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Zdanowicz MM, Valdes B, Salani D. Management of HIV in the older adults: Clinical and public health challenge. Public Health Nurs 2024; 41:406-415. [PMID: 38323718 DOI: 10.1111/phn.13288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 02/08/2024]
Abstract
As a result of significant advances in antiretroviral therapy (ART), the number of people living with human immunodeficiency virus (PLWH) who are alive well into their senior years has increased significantly in recent years. While increased life expectancy is a highly desired outcome for PLWH, it brings with it a number of challenges that are only now starting to be understood and fully appreciated. These challenges include higher rates of co-morbidities, polypharmacy, drug side effects, and cognitive deficits, as well as numerous psychosocial issues such as stigma, loneliness, and depression. Older PLWH also face challenges related to housing, health insurance, and long-term care. This review will discuss many of the challenges faced by older PLWH and present clinical and public health responses with suggested interventions that may improve outcomes for this population.
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Affiliation(s)
- Martin M Zdanowicz
- Professor of Phamaceutical and Appplied Life Science, Keck Graduate Institute, School of Pharmacy and Health Sciences, Claremont, California, USA
| | - Beatriz Valdes
- Associate Professor of Clinical, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
| | - Deborah Salani
- Professor of Clinical, University of Miami School of Nursing and Health Studies, Coral Gables, Florida, USA
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2
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Dugal C, Brassard A, Kusion PY, Lefebvre AA, Péloquin K, Godbout N. Romantic Attachment, Sex Motives and Sexual Difficulties in Emerging Adults: The Role of Childhood Interpersonal Victimization. JOURNAL OF SEX RESEARCH 2024; 61:359-373. [PMID: 36378882 DOI: 10.1080/00224499.2022.2141676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A growing body of research has revealed that many emerging adults (i.e., aged 18 to 25) experience sexual difficulties. Past studies have emphasized the need to examine sexual difficulties by accounting for sex motives (i.e., reasons for engaging in sex) and by using a trauma-focused or attachment-based framework. This study examined the role of sex motives in the associations among attachment insecurities (anxiety, avoidance) and sexual difficulties in emerging adults, and assessed whether these links varied on the basis of low or high exposure to childhood interpersonal victimization (CIV) (i.e., 0-3 different types of CIV or 4 or more types of CIV). A sample of 437 French-Canadian emerging adults completed validated questionnaires online. Path analyses revealed that participants with higher attachment anxiety were more likely to endorse the partner approval sex motive, which was related to more sexual difficulties. Participants with higher attachment avoidance were less likely to endorse the pleasure sex motive, which was associated with more sexual difficulties. Results indicated a significant effect of CIV showing that some indirect effects were significant only in participants who reported high CIV exposure. Results suggest that addressing sex motives using an attachment- and trauma-focused framework might help understand, prevent and treat sexual difficulties among emerging adults.
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Affiliation(s)
- Caroline Dugal
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Audrey Brassard
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre-Yves Kusion
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Audrey-Ann Lefebvre
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Katherine Péloquin
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Natacha Godbout
- Département de Sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
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3
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Ford JV, Carter A, Wong HT. Orgasm and Faking Orgasm: Heterosexual Interactions in China. JOURNAL OF SEX RESEARCH 2023; 60:484-497. [PMID: 35138969 DOI: 10.1080/00224499.2021.2023087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This article examines the prevalence and correlates of orgasm and faking orgasm in the last year among a representative sample of Chinese men and women. Existing research on orgasm in China has largely been confined to medical research. To our knowledge, no published studies have examined faking orgasm in a Chinese context. These data come from the Chinese Health and Family Life Survey (CHFLS) conducted in 1999 and 2000. We used multivariable logistic regression to identify independent correlates of orgasm and faking orgasm among 1496 women and 1497 men, ages 20-64. In accounting for orgasm and faking orgasm in China, we found evidence that men and women are trying to manage social expectations and to act in accordance with gender expectations, consistent with research in other countries. Results provide insight into how specific sexual practices (e.g., oral sex) and interactional pressures (e.g., insecurity) are correlated with orgasm and faking orgasm. Findings pave the way for future research on the presence of gender inequality as evidenced through lower orgasm rates among women and higher rates of faking orgasm. These findings have implications for how we conceptualize and study gendered and interactional components of sex, which are often overlooked in research and programmatic efforts in China.
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Affiliation(s)
- Jessie V Ford
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University
| | - Allison Carter
- Faculty of Medicine, Kirby Institute, UNSW Sydney
- Australian Human Rights Institute, Faculty of Law, UNSW Sydney
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4
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Wang L, Zou H, Liu J. Mediating effects of ageism and knowledge on the relationship between contact with older adults and attitudes toward older adults' sexuality among nursing students. NURSE EDUCATION TODAY 2023; 122:105740. [PMID: 36724590 DOI: 10.1016/j.nedt.2023.105740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 12/08/2022] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare professionals often ignore sexuality in aging and avoid discussing related topics, especially in China. Nursing students, as future professionals, can address the sexuality of older adults encountered in clinical practice by establishing positive attitudes toward aging sexuality. Previous studies have demonstrated that contact has positive impacts on nursing students' attitudes toward aging sexuality. However, little is known about the mechanism underlying this relationship between contact and attitudes. OBJECTIVES To explore the mediating effects of ageism and knowledge on the relationship between contact and nursing students' attitudes toward aging sexuality. DESIGN This was a cross-sectional study. SETTINGS The study was conducted at a nursing school in Hefei city, China. PARTICIPANTS AND METHODS 614 nursing students completed online-administered questionnaires measuring the level of contact with older adults, ageism, knowledge, and attitudes toward aging sexuality. Data were analyzed using SPSS and AMOS. RESULTS The mean scores for knowledge and attitudes toward aging sexuality were 85.70 (SD = 16.39) and 104.91 (SD = 14.88), respectively. Overall, our findings confirmed that these hypotheses were accepted. Ageism (β = -0.079, P = 0.007) and knowledge (β = -0.070, P < 0.001) mediated the relationship between contact and attitude. CONCLUSION Given the mediating role of ageism and knowledge in the relationship between contact and attitude, reducing ageism and enhancing knowledge are vital to changing students' attitudes, including integrating ageism and aging sexuality knowledge learning into the nursing curriculum and creating opportunities for contact with older adults. The frequency and quality of contact between nursing students and older adults can be improved by rationalizing the internship duration, tasks, and assessment objectives of placements on geriatric wards and by the role of clinical faculty role models in cultivating positive attitudes toward aging sexuality.
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Affiliation(s)
- Lu Wang
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China.
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, Beijing 100144, China
| | - Jun Liu
- Department of Nursing, Beijing An Ding Hospital, Beijing 100088, China
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5
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Meskó N, Zsidó AN, Birkás B, Meston CM, Buss DM. Why Hungarians Have Sex: Development and Validation of a Brief 15-Item Instrument (YSEX?-15H). ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:4007-4022. [PMID: 35939160 PMCID: PMC9663389 DOI: 10.1007/s10508-022-02380-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 06/15/2023]
Abstract
The present study developed a brief version of the Hungarian Why Sex? questionnaire (Meskó et al., 2022). The study was in part based on previously reported data obtained from several samples (N = 6193; 1976 men, 4217 women). Using Mokken Scaling Procedure, Item Response Model and redundancy analysis indicated that retaining three summary scales comprising five items each was the optimal solution for the brief version. The validity of the brief scale was tested with the Sexual System Functioning Scale (SSFS), the Experiences in Close Relationships Scale-Short Form (ECR-S) and, the Hungarian version of the Attachment Style Questionnaire (ASQ-H; n = 297, 127 men, 170 women). In addition, correlations between the long and brief versions of YSEX? with sociosexual orientation (SOI-R) and the five-factor personality construct (BFI-S) were compared (n = 1024, 578 women, 446 men). The results suggest that the three summary scales of the Hungarian 15-item Form of the Why Sex Questionnaire (YSEX?-15H) provide reliable and valid measures of the previously affirmed three broad sexual motives (Personal Goal Attainment, Relational Reasons, Sex as Coping). The Relational Reasons summary scale was associated with secure emotional and sexual attachment. The Personal Goal Attainment and Sex as Coping summary scales showed coherent patterns of associations with the emotional and sexual aspects of secondary attachment strategies (over- and under-functioning). The YSEX?-15H offers both researchers and practitioners a concise and useful instrument for the assessment of sexual motivation.
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Affiliation(s)
- Norbert Meskó
- Institute of Psychology, University of Pécs, Ifjúság utca 6., Pécs, 7624, EU, Hungary.
| | - András N Zsidó
- Institute of Psychology, University of Pécs, Ifjúság utca 6., Pécs, 7624, EU, Hungary
| | - Béla Birkás
- Department of Behavioural Sciences, University of Pécs, Pécs, EU, Hungary
| | - Cindy M Meston
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - David M Buss
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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Gewirtz-Meydan A, Levkovich I, Pinto G, Ayalon L. Discomfort in Discussing Sexual Issues: Developing a New Scale for Staff at Long-Term Care Facilities for Older Adults. J Gerontol Nurs 2022; 48:27-37. [PMID: 36007217 DOI: 10.3928/00989134-20220808-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Interviews reveal that many health professionals working with older adults are uncomfortable discussing sexual issues with those under their care. Nevertheless, to date, discomfort in discussing sexual issues with older adults has not been empirically investigated. To facilitate exploration of this subject, the current study evaluated the psychometric properties of a new measure: The Discomfort in Discussing Sexual Issues (DDSI) with Older Adults scale. The study was conducted via online survey among 127 long-term care staff (e.g., nurses, physicians, physical therapists, social workers, speech therapists, occupational therapists) serving older adults. A confirmatory factor analysis confirmed the DDSI scale's structure as a single, four-item construct. More conservative attitudes regarding sexuality in later life were associated with higher DDSI scores. In addition, DDSI scale scores were negatively correlated with knowledge about sexuality in later life and educational level. Findings indicate that the DDSI has good psychometric properties, as reflected by its high reliability and adequate validity, making it a useful assessment tool for future research. [Journal of Gerontological Nursing, 48(9), 27-37.].
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Okun S, Ayalon L. Eradicating ageism through social campaigns: An Israeli case study in the shadows of the COVID-19 pandemic. THE JOURNAL OF SOCIAL ISSUES 2022; 78:JOSI12540. [PMID: 36249555 PMCID: PMC9539108 DOI: 10.1111/josi.12540] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 07/07/2022] [Accepted: 07/07/2022] [Indexed: 05/22/2023]
Abstract
This study examined three social campaigns for the eradication of ageism that were undertaken in Israel during the COVID-19 pandemic (April, 2020-May, 2021). The documentation and analysis of the campaigns were undertaken via the lens of the Theory of Change and Five Key Principles for social campaigns: planning strategically, communicating effectively, fostering community engagement, implementing key activities, and using research. We conducted desk reviews and qualitative interviews with the campaigns' organizers. The Theory of Change implemented by the campaigns targeted self-ageism among independent older people and/or employers of older adults. All campaigns emphasized "active aging" and "successful aging," to decrease (self)-ageism. The focus on one dimension of active and positive aging may result in ageism and exclusion of older people who do not fit into the category of independent and active people. The complex timing of the campaigns had influenced the degree of implementation of the five key principles. The joining of forces of different organizations and the employment of more diverse representations of old age, may facilitate the achievement of campaign goals. Finally, an empirical evaluation of social campaigns' efforts is still necessary to gather evidence about the effectiveness of social campaigns.
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Affiliation(s)
- Sarit Okun
- Louis and Gabi Weisfeld School of Social WorkBar Ilan UniversityIsrael
| | - Liat Ayalon
- Louis and Gabi Weisfeld School of Social WorkBar Ilan UniversityIsrael
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Gewirtz-Meydan A, Ayalon L. Reasons people refrain from sex in later life. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:189-207. [PMID: 35708188 DOI: 10.1080/0092623x.2022.2087811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
There has been an increase in research on sexual activity in later life, yet far less is known about the actual perceptions and experiences of older adults who refrain from sexual activity. In the current study, a thematic analysis was conducted to identify patterns in semi-structured interviews with 47 older adults, aged 60-91. The analysis yielded seven themes that describe why older adults refrain from sex: 1) avoiding confronting sexual dysfunctions, 2) avoiding confronting the aging body, 3) avoiding performance anxiety, 4) being uninterested in sexual activity, 5) taking time to grieve the loss of a partner, 6) avoiding judgment, and 7) seeing sexuality as evolving and changing. Themes were organized according to the bio-psycho-social perspective and based on the axis of personal (self-focused) and interpersonal (partner-focused) motives. It is perfectly acceptable for people to refrain from sexual activity for their own reasons. However, if older adults want to remain sexually active, they should receive complete information about the many possibilities of treating different sexual problems in later life and about the many ways, beyond sexual penetration, one can enjoy sexual activity even in old age.
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Affiliation(s)
- Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel
| | - Liat Ayalon
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
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Štulhofer A, Mehulić J, Briken P, Klapilová K, de Graaf H, Carvalheira AA, Löfgren-Mårtenson C, Nobre P, Chollier M, Köse Ö, Elmerstig E, Lançon C, Plášilová L, Schröder J. Perceived Changes in Sexual Interest and Distress About Discrepant Sexual Interest During the First Phase of COVID-19 Pandemic: A Multi-Country Assessment in Cohabiting Partnered Individuals. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:231-246. [PMID: 35039982 PMCID: PMC8763301 DOI: 10.1007/s10508-021-02279-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/02/2021] [Accepted: 12/22/2021] [Indexed: 05/07/2023]
Abstract
Due to COVID-19 pandemic, different restrictive measures in terms of physical distancing and lockdowns have been introduced in most European countries, affecting all facets of social life. Currently, little is known about how partnered individuals perceive changes in their sexual life during this complex emergency. This study explored retrospectively assessed changes in sexual interest for one's partner and levels of distress related to perceived sexual interest discrepancy during the first phase of the pandemic in a large-scale online sample of partnered individuals (n = 4813; Mage = 38.5 years, SD = 10.74) recruited between May and July 2020 in seven European Union countries and Turkey. We also examined the possible role of approach/avoidance motives for sex in reported changes in sexual interest and associated distress. Most participants (53%) reported no change in their sexual interest during the pandemic, followed by those who reported an increase (28.5%). The pattern was similar across the eight countries. Distress about discrepant sexual interest, which was only weakly related to changes in sexual interest, was significantly associated with relationship quality and emotional closeness with a partner, coping with and worrying about the pandemic, and specific motivation for sex. In contrast to avoidant and relationship-focused approach motivation, ego-focused approach motivation was related to stable sexual interest during the pandemic. The current study contributes to the understanding of the link between sexual interest and complex emergencies. Considering that the COVID-19 pandemic continues, the reported experiences and perceptions are prone to change.
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Affiliation(s)
- Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, I. Lučića, 10000, Zagreb, Croatia.
| | - Jasmina Mehulić
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Peer Briken
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | | | - Pedro Nobre
- Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Marie Chollier
- Assistance Publique Hôpitaux de Marseille, Marseilles, France
| | | | - Eva Elmerstig
- Centre for Sexology and Sexuality Studies, Department of Social Work, Malmö University, Malmö, Sweden
| | - Christophe Lançon
- CEReSS-Health Services and Quality of Life Research, Aix-Marseille University, Marseilles, France
| | - Leona Plášilová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Johanna Schröder
- Center for Psychosocial Medicine, Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, Medical School Hamburg, Hamburg, Germany
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‘Why would I want sex now?’ A qualitative study on older women's affirmative narratives on sexual inactivity in later life. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The existing research tries to understand the reasons for discontinuing sex in later life with the assumption that people want to be sexual. Although the growing body of literature informs that sex remains an integral part of older adults’ lives, a substantial number of older adults declare not being sexually active. This study aimed at exploring motives for deliberately choosing sexual inactivity among older women. Semi-structured interviews with 16 Polish women (aged 65–82) were thematically analysed in relation to the sexual scripts theory and the participants’ specific socio-cultural background. Three main themes regarding the reasons for cessation of their sex life were identified: ‘I am glad that sex does not concern me anymore’, ‘I am satisfied with my memories’ and ‘The right one’ or no one. The results indicate that some women give up sex for good, with no regrets or feeling of a loss; for others, it may be a temporary decision, its duration dependent on meeting the right partner. Developing sexual agency may encourage discontinuing their sex life – a choice perceived as optimal and liberating. Personal factors and the memories of marital relationships seem to shape older women's (a)sexual expectations. Acknowledging these nuances may contribute to a better understanding of older women's sexual functioning; implications for consideration in further research and practice are also discussed.
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Factors Associated with Four Sexual Behaviors among Married/Partnered Women Ages 60 and Older in the United States. SEXES 2021. [DOI: 10.3390/sexes2040035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Women ages 60 and older vary in sexual behaviors. This study examined the prevalence of vaginal intercourse, outercourse, and receipt and performance of oral sex reported among 461 married/partnered women age ≥ 60 years in the United States and factors associated with these four sexual behaviors. Using data from the National Social Life, Health, and Aging Project, associations between participants’ socio-demographics, health indicators, sexual perceptions, communication, and sexual behaviors were examined. In the past year, 53.6% reported having vaginal intercourse, 56.0% outercourse, and 21.7% receiving and 20.6% performing oral sex. Women with depressive symptomology were less likely to report intercourse and outercourse (p < 0.05). Women endorsing pleasurable sex as necessary to maintain relationships were more likely to report all four behaviors (p < 0.01). Women who communicated openly with partners were more likely to report intercourse (p = 0.002), outercourse (p = 0.001), and performing oral sex (p = 0.025). Findings may inform strategies about positive sex perceptions and strengthening partner communication.
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Gore-Gorszewska G. "What Do You Mean by Sex?" A Qualitative Analysis of Traditional versus Evolved Meanings of Sexual Activity among Older Women and Men. JOURNAL OF SEX RESEARCH 2021; 58:1035-1049. [PMID: 32779942 DOI: 10.1080/00224499.2020.1798333] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
ABSTRACTOlder adults remain sexually active well into later life; yet, there is no consistency in the literature about what sex means to them. The study described in this paper investigated the understanding of sexual activity as reported by 30 women and men from Poland, aged 65 to 82 (M = 71, SD = 5,24). Semi-structured interviews were thematically analyzed in relation to sexual scripts theory and the participants' specific sociocultural background. The results demonstrate the diversity of opinions on what sex is: from penetrative intercourse, through various expressions of physical intimacy, to emotional intimacy as a central concept. The dominant perception of sex as intercourse among some study participants evolved into an intimacy-oriented and partner-focused activity, with the discovery of fondling and female sexual pleasure as components of sex. Certain life events - such as ending a long-term marriage or engaging in a new romantic relationship - were identified as facilitating this change. Notable similarities in older women's and men's perceptions of satisfying sex in later life were observed. Acknowledging the nuanced meaning of sex for this population can contribute to a better understanding of the specificity of older adults' sexuality.
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Nutor JJ, Duah HO, Duodu PA, Agbadi P, Alhassan RK, Darkwah E. Geographical variations and factors associated with recent HIV testing prevalence in Ghana: spatial mapping and complex survey analyses of the 2014 demographic and health surveys. BMJ Open 2021; 11:e045458. [PMID: 34244255 PMCID: PMC8273465 DOI: 10.1136/bmjopen-2020-045458] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high HIV testing rates in Ghana. DESIGN Secondary analysis of Demographic and Health Survey. SETTING Rural and urban Ghana PARTICIPANTS: The study sample comprised 9380 women and 3854 men of 15-49 years. RESULTS We found that 13% of women and 6% of men of Ghana had tested for HIV in the past 12 months. For women, being within the age groups of 15-39 years, being currently married, attainment of post-secondary education, having only one sexual partner and dwelling in certain regions with reference to greater Accra (Volta, Eastern, Upper West and Upper East) were associated with a higher likelihood of HIV testing. For men, being older than 19 years, attainment of post-secondary education and dwelling in the Upper East region with reference to the greater Accra region were significantly associated with a higher likelihood of HIV testing. The surface map further revealed intra-regional level differences in HIV testing estimates. CONCLUSION Given the results, HIV testing must be expanded with equitable testing resource allocation that target areas within the regions in Ghana with low HIV testing prevalence. Men should be encouraged to be tested for HIV.
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Affiliation(s)
- Jerry John Nutor
- Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, California, USA
| | | | - Precious Adade Duodu
- Department of Nursing and Midwifery, University of Huddersfield School of Human and Health Sciences, Huddersfield, UK
| | - Pascal Agbadi
- School of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Robert Kaba Alhassan
- Centre for Health Policy and Implementation Research, University of Health and Allied Sciences, Ho, Ghana
| | - Ernest Darkwah
- Department of Psychology, University of Ghana, Legon, Ghana
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14
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Sexual satisfaction of older adults: testing the Interpersonal Exchange Model of Sexual Satisfaction in the ageing population. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Abstract
Having a satisfying sex life is important to older adults. Thus, this study aimed to provide information about the sexual satisfaction of older adults in a relationship, using the Interpersonal Exchange Model of Sexual Satisfaction (IEMSS) as a theoretical framework. Participants were 187 sexually active individuals (98 men and 89 women) in a romantic relationship (age 65–75 years). They were recruited using Amazon's Mechanical-Turk, and completed the Interpersonal Exchange Model of Sexual Satisfaction Questionnaire and two open-ended questions asking what they enjoyed most and least about their sexual relationship. On average, participants were highly sexually satisfied. In keeping with the IEMSS, greater sexual satisfaction was predicted by a more favourable balance of sexual rewards to costs, greater equality of sexual costs and higher satisfaction with the non-sexual aspects of the relationship. Four themes emerged regarding what participants liked most and least about their sexual relationship: emotional aspects of the relationship, physical aspects of the relationship, dyadic aspects of the relationship and age-related aspects of being sexual. None of the four themes were specific to men or women, although some gender/sex differences were found. The results paint a positive picture of the sexual relationships of older adults and support the utility of the IEMSS as a framework to understand sexual satisfaction in older adults.
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15
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Harder H, Starkings RM, Fallowfield LJ, Menon U, Jacobs IJ, Jenkins VA. Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis. Menopause 2019; 26:1100-1109. [PMID: 31290761 PMCID: PMC6791508 DOI: 10.1097/gme.0000000000001377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Sexual well-being can contribute significantly to the overall quality of women's lives. This qualitative study aimed to examine sexual activity, functioning, and satisfaction in a large sample of postmenopausal women from the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) METHODS:: Thematic analysis was used to evaluate the free-text data of the Fallowfield Sexual Activity Questionnaire (FSAQ) completed by UKCTOCS participants at baseline before annual screening. RESULTS A total of 24,305 women completed the baseline FSAQ and 4,525 (19%) provided free-text data, with 4,418 comments eligible for analysis. Median age was 64 years; 65% had a partner and 22.5% were sexually active. Four interrelated themes were derived: partner availability, physical and sexual health, mental well-being, and interpersonal relationships. Primary reason for absence of sexual activity was lack of a partner, mainly due to widowhood (n = 1,000). Women discussed how partner's medical condition (27%) or sexual dysfunction (13.5%), their own physical health (18%) or menopause-related symptoms (12.5%), and prescribed medication (7%) affected sexual activity. Impact of low libido in self (16%) or partner (7%), relationship problems (10.5%) or logistics (6%), and perceptions of ageing (9%) were also mentioned. Few (3%) referred to positive sexual experiences or had sought medical help for sexual problems (6%). CONCLUSIONS This qualitative analysis explored postmenopausal women's perspective on their sexual functioning. Having an intimate partner and good physical health are key factors for continuation of sexual activity and satisfaction. Further sexual education for healthcare professionals is needed to raise awareness about sexuality and sexual difficulties in later life. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A426.
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Affiliation(s)
- Helena Harder
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Rachel M.L. Starkings
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Lesley J. Fallowfield
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Usha Menon
- MRC Clinical Trials Unit at UCL, Institute of Clinical Trials & Methodology, University College London, London, United Kingdom
| | - Ian J. Jacobs
- EGA Institute for Women's Health, University College London, London, United Kingdom
- University of New South Wales, Sydney, Australia
| | - Valerie A. Jenkins
- Sussex Health Outcomes Research and Education in Cancer (SHORE-C), Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
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16
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Ayalon L, Gewirtz-Meydan A, Levkovich I, Karkabi K. Older men and women reflect on changes in sexual functioning in later life. SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2019.1633576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Liat Ayalon
- The Louis and Gaby Weisfeld School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Ateret Gewirtz-Meydan
- Crimes against Children Research Center and Family Research Laboratory, Department of Sociology, University of New Hampshire, Durham, NH, USA
- Sex and Couples Therapy Unit, Meir Medical Center, Kfar-Saba, Israel
| | - Inbar Levkovich
- The Division of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Khaled Karkabi
- Department of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Clalit Health Services, Haifa & Western Galilee District, Israel
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17
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Ayalon L, Gewirtz-Meydan A, Levkovich I. Older Adults’ Coping Strategies With Changes in Sexual Functioning: Results From Qualitative Research. J Sex Med 2019; 16:52-60. [DOI: 10.1016/j.jsxm.2018.11.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 11/02/2018] [Accepted: 11/09/2018] [Indexed: 11/17/2022]
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