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Kong D, Romli MH, Devaraj NK, Sallehuddin H, Tan MP. A Meta-Synthesis on Sexuality in Persons with Dementia Mapped Using the Model of Human Occupation. Occup Ther Health Care 2024:1-31. [PMID: 38975945 DOI: 10.1080/07380577.2024.2375533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/29/2024] [Indexed: 07/09/2024]
Abstract
Dementia affects the individual's functional ability including sexual activity. Limited understanding is available to support sexual health practices. This meta-synthesis review aimed to identify the gaps in the study of sexuality in dementia using the Model of Human Occupation (MOHO). Electronic searches utilizing six databases for existing articles involving persons living with dementia, care partners, and healthcare workers. The result showed that available studies primarily explored sexuality from the viewpoint of spouses of persons living with dementia. The volition domain of MOHO was the most explored provides a deeper understanding of volition on intrinsic perspective on sexuality in people with dementia. The environment domain was the least explored, highlighting healthcare professionals' need for social support and training. The topic of sexuality remains sensitive, limiting the availability of evidence-based interventions in this area.
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Affiliation(s)
- Dinnee Kong
- Genting Dementia Care Centre, Kuala Lumpur, Malaysia
| | - Muhammad Hibatullah Romli
- Department of Rehabilitation Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Navin Kumar Devaraj
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Hakimah Sallehuddin
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Maw Pin Tan
- Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur
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Co M, Moreno-Agostino D, Wu YT, Couch E, Posarac A, Wi T, Sadana R, Carlisle S, Prina M. Non-pharmacological interventions for the prevention of sexually transmitted infections (STIs) in older adults: A systematic review. PLoS One 2023; 18:e0284324. [PMID: 37224103 PMCID: PMC10208510 DOI: 10.1371/journal.pone.0284324] [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: 01/27/2021] [Accepted: 03/28/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND STIs in older adults (adults aged 50 years and older) are on the rise due to variable levels of sex literacy and misperceived susceptibility to infections, among other factors. We systematically reviewed evidence on the effect of non-pharmacological interventions for the primary prevention of sexually transmitted infections (STIs) and high-risk sexual behaviour in older adults. METHODS We searched EMBASE, MEDLINE, PSYCINFO, Global Health and the Cochrane Library from inception until March 9th, 2022. We included RCTs, cluster-randomised trials, quasi-RCTs, interrupted time series (ITS) and controlled and uncontrolled before-and-after studies of non-pharmacological primary prevention interventions (e.g. educational and behaviour change interventions) in older adults, reporting either qualitative or quantitative findings. At least two review authors independently assessed the eligibility of articles and extracted data on main characteristics, risk of bias and study findings. Narrative synthesis was performed. RESULTS Ten studies (two RCTs, seven quasi-experiment studies and one qualitative study) were found to be eligible for this review. These interventions were mainly information, education and communication activities (IECs) aimed at fostering participants' knowledge on STIs and safer sex, mostly focused on HIV. Most studies used self-reported outcomes measuring knowledge and behaviour change related to HIV, STIs and safer sex. Studies generally reported an increase in STI/HIV knowledge. However, risk of bias was high or critical across all studies. CONCLUSIONS Literature on non-pharmacological interventions for older adults is sparse, particularly outside the US and for STIs other than HIV. There is evidence that IECs may improve short-term knowledge about STIs however, it is not clear this translates into long-term improvement or behaviour change as all studies included in this review had follow-up times of 3 months or less. More robust and higher-quality studies are needed in order to confirm the effectiveness of non-pharmacological primary prevention interventions for reducing STIs in the older adult population.
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Affiliation(s)
- Melissa Co
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Darío Moreno-Agostino
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Centre for Longitudinal Studies, UCL Social Research Institute, University College London, London, United Kingdom
- ESRC Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Yu-Tzu Wu
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elyse Couch
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Center for Gerontology and Healthcare Research, Brown University, Providence, RI, United States of America
| | - Ana Posarac
- Ageing and Health Unit, Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organisation, Geneva, Switzerland
| | - Teodora Wi
- Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, World Health Organisation, Geneva, Switzerland
| | - Ritu Sadana
- Ageing and Health Unit, Maternal, Newborn, Child and Adolescent Health and Ageing Department, World Health Organisation, Geneva, Switzerland
- World Health Organization Secretariat, Council on the Economics of Health for All, Geneva, Switzerland
| | - Sophie Carlisle
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Brennan-Ing M, Mattas E. Aging with HIV: Working to Ensure Equity and Inclusion. Gerontology 2023; 69:946-952. [PMID: 37071979 DOI: 10.1159/000530723] [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: 01/09/2023] [Accepted: 04/08/2023] [Indexed: 04/20/2023] Open
Abstract
Due to effective anti-retroviral therapy (ART), the people with HIV are aging, and this is observed globally wherever ART is readily available. While this represents the success of HIV treatment, those aging with HIV face several health challenges that emphasize the importance of access to health care and health equity. These challenges include changes to the immune system, chronic inflammation, and higher rates of multimorbidity at younger ages compared to people without HIV. Intersectional identities impact health care access and health equity and include age, sexual orientation, gender identity, race/ethnicity, socioeconomic position, and HIV serostatus. Intersectional identities are also associated with psychosocial burdens among older adults with HIV such as depression, social isolation, and HIV stigma. Social integration of older people with HIV can mitigate some of these burdens and is associated with better psychological well-being, better physical functioning, and greater sufficiency of informal social supports. There are several grassroots and advocacy initiatives to improve health equity and social integration which bring greater visibility to HIV and aging. These efforts should be coupled with a systematic and sustained policy response to the aging of this population that prioritizes human needs and is grounded in principles of social justice. Action must be taken, and this responsibility falls on policymakers, health care professionals, researchers, and community advocates alike.
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Affiliation(s)
- Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, New York, USA
| | - Eleni Mattas
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, New York, USA
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Wang B, Peng X, Liang B, Fu L, Tian T, Liu J, Li Y, Li X, Wang S, Zheng W, Xiao X, Shi T, Cao G, Ouyang L, Wang Y, Tucker J, Tang W, Wu D, Meng X, Yu M, Wu G, Cai Y, Zou H. Sexual well-being among older adults in China (SWELL): protocol for a multicenter cross-sectional study. BMJ Open 2023; 13:e067338. [PMID: 36717139 PMCID: PMC9887691 DOI: 10.1136/bmjopen-2022-067338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Existing studies on sexual health generally focus on younger populations, while the sexual well-being of older adults has received insufficient attention. This protocol describes the design of a study on sexual well-being and its correlates among older adults in China. METHODS AND ANALYSIS We present the protocol for a multicentre observational study to investigate sexual well-being among Chinese older adults (SWELL). Eligible participants are men and women aged 50 years and older from East, West, South and North China, including older adults living in the community and older adults living with HIV. A multistage sampling approach is used in the SWELL Study. We will collect a questionnaire about sexual health (sexual knowledge, sexual attitude, sexual behaviours, sexually transmitted infections, etc). Blood specimens will be tested for sex hormones (estradiol for women, testosterone for men), biochemical items (eg, cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein, urea, creatinine and uric acid) and syphilis (determined by toluidine red unheated serum test and Treponema pallidum particle agglutination test). The primary analysis will elucidate the current status of sexual health among older adults in China and its correlates. Secondary analyses will compare sexual well-being among older adults in four regions across China. Approximately 3540 older adults will be recruited into the SWELL Study. ETHICS AND DISSEMINATION This study was approved by the Human Research Ethics Committee of the School of Public Health (Shenzhen), Sun Yat-sen University (approval number SYSU-PHS[2019]006). Verbal informed consent will be obtained from all participants before any study procedure. Data will be anonymised, and participants will not be identified through any data, transcripts or publications. Findings from the SWELL Study will be disseminated widely through peer-reviewed scientific journals and at national and international conferences.
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Affiliation(s)
- Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xin Peng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Bowen Liang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Jiewei Liu
- Department of AIDS/STD Control and Prevention, Baiyun District Center for Disease Control and Prevention, Guangzhou, Guangdong, China
| | - Yuwei Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xinyi Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Shihao Wang
- Department of AIDS/STD Control and Prevention, Shizhong District Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Weiran Zheng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
- Center for Optometry and Visual Science, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Tongxin Shi
- Department of AIDS/STD Control and Prevention, Tianjin Hexi District Center for Disease Control and Prevention, Tianjin, China
| | - Gaozhou Cao
- Community Health Center, Erqi Xincun Subdistrict, Shizhong District, Jinan, Shandong, China
| | - Lin Ouyang
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Joseph Tucker
- Project China, University of North Carolina at Chapel Hill, Guangzhou, Guangdong, China
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Weiming Tang
- Project China, University of North Carolina at Chapel Hill, Guangzhou, Guangdong, China
- Dermatology Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Dan Wu
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Xiaojun Meng
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Guohui Wu
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huachun Zou
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, Guangdong, China
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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Jackson DA, McDonald R, Quilter LAS, Weinstock H, Torrone EA. Reported Neurologic, Ocular, and Otic Manifestations Among Syphilis Cases-16 States, 2019. Sex Transm Dis 2022; 49:726-732. [PMID: 35819903 PMCID: PMC9481702 DOI: 10.1097/olq.0000000000001673] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Syphilis can cause neurologic, ocular, or otic manifestations, possibly resulting in permanent disability or death. In 2018, the Centers for Disease Control and Prevention began collecting syphilis clinical manifestation data via the National Notifiable Diseases Surveillance System. We present the first reported US syphilis neurologic, ocular, and otic manifestation prevalence estimates. METHODS We reviewed 2019 National Notifiable Diseases Surveillance System data to identify jurisdictions reporting 70% or greater of syphilis cases 15 years or older with clinical manifestation data (considered "complete reporting"). Among these jurisdictions, we determined reported neurologic, ocular, and otic manifestation prevalence, stratified by demographic, behavioral, and clinical characteristics. RESULTS Among 41,187 syphilis cases in 16 jurisdictions with complete reporting, clinical manifestations were infrequently reported overall: neurologic (n = 445, 1.1%), ocular (n = 461, 1.1%), otic (n = 166, 0.4%), any (n = 807, 2.0%). Reported clinical manifestation prevalence was highest among cases 65 years or older (neurologic, 5.1%; ocular, 3.5%; otic, 1.2%) and those reporting injection drug use (neurologic: 2.8%; ocular: 3.4%; otic: 1.6%). Although reported neurologic and ocular manifestation prevalence was slightly higher among human immunodeficiency virus (HIV)-infected versus HIV-negative persons, approximately 40% of cases with manifestations were HIV-negative. Reported otic manifestation prevalence was similar regardless of HIV status. When stratifying by HIV status and syphilis stage, reported prevalence was highest among HIV-infected persons with unknown duration/late syphilis (neurologic, 3.0%; ocular, 2.3%; otic, 0.7%). CONCLUSIONS Reported neurologic, ocular, and otic manifestation prevalence was low among syphilis cases, but these data are likely an underestimate given potential underreporting. Reported clinical manifestation frequency, including among HIV-negative persons, emphasizes the importance of evaluating all syphilis cases for signs/symptoms of neurosyphilis, ocular syphilis, and otosyphilis.
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Affiliation(s)
- David A Jackson
- From the Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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Pretorius D, Mlambo MG, Couper ID. Perspectives on sexual history taking in routine primary care consultations in North West, South Africa: Disconnect between patients and doctors. Afr J Prim Health Care Fam Med 2022; 14:e1-e10. [PMID: 35792630 PMCID: PMC9257710 DOI: 10.4102/phcfm.v14i1.3286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/18/2022] [Accepted: 03/24/2022] [Indexed: 11/01/2022] Open
Abstract
Background: Sexual history is rarely taken in routine consultations and research reported on common barriers that doctors experience, such as gender, age and cultural differences. This article focuses on how patients and doctors view sexual history taking during a consultation and their perspectives on barriers to and facilitators of sexual history taking.Aim: This study aimed to explore doctors’ and patients’ perspectives on sexual history taking during routine primary care consultations with patients at risk of sexual dysfunction.Setting: The research was conducted in primary care facilities in the Dr Kenneth Kaunda Health District, North West province.Methods: This was part of grounded theory research, involving 151 adult patients living with hypertension and diabetes and 21 doctors they consulted. Following recording of routine consultations, open-ended questions on the demographic questionnaire and brief interactions with patients and doctors were documented and analysed using open inductive coding. The code matrix and relations browsers in MaxQDA software were used.Results: There was a disconnect between patients and doctors regarding their expectations on initiating the discussion on sexual challenges and relational and clinical priorities in the consultation. Patients wanted a doctor who listens. Doctors wanted patients to tell them about sexual dysfunction. Other minor barriers included gender, age and cultural differences and time constraints.Conclusion: A disconnect between patients and doctors caused by the doctors’ perceived clinical priorities and screening expectations inhibited sexual history taking in a routine consultation in primary care.
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Affiliation(s)
- Deidré Pretorius
- Division of Family Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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Pretorius D, Couper ID, Mlambo MG. Sexual history taking: Doctors' clinical decision-making in primary care in the North West province, South Africa. Afr J Prim Health Care Fam Med 2021; 13:e1-e9. [PMID: 34636612 PMCID: PMC8517797 DOI: 10.4102/phcfm.v13i1.2985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Clinical reasoning is an important aspect of making a diagnosis for providing patient care. Sexual dysfunction can be as a result of cardiovascular or neurological complications of patients with chronic illness, and if a patient does not raise a sexual challenge, then the doctor should know that there is a possibility that one exists and enquire. AIM The aim of this research study was to assess doctors' clinical decision-making process with regards to the risk of sexual dysfunction and management of patients with chronic illness in primary care facilities of the North West province based on two hypothetical patient scenarios. SETTING This research study was carried out in 10 primary care facilities in Dr Kenneth Kaunda health district, North West province, a rural health district. METHODS This vignette study using two hypothetical patient scenarios formed part of a broader grounded theory study to determine whether sexual dysfunction as comorbidity formed part of the doctors' clinical reasoning and decision-making. After coding the answers, quantitative content analysis was performed. The questions and answers were then compared with standard answers of a reference group. RESULTS One of the doctors (5%) considered sexual dysfunction, but failed to follow through without considering further exploration, investigations or management. For the scenario of a female patient with diabetes, the reference group considered cervical health questions (p = 0.001) and compliance questions (p = 0.004) as standard enquiries, which the doctors from the North West province failed to consider. For the scenario of a male patient with hypertension and an ex-smoker, the reference group differed significantly by expecting screening for mental health and vision (both p = 0.001), as well as for HIV (p 0.001). The participating doctors did not meet the expectations of the reference group. CONCLUSION Good clinical reasoning and decision-making are not only based on knowledge, intuition and experience but also based on an awareness of human well-being as complex and multidimensional, to include sexual well-being.
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Affiliation(s)
- Deidré Pretorius
- Division of Family Medicine, School of Clinical Medicine, University of the Witwatersrand, Johannesburg.
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Brennan-Ing M, Kaufman JE, Larson B, Gamarel KE, Seidel L, Karpiak SE. Sexual Health Among Lesbian, Gay, Bisexual, and Heterosexual Older Adults: An Exploratory Analysis. Clin Gerontol 2021; 44:222-234. [PMID: 33203315 DOI: 10.1080/07317115.2020.1846103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objectives: A significant gap in our knowledge concerns sexual health among the older lesbian, gay, and bisexual (LGB) population.Methods: We compared a community-based sample of self-identified LGB older adults (n = 128) with population-based samples of behaviorally-defined LGB older adults (i.e., reporting same-sex experiences) (n = 112) and behaviorally-defined older heterosexuals (i.e., reporting no same-sex experiences) (n = 2,893) from the National Social Life, Health and Aging Project (NSHAP). Differences in sexual activity and sexual problems were examined.Results: Older LGB adults were as likely to remain sexually active as older heterosexuals. Gay and bisexual men were more likely than heterosexual men to report some sexual problems. Regardless of sexual orientation, older adults rarely had their sexual health needs addressed in healthcare settings.Conclusions: Results highlight the need for more research on LGB older adult sexual health.Clinical Implications: The lack of attention to LGB older adults' sexual health in healthcare settings may be exacerbated by ageism and heterosexism, leading these individuals to avoid disclosing their sexual orientations and avoid conversations about sexuality. Mental health practitioners require education on associations between sexual health and mental health, and how sexual health problems may contribute to mental health concerns in vulnerable populations like older LGB adults.
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Affiliation(s)
- Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | - Jennifer E Kaufman
- Brookdale Center for Healthy Aging, Hunter College, The City University of New York, New York, NY, USA
| | | | - Kristi E Gamarel
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Liz Seidel
- Hartford Institute of Geriatric Nursing, New York University Rory Meyers College of Nursing, New York, New York, USA
| | - Stephen E Karpiak
- ACRIA Center on HIV and Aging at GMHC, New York, New York, USA
- New York University Rory Meyers College of Nursing, New York, New York, USA
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Smith ML, Bergeron CD, Goltz HH, Coffey T, Boolani A. Sexually Transmitted Infection Knowledge among Older Adults: Psychometrics and Test-Retest Reliability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2462. [PMID: 32260298 PMCID: PMC7177870 DOI: 10.3390/ijerph17072462] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/29/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022]
Abstract
Sexually transmitted infections (STI) among older adults have dramatically increased in recent years, especially among those who are widowed and divorced. The purposes of this study were to: (1) identify STI-related knowledge among older adults; (2) report the psychometric properties of a tool commonly used to assess STI-related knowledge among younger populations using data from adults 65 years and older; and (3) determine test-retest reliability of the tool. Data were analyzed from 43 adults, aged 65-94 years, using the 27-item Sexually Transmitted Disease Knowledge Questionnaire (STD-KQ). Participants completed identical instruments on two separate days with approximately two weeks between. After responses were coded for correctness, composite scores were created. Cronbach's reliability coefficients were calculated to determine response consistency, and Pearson's r coefficients were used to assess test-retest reliability. Of 27 possible correct answers, participants reported an average of 11.47 (±6.88) correct responses on Day 1 and 11.67 (±7.33) correct responses on Day 2. Cronbach's alpha coefficients for the 27-item composite scale were high for both days (0.905 and 0.917, respectively), which indicates strong response consistency. Pearson's r coefficients were high between responses for the 27-item composite scale on Days 1 and 2 (r = 0.882, P < 0.01), which indicates strong test-retest reliability. Pearson's r coefficients were high between responses for all but three of the 27 items when assessed separately. Findings suggest the utility of the STD-KQ to assess STI knowledge among older adults. However, the consistently low knowledge scores highlight the need for educational interventions among this population.
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Affiliation(s)
- Matthew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX 77843, USA
- School of Public Health, Texas A&M University, College Station, TX 77843, USA
- College of Public Health, The University of Georgia, Athens, GA 30602, USA
| | | | - Heather H. Goltz
- Baylor College of Medicine, University of Houston—Downtown, Houston, TX 77030, USA;
| | - Tammy Coffey
- Alice Hyde Medical Center, Malone, NY 12953, USA;
| | - Ali Boolani
- Department of Physical Therapy and Department of Biology, Clarkson University, Potsdam, NY 13699, USA;
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