1
|
Bigras N, Popova N, Pedneault L, Brassard A, Bergeron S. Sexual well-being among partnered adults and couples over 60: a scoping review. Sex Med Rev 2024:qeae037. [PMID: 38824393 DOI: 10.1093/sxmrev/qeae037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/25/2024] [Accepted: 05/08/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Although society still holds age-related stereotypes dismissing the sexuality of aging individuals, older adults remain sexually active and find sexuality to be an important part of their quality of life. Primarily oriented toward a biomedical and dysfunctional lens, prior research neglected the subjective well-being of elderly individuals, especially partnered adults and couples aged 60 years or more. Shedding a more positive light on this area of life could promote older individuals' and couples' sexual well-being. OBJECTIVES This scoping review aimed to synthetize the studies including community samples of partnered adults or couples over 60 who reported on various indicators of subjective sexual well-being including sexual satisfaction, distress, and function using validated measures. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR), the electronic literature search was conducted using PubMed, PsycINFO, Medline, and CINAHL for peer-reviewed journal articles published before July 2023. RESULTS Results showed how relational variables such as relationship satisfaction and intimacy emerge as important correlates of older adults' sexual well-being. CONCLUSION Avenues for future research arising from gaps in the studies identified thorough this scoping review, including the underrepresentation of sexual/gender diverse individuals and the use of single and/or non-validated items to assess sexual well-being, are discussed.
Collapse
Affiliation(s)
- Noémie Bigras
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Québec, J8X 3X7, Canada
| | - Nevena Popova
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
| | - Lydia Pedneault
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, 2500, boul. Université, Sherbrooke, Quebec, J1K 2R1, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
| |
Collapse
|
2
|
Stowell M, Hall A, Warwick S, Richmond C, Eastaugh CH, Hanratty B, McDermott J, Craig D, Spiers GF. Promoting sexual health in older adults: Findings from two rapid reviews. Maturitas 2023; 177:107795. [PMID: 37454470 DOI: 10.1016/j.maturitas.2023.107795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/01/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Sexual health throughout the life course is increasingly recognised as important to maintaining one's overall health, wellbeing, and relationships. We aimed to provide an overview of the evidence on sexual health needs and sexual health promotion in later life. METHODS We undertook two rapid reviews, drawing on systematic review evidence. Searches were conducted in Epistemonikos. Studies were eligible if they reported evidence about the sexual health needs of, or sexual health promotion interventions for, people aged 50+ years. Evidence was quality assessed and summarised in a narrative synthesis. RESULTS Fifteen systematic reviews were included in Review 1 (sexual health needs) and 12 in Review 2 (interventions). Key concerns and needs of older adults included the impacts of cultural stigma/misperceptions, barriers to sexual expression, and a need for tailored support in a welcoming environment. Key concerns and needs of health and social care professionals included mixed attitudes towards and knowledge of later-life sexuality and a need for more training and education. Approaches to promoting sexual health in later life included training and workshops for care home professionals, education for older people at risk of/living with HIV, and interventions to address sexual health-related symptoms of menopause. Gaps in the evidence from current reviews and methodological issues in primary studies were identified. CONCLUSION Older people have specific needs relating to their sexual health. Health and social care professionals working with older people may benefit from education/training around sexuality in later life. Evidence on effective interventions and strategies is limited.
Collapse
Affiliation(s)
- Melanie Stowell
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Stephanie Warwick
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Catherine Richmond
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Claire H Eastaugh
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Barbara Hanratty
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Jane McDermott
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Dawn Craig
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Gemma Frances Spiers
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| |
Collapse
|
3
|
King EM, Carter A, Loutfy M, Webster K, Muchenje M, Murray MCM, de Pokomandy A, Ding E, Li J, Kaida A. Sexual Satisfaction of Midlife Women Living With HIV in Canada: A Prospective Cohort Analysis. J Acquir Immune Defic Syndr 2023; 93:272-281. [PMID: 37019076 DOI: 10.1097/qai.0000000000003204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
BACKGROUND Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated the prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and sociostructural experiences. SETTING We studied women in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) over 3 survey waves (2013-2018). METHODS We included women living with HIV aged ≥45 years who reported ever having consensual sex. Sexual satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women and was dichotomized into satisfactory ("completely/very/reasonably satisfactory") and not satisfactory ("not very/not at all satisfactory"). Probable depression was based on CES-D ≥10. Multivariable logistic regression and fixed effects models determined correlates of sexual satisfaction. Reasons for sexual inactivity and alternate forms of sexual expression were also explored. RESULTS Among 508 midlife women, 61% were satisfied with their sexual lives at baseline. Women with probable depression had lower odds of sexual satisfaction than those without (aOR: 0.44; 95% CI: 0.27 to 0.71) and worsening depressive symptoms over time were associated with poorer sexual satisfaction ( P = 0.001). Increased sexual activity was associated with higher sexual satisfaction (aOR: 2.75; 95% CI: 1.54 to 4.91); however, 51% of women reporting sexual satisfaction were sexually inactive. Sexually inactive women engaged in alternate forms of sexual expression such as self-pleasure (37%) and intimate relationships without sex (13%). CONCLUSION Midlife women with HIV have high rates of sexual satisfaction, even in the absence of sexual activity. Depressive symptoms were closely associated with sexual dissatisfaction, alerting providers to the importance of screening for depression and sexual health together.
Collapse
Affiliation(s)
- Elizabeth M King
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
| | - Allison Carter
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Mona Loutfy
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Webster
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law, UNSW Sydney, Sydney, Australia
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
- McGill University Health Center, Montreal, Quebec, Canada; and
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Marvelous Muchenje
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Kirby Institute, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
- Australian Human Rights Institute, Faculty of Law, UNSW Sydney, Sydney, Australia
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
- McGill University Health Center, Montreal, Quebec, Canada; and
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
- Division of Infectious Diseases, Department of Medicine, University of British Columbia (UBC), Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | | | - Erin Ding
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Jenny Li
- BC Center for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
- Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada
| |
Collapse
|
4
|
Stanton AM, Bwana M, Owembabazi M, Atukunda E, Musinguzi E, Ezegbe H, Smith P, Psaros C, Matthews LT, Kaida A. Sexual and Relationship Benefits of a Safer Conception Intervention Among Men with HIV Who Seek to Have Children with Serodifferent Partners in Uganda. AIDS Behav 2022; 26:1841-1852. [PMID: 34796420 PMCID: PMC9050835 DOI: 10.1007/s10461-021-03533-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 10/19/2022]
Abstract
Many men with HIV (MWH) in Uganda desire children, yet seldom receive reproductive counseling related to HIV care. Because men are under engaged in safer conception programming, they miss opportunities to reap the benefits of these programs. The objective of this sub-analysis was to explore the relationship and intimacy benefits of integrating safer conception counseling and strategies into HIV care, an emergent theme from exit interviews with men who participated in a pilot safer conception program and their partners. Twenty interviews were conducted with MWH who desired a child in the next year with an HIV-uninfected/status unknown female partner, and separate interviews were conducted with female partners (n = 20); of the 40 interviews, 28 were completed by both members of a couple. Interviews explored experiences participating in The Healthy Families program, which offered MWH safer conception counseling and access to specific strategies. Data were analyzed using thematic analysis. Three major subthemes or "pathways" to the relationship and intimacy benefits associated with participation in the program emerged: (1) improved dyadic communication; (2) joint decision-making and power equity in the context of reproduction; and (3) increased sexual and relational intimacy, driven by reduced fear of HIV transmission and relationship dissolution. These data suggest that the intervention not only helped couples realize their reproductive goals; it also improved relationship dynamics and facilitated intimacy, strengthening partnerships and reducing fears of separation. Directly addressing these benefits with MWH and their partners may increase engagement with HIV prevention strategies for conception.
Collapse
Affiliation(s)
- Amelia M Stanton
- Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Mwebesa Bwana
- Faculty of Medicine, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
- Department of Medicine, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Moran Owembabazi
- Faculty of Medicine, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Esther Atukunda
- Faculty of Medicine, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Elijah Musinguzi
- Faculty of Medicine, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Henrietta Ezegbe
- Simon Fraser University (SFU), Faculty of Health Sciences, BLU 10522, 8888 University Drive, Burnaby, B.C., V5A 1S6, Canada
| | - Patricia Smith
- Simon Fraser University (SFU), Faculty of Health Sciences, BLU 10522, 8888 University Drive, Burnaby, B.C., V5A 1S6, Canada
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Behavioral Medicine, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - Angela Kaida
- Simon Fraser University (SFU), Faculty of Health Sciences, BLU 10522, 8888 University Drive, Burnaby, B.C., V5A 1S6, Canada.
| |
Collapse
|
5
|
Carlsson-Lalloo E, Mellgren Å, Berg M, Rusner M. Supportive conditions for sexual and perinatal wellbeing in women living with HIV in Sweden: A phenomenological study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100640. [PMID: 34087654 DOI: 10.1016/j.srhc.2021.100640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 03/26/2021] [Accepted: 05/15/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Women living with HIV have specific needs regarding sexuality, pregnancy, and childbirth. However, there is lack of knowledge about how these needs can be met. The aim of this study was to identify supportive conditions for sexual and perinatal wellbeing in women living with HIV in Sweden. METHODS A phenomenological reflective lifeworld research approach was used. Transcribed interviews with 18 women living with HIV in Sweden were analyzed focusing on the meanings of the study phenomenon. RESULTS When living with HIV, "feeling safe with oneself and in relationships with others" is essential for sexual and perinatal wellbeing. This is constituted by having good overall health, being in a caring context, having access to high quality information about HIV, and being ensured the same rights as other women. CONCLUSIONS The study shows that women living with HIV have specific needs for the support of their sexual and perinatal wellbeing. This knowledge can be used by all those engaged in HIV care and HIV prevention in order to improve and implement supportive conditions for women living with HIV. It is important that all those involved in the care of women living with HIV constantly update their knowledge about HIV and women's experiences of living with HIV in order to provide safe arenas and caring contexts that support the wellbeing of these women.
Collapse
Affiliation(s)
- Ewa Carlsson-Lalloo
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Regional Cancer Center West, Region Västra Götaland, Medicinaregatan 18 G, 413 45 Gothenburg, Sweden.
| | - Åsa Mellgren
- Department of Infectious Diseases, Sahlgrenska University Hospital, Region Västra Götaland, Journalvägen 10, 416 50 Gothenburg, Sweden
| | - Marie Berg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Department of Obstetrics, Sahlgrenska University Hospital, Region Västra Götaland, Diagnosvägen 15, 416 50 Gothenburg, Sweden; Department of Gynaecology and Obstetrics, Faculty of Medicine and Community Health, Evangelical University of Africa, Bukavu, The Democratic Republic of the Congo
| | - Marie Rusner
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, 405 30 Gothenburg, Sweden; Department of Research, Education and Innovation, Södra Älvsborg Hospital, Region Västra Götaland, Brämhultsvägen 53, 501 82 Borås, Sweden
| |
Collapse
|
6
|
Impact of Moringa Oleifera leaves supplementation on quality of life of people living with HIV: A double-blind randomized controlled trial. Qual Life Res 2021; 30:2563-2571. [PMID: 33881700 DOI: 10.1007/s11136-021-02842-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Advances in antiretroviral therapy (ART) and increased interest on nutritional interventions have led to improvements in life expectancy of people living with HIV (PLHIV). These have led to greater emphasis on their quality of life (QoL). This study was aimed at exploring the effects of Moringa oleifera leaves supplementation on QoL of HIV-positive adults in Nigeria. METHOD A double-blind randomized controlled trial was conducted to determine the six months' impact of consuming Moringa oleifera leaves powder as a nutritional supplement on the different domains of QoL of PLHIV that are on ART. Two hundred consented patients were randomly allocated to either Moringa Oleifera group (MOG) or control group (COG). The WHOQOL-HIV-BREF was used to assess QoL at baseline and at six-month follow-up. RESULTS One hundred and seventy seven patients completed the study. At six-month follow-up, a significant (p < 0.05) increase in the mean scores of all the six domains of QoL was observed in the MOG. However, in the COG, a significant increase was observed in the social relationship, environment, and spirituality/religion/personal beliefs domains. The comparison between the MOG and COG at 6 months' follow-up showed a significant mean score difference in the MOG in the physical, psychological, level of independence, and social relationships domains of QoL. CONCLUSION This study shows that supplementation with Moringa oleifera leaves for PLHIV that are on ART improves the QoL domains of physical, psychological, level of independence, and social relationships. Clinical Trial Registry registration number: PACTR201811722056449.
Collapse
|