of this research was to examine disparities in HIV and STI testing, diagnoses, and prevention in a large group of older adults. An online survey asked 794 residents of Columbus, Ohio, aged ≥ 50 years, about their HIV and STI prevention and testing history. The sample included 11 intersex participants, with the remainder almost evenly split between those assigned male or female at birth. Eighty-seven percent of participants identified as cisgender, 7% as transgender, and 7% as another gender identity. Heterosexuals comprised 40%, gays or lesbians 50%, and bisexuals 7% of participants, while 4% of participants identified with none of these categories.
While condom use was common (male condoms: 52% of participants; internal condoms: 10% of participants), 28% of respondents reported not using any prevention method at all during the prior six months. Heterosexual or older participants reported not using preventive methods more often than LGBTQ or younger participants.
Cisgender men reported more condom use than women or intersex participants, while bisexual respondents used condoms more than gay or lesbian respondents. Pre-/post-exposure prophylaxis was reported by 15% of participants, most commonly by transgender women.
Around half of all participants had ever been tested for STIs or HIV, with 16% of those tested during the prior six months reporting a positive STI test and 7% of tested participants disclosing that they are living with HIV. The overall rate of recent STI diagnoses did not differ by demographic characteristics. (The study did not differentiate between STIs.) Older people were more likely, and heterosexuals were less likely, to be living with HIV compared to younger or LGB respondents, respectively.
Discussion Highlights and Implications for Practice
The researchers remarked that previous research has demonstrated that beliefs assuming low sexual activity among older adults are incorrect. “Future research should aim to educate individuals differently based on their specific needs rather than treating older adults as a homogenous population, or worse, ignoring their sexually active nature entirely,” study authors concluded.