Sexual Reproductive Health for Older Adults

Today's National Public Health Week guest blog is by Lené Levy-Storms, PhD, MPH, Section Chair of Aging & Public Health Section.

Are you having sex after 50? Chances are: yes. In a New England Journal of Medicine study by Dr. Stacey Tessler Lindau et al. (2007), 50-75 percent of adults ages 57-85 reported being sexually active in the past year [1].

With Viagra readily available and women’s reproductive years behind them, why not? Well, there are barriers, such as illness, but also risks for communicable diseases, such as being sexually active. One sexually transmitted disease in particular, Human Immunodeficiency Virus is not only communicable for anyone who is sexually active but also now not necessarily a death sentence, if one receives ongoing drug therapy. Without a cure, though, HIV and Acquired Immune Deficiency Syndrome are on the rise among adults over 50. In 2005, persons aged 50 and older accounted for

• 15 percent of new HIV/AIDS diagnoses [2]*
• 24 percent of persons living with HIV/AIDS (increased from 17% in 2001) [2]*

So HIV/AIDS is yet another chronic condition that we face with age. Older adults need to be aware of their risks for HIV/AIDS and other communicable STDs, if they continue to be sexually active in the golden years, as well as how to prevent them. According to the CDC, such persons who are age 50 and older may have some of the same prevention challenges as younger adults including:

•  Lack of practicing safe sex [1].  
•  Engaging in risky accompanying behaviors such as drug use.
•  Low knowledge and/or awareness of risk [3, 4]
• Discrimination that may deter access to care and/or slow down treatment [5]. 
• Health care providers who underestimate the risk for HIV/AIDS [1]. 
• Physicians missing a diagnosis due to other age-associated diseases
• Stigma associated with positive HIV/AIDS status. 

Get educated about and screened for HIV/AIDS, regardless of age if you are sexually active, and enjoy safe sex after 50!

References
1. Lindau ST, Schumm MA, Laumann EO, et al. A study of sexuality and health among older adults in the United States. N Eng J Med 2007;357:762–774.
2. CDC. HIV/AIDS Surveillance Report, 2005. Vol. 17. Rev ed. Atlanta: U.S. Department of Health and Human Services, CDC; 2007:1–54. 
3. Lindau ST et al. Older women’s attitudes, behavior, and communication about sex and HIV: a community-based study. J Womens Health 2006;6:747–53.
4. Henderson SJ et al. Older women and HIV: how much do they know and where are they getting their information? J Am Geriatr Soc 2004;52:1549–53.
5. Zingmond DS et al. Circumstances at HIV diagnosis and progression of disease in older HIV-infected Americans.Am J Public Health 2001;91:1117–20.