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Emerson A, Valleroy E, Knittel A, Ramaswamy M. Sex and aging: Perspectives of older adult women with experience of incarceration. J Women Aging 2023; 35:487-503. [PMID: 36840534 PMCID: PMC10450097 DOI: 10.1080/08952841.2023.2180246] [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] [Received: 08/26/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
To explore perspectives on sexuality, sexual health, and sexual health care of older adult women with a history of criminal legal system involvement, we conducted phone interviews with women aged 50 years or older who were living in the community but had a history of jail and/or prison incarceration. Interview questions and initial analysis were guided by the sexual health framework for public health and Mitchell's sexual wellness model. Data analysis followed a framework method. Nine women, aged 53-66, participated in phone interviews between December 2020 and December 2021. Slightly over half the participants were Black; none were Hispanic. Most were single. We formulated a sex-in-aging (SAGE) framework comprising three categories and two overarching themes. Women with a history of criminal-legal system involvement have heterogeneous views on sex and sexual health and describe a range of desire and sexual activity as they age, including shifting ideas about what they expect from partners, how they keep themselves safe in sexual and intimate relationships, and how life circumstances that are often associated with criminal legal system involvement (substance use, trauma) impact their interest in sex as they age. The SAGE framework integrates these categories and themes and offers a starting point for further research and intervention development.
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Affiliation(s)
- Amanda Emerson
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Ella Valleroy
- School of Biological and Chemical Sciences, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Andrea Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Tyndall I, Hartland T, Banerjee M, Giacomelli V, Ball I, Churchill S, Pereira A, Lowry R. Tailoring Sexual Health Interventions for Middle-Aged and Older Adults, Including Vulnerable Populations: A Scoping Review. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2022; 34:593-613. [PMID: 38596395 PMCID: PMC10903680 DOI: 10.1080/19317611.2022.2089313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/03/2022] [Accepted: 06/07/2022] [Indexed: 04/11/2024]
Abstract
Objective This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Methods Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Results Of the nine studies that met the inclusion criteria, seven were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. Conclusions This review highlights the imperative for further research on sexual health interventions with these overlooked populations.
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Affiliation(s)
- Ian Tyndall
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Tess Hartland
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Moitree Banerjee
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Victoria Giacomelli
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Isabelle Ball
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Susan Churchill
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Antonina Pereira
- Department of Psychology, Institute of Education, Social, and Life Sciences, University of Chichester, Chichester, UK
| | - Ruth Lowry
- School of Sport, Rehabilitation and Exercise Sciences, University of Essex, Colchester, UK
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3
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Li T, Luo Y, Meng Y, Yue J, Nie M, Fan L, Tong C. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022; 19:302-310. [PMID: 34973899 DOI: 10.1016/j.jsxm.2021.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/21/2021] [Accepted: 11/29/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sexuality has an important impact on people's physical and mental health, but current research on the sexual activity of older Chinese women has many limitations and more detailed studies are needed. AIM The objective was to determine the prevalence of sexual activity and related factors in women aged 55 to 85 years in Hunan, China. METHODS Based on the data from the Hunan Provincial Women Health Needs Survey in 2018, we conducted a secondary analysis of 2,401 older women aged 55 and above. The dependent variable was sexual activity, and independent variables included sociodemographic characteristics, health behaviors, reproductive and chronic medical history, and psychological characteristics. All statistical analyses were performed using SPSS 26.0. Chi-square test was used to assess the association between categorical variables, and binary logistic regression was used to examine factors related to sexual activity. OUTCOMES Sexual activity and related factors. RESULTS The prevalence of sexual activity among older women was 12.5% (301/2401) in the past month. Having a partner (OR = 1.484; 95% CI, 1.048-2.101; P = .026), jogging (OR = 2.061; 95% CI, 1.391-3.054; P < .001), dancing (OR = 1.477; 95% CI, 1.106-1.974; P = .008), vegetarian-based diet (OR = 2.197; 95% CI, 1.334-3.618; P = .002), meat-based diet (OR = 2.196; 95% CI, 1.144-4.216; P = .018) were positively associated with being sexually active. Whereas, aging (OR = 0.781; 95% CI, 0.647-0.942; P = .010), living in the urban (OR = 0.628; 95% CI, 0.488-0.808; P < .001), hypertension (OR = 0.702; 95% CI, 0.520-0.949; P = .021), and anxiety (OR = 0.680; 95% CI, 0.475-0.972; P = .034) were negatively associated with being sexually active. CLINICAL IMPLICATIONS Health care workers need to be aware that older women still have sexual activity and understand the needs of older women for sex education, take the initiative to discuss safe sex with them, and solve their sexual problems. STRENGTHS AND LIMITATIONS This is one of the largest studies to determine the prevalence of sexual activity among older women in China and its related factors. In addition, new factors such as exercise types and eating habits related to sexual activity were discovered. The limitation of this study is that it did not use a specific questionnaire to assess the sexual activity and did not consider physical tenderness other than sexual intercourse. CONCLUSIONS Some older women still have had sexual activity in the past month and factors such as lifestyles that can be changed and chronic diseases that can be self-managed were found to predict sexual activity. Li T, LuoY, Meng Y, et al. Sexual Activity and Related Factors of Older Women in Hunan, China: A Cross-Sectional Study. J Sex Med 2022;19:302-310.
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Affiliation(s)
- Ting Li
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
| | - Yang Luo
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China.
| | - Yanting Meng
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
| | - Jing Yue
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
| | - Ming Nie
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
| | - Ling Fan
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
| | - Chenxi Tong
- Xiangya Nursing School of Central South University, Changsha, Hunan province, China
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Friedmann E, Cwikel J. Women and Men's Perspectives on the Factors Related to Women's Dyadic Sexual Desire, and on the Treatment of Hypoactive Sexual Desire Disorder. J Clin Med 2021; 10:jcm10225321. [PMID: 34830603 PMCID: PMC8623679 DOI: 10.3390/jcm10225321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/25/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Sexuality is a basic human need, which is expressed in the context of intimate personal relations. However, in studies of women's sexuality, men's attitudes are often overlooked. Health care providers can benefit from the examination of how both women and men perceive women's sexual desire and what are the most acceptable avenues for treatment for women's hypoactive sexual desire disorder (HSDD). This research aimed to explore differences between women and men on the factors affecting women's sexual desire and the appropriate avenues for treatment. Data were collected using an online questionnaire from 233 heterosexual adults who had a dyadic, steady intimate relationship over most of the previous year. A theory-based questionnaire of 28 items was developed to explore the factors associated with women's sexual desire. One quarter (7/28) of the items affecting women's sexual desire were ranked significantly differently between women and men. Among women, interpersonal issues and physical attraction, and among men, physical attraction and daily hassles were the significant predictors of women's sexual desire. Women more than men endorsed psychological help such as a sex therapist or psychologist as a more appropriate treatment for HSDD, while both men and women viewed the internet as a reasonable way to gain treatment information. Both women and men viewed gynecologists as a more acceptable source of treatment than a family doctor. Religious authorities were the least likely source of treatment advice for both women and men. The results support a multi-dimensional model of women's sexual desire and suggest that psychological interventions to treat HSDD may be preferred by women more than men.
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Affiliation(s)
- Enav Friedmann
- Department of Business Administration, Guilford Glazer Faculty of Business and Management, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, Israel;
| | - Julie Cwikel
- Center for Women’s Health Studies and Promotion and Spitzer, Department of Social Work, Ben Gurion University of the Negev, POB 653, Beer Sheva 84105, Israel
- Correspondence: ; Tel.: +972-8-6472321
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5
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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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Dubin JM, Wyant WA, Balaji NC, Efimenko IV, Rainer QC, Mora B, Paz L, Winter AG, Ramasamy R. Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction? Sex Med 2021; 9:100352. [PMID: 34062495 PMCID: PMC8240332 DOI: 10.1016/j.esxm.2021.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Several studies have investigated the association between erectile dysfunction (ED), its treatment, and female sexual dysfunction, but the impact of males blaming their female partners for their ED remains unknown. Aims To investigate whether women who are blamed by their male partners for their ED experience worse overall sexual function and satisfaction. Methods We performed a global, cross-sectional web-based survey to investigate female perceptions of ED. We distributed the 30-item survey via email, Reddit, Amazon Mechanical Turk, and Facebook. Women 18 years of age or older were eligible to participate and answered questions based on a 5-point Likert scale. Women were grouped by ages 18-29, 30-39, and 40 and older. Main Outcome Measures The survey collected data that included general demographics and questions regarding experiencing male blame for ED and its relationship with each subject's sexual health and wellness. Results A total of 13,617 females participated in the survey. Of the women surveyed, 79% have experienced their partner losing their erection during sexual activity and approximately 1 out of 7 women (14.7%) had experienced being blamed by their partner for loss of their erection. Women who were blamed for their partner's ED were more likely to end the sexual encounter, were less sexually satisfied, and were more likely to end relationships due to their partner's ED. Conclusion Approximately 1 out of 7 women have experienced male blame for their partner's ED which is associated with negative impacts on female mental health, sexual satisfaction and the success of the overall partnership. Because of its widespread impact on female wellness, male blame should be considered during evaluation of female sexual history and men must be educated on the significant impact their reactions during intimacy have on their female partners and their relationships as a whole. Dubin JM, Wyant WA, Balaji NC, et al. Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?. Sex Med 2021;9:100352.
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Affiliation(s)
- Justin M Dubin
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - W Austin Wyant
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Navin C Balaji
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Iakov V Efimenko
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Quinn C Rainer
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Belen Mora
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lisa Paz
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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7
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Agochukwu-Mmonu N, Malani PN, Wittmann D, Kirch M, Kullgren J, Singer D, Solway E. Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults. Clin Gerontol 2021; 44:299-306. [PMID: 33616005 DOI: 10.1080/07317115.2021.1882637] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: Sexual health is an important component of overall health and well-being for older adults. Despite this, little is known about the importance of sex to quality of life, as part of romantic relationships for older adults, and potential drivers of interactions between healthcare providers and older adults about sexual health. In this study using a nationally representative population, we describe perceptions and experiences of sex among older adults.Methods: A nationally representative, cross-sectional sample of community-dwelling U.S. adults aged 65-80 was surveyed about their sexual health and interaction with their health care providers about sexual health.Results: The survey completion rate was 75% (N = 1,002). Overall, 50.9% of men and 30.8% of women reported being sexually active. In all, 17.3% of adults aged 65-80 reported speaking to their health care provider about sexual health in the past two years and of those, 60.5% of patients initiated the conversation. Multivariable logistic regression demonstrated that sexual activity (yes/no), interest in sex, and satisfaction with sex life are major drivers of sexual health conversations between patients and healthcare providers.Conclusions: Many adults aged 65-80 are interested in and engage in sexual activity. While the majority of older adults reported a willingness to discuss their sexual health with their health care providers, few had done so, and most conversations were initiated by patients. Iterest in sex and satisfaction with sex life may be targets for intervention and offer a segue for providers as they begin the conversation to engage with older adults about their sexual health.Clinical Implications: Providers may have conversations with older adults about sexual health and may need sexual health training to have effective discussions; age nor chronic conditions should preclude this essential conversation. Clinical gerontologists may be helpful in this training and in encouraging patients to bring up sexual health concerns during their medical appointments.
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Affiliation(s)
| | - Preeti N Malani
- Department of Internal Medicine, Division of Infectious Diseases, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniela Wittmann
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthias Kirch
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeff Kullgren
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA.,Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA.,Departments of Internal Medicine and Health Management and Policy, University of Michigan, Ann Arbor, Michigan, USA
| | - Dianne Singer
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Erica Solway
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
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8
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Zhang X, Sherman L, Foster M. Patients' and providers' perspectives on sexual health discussion in the United States: A scoping review. PATIENT EDUCATION AND COUNSELING 2020; 103:2205-2213. [PMID: 32601041 DOI: 10.1016/j.pec.2020.06.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 06/14/2020] [Accepted: 06/18/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The objective of this scoping review was to explore patients' and providers' perspectives on sexual health communication. METHODS A literature search was conducted in three databases, Medline (OVID), CINAHL (Ebsco), and PsycINFO (Ebsco) covering January 1, 2000-May 12, 2020. A coding sheet with a list of questions was created in Qualtrics to extract information from each article. RESULTS Thirty-three (33) studies were included in this review. The findings indicated that 1) the current sexual health discussion does not meet the needs of the patients; and 2) patients and providers hold uniquely different perspectives on the importance of the discussion, the responsibility of conversation initiation, and the comfort level of the discussion. CONCLUSIONS There remains a significant gap between providers' perceptions and patients' needs regarding sexual health discussion. More efforts should be made to promote the necessary sexual health communication. PRACTICE IMPLICATIONS Providers should initiate the discussion when necessary because it is very likely that patients welcome the discussion. Medical education and training should incorporate sexual health into its curricula to enhance health care professionals' abilities in addressing sexual health issues. Providers should model a sense of openness and comfort in conversation to encourage patients to discuss sexual health.
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Affiliation(s)
- Xiaoying Zhang
- Department of Health and Kinesiology, Texas A&M University, College Station, USA.
| | - Ledric Sherman
- Department of Health and Kinesiology, Texas A&M University, College Station, USA
| | - Margaret Foster
- University libraries, Texas A&M University, College Station, USA
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9
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Macleod A, McCabe MP. Defining sexuality in later life: A systematic review. Australas J Ageing 2020; 39 Suppl 1:6-15. [PMID: 32567178 DOI: 10.1111/ajag.12741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To identify whether a consistent definition of sexuality is used across research articles to describe sexuality in later life for heterosexual men and women. METHODS A systematic review was conducted that examined how researchers define sexuality for heterosexual adults. Peer-reviewed journal articles on sexuality published between 1999 and 2018 were examined for the presence of sexuality definitions. Sexuality themes discussed in each article were recorded, and results were tabulated. RESULTS Few articles explicitly provide a definition of 'sexuality' as it pertains to later life. Definitions from articles that defined sexuality explicitly were inconsistent across studies. Topics included in implicit and explicit definitions of sexuality were disparate across studies and included a diverse range of sexuality dimensions. CONCLUSION Greater consistency is needed in how "sexuality" in later life is defined across studies and should be informed by data so that it accurately reflects the sexual experiences of older adults.
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Affiliation(s)
- Ashley Macleod
- Swinburne University of Technology, Hawthorn, Vic., Australia
| | - Marita P McCabe
- Swinburne University of Technology, Hawthorn, Vic., Australia
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10
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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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11
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Abstract
Public opinion on later-life sexuality affects older people's sexual health, behaviour, and satisfaction. In this study, we explored public opinion on later-life sexuality by participants' responding to an open-ended question rather than rank their level of agreement or disagreement with different statements about older people's sexuality. Responses from 135 men and women reflecting on how sexuality changes in older age were thematically analysed. Five themes emerged, varying from positive to negative perceptions of later-life sexuality. Older people's sexuality was described as declining, non-existent, conservative, narrow, tedious, and boring, but also as encompassing more emotions and feelings; being better and more "complete". This study provides qualitative data and an opportunity to gain insights on valuable opinions on what young and middle-aged people think about later-life sexuality. Assessing what people think about later-life sexuality is the first stage in instilling more liberating views about the diversity of sexual expressions in old age.
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12
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Sexual Orientation and Patient-Provider Communication About Sexual Problems or Concerns Among US Adults. J Gen Intern Med 2019; 34:2505-2511. [PMID: 31452036 PMCID: PMC6848742 DOI: 10.1007/s11606-019-05300-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 05/02/2019] [Accepted: 07/17/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Limited patient-provider communication about sexual health is a crucial barrier to patients receiving treatment for sexual problems, and little is known about how patient sexual orientation is associated with patient-provider communication about sexual problems. OBJECTIVE To describe the prevalence of patient-provider communication about sexual problems and the associations between communication and (1) persistent sexual problems and (2) whether those who identified as lesbian, gay, or bisexual had disclosed their sexual orientation to their clinicians. DESIGN Cross-sectional, online survey PARTICIPANTS: 4325 English-speaking US adults from KnowledgePanel®, a probability-based sample of the civilian, noninstitutionalized population. MAIN MEASURES Sexual orientation, disclosure of sexual orientation (being "out") to a health care provider, communication with health care providers regarding sexual problems or concerns, and persistent sexual problems or concerns. KEY RESULTS In the past year, 8-15% of US adults discussed a sexual problem or concern with a health care provider. Between 23 and 42% of US adults reported persistent sexual problem(s) in the past year, and of those, 18% of gay/lesbian women, 20% of heterosexual women, 22% of bisexual women, 30% of gay men, 31% of heterosexual men, and 37% of bisexual men had discussed a sexual concern with a clinician. Eighty percent of gay/lesbian women and 70% of gay men had disclosed their sexual orientation to their regular health care provider, versus only 24% of bisexual men and women. Among those who were "out," 30% had ever talked to a clinician about a sexual problem compared with 17% of those who were not "out." A smaller proportion of lesbian women had ever received care or treatment for a sexual problem, 6% compared with 14-23% in the other groups. CONCLUSIONS There are significant unmet needs among US adults with regard to patient-provider communication about sexual problems or concerns. Improving patient-provider communication about sexual health is critical.
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13
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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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Khunda A, McCormick C, Ballard P. Sacral neuromodulation and sexual function: a systematic review and meta-analysis of the literature. Int Urogynecol J 2018; 30:339-352. [PMID: 30535791 DOI: 10.1007/s00192-018-3841-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 11/28/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Sexual function is being increasingly recognized as an important patient-reported outcome. Sacral neuromodulation (SNM) is a treatment with an expanding list of indications. The effect of sacral neuromodulation on sexual function has been examined in a number of studies with variable results. In this review, we aim to systematically review the literature and pool the data if appropriate. METHODS The literature search was conducted primarily on the Healthcare Databases Advanced Search (HDAS) platform using the Medline, EMBASE and CINHAL search engines. Of 196 initial citations, 17 articles met our predefined inclusion criteria. Thirteen studies reported enough information to be included in our meta-analysis. RevMan5 software was used for analysis. RESULTS Eight of 17 studies reported a positive effect of SNM on sexual function. Pooled analysis of data from 11 studies involving 573 patients before SNM and 438 patients after SNM showed significant improvement in sexual function (SMD = -0.39; 95% CI: -0.58 to -0.19; p = 0.0001). The results remained significant in most subgroup analyses except in patients suffering from fecal incontinence. CONCLUSIONS SNM in women with pelvic floor disorders, especially bladder dysfunction, seems to have a positive effect on sexual function. This needs to be verified in adequately powered primary research using sexual function as the primary outcome.
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Affiliation(s)
- Aethele Khunda
- James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
| | | | - Paul Ballard
- James Cook University Hospital, Middlesbrough, TS4 3BW, UK
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