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Stowell M, Hall A, Warwick S, Richmond C, Eastaugh CH, Hanratty B, McDermott J, Craig D, Spiers GF. Promoting sexual health in older adults: Findings from two rapid reviews. Maturitas 2023; 177:107795. [PMID: 37454470 DOI: 10.1016/j.maturitas.2023.107795] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/01/2023] [Accepted: 07/01/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Sexual health throughout the life course is increasingly recognised as important to maintaining one's overall health, wellbeing, and relationships. We aimed to provide an overview of the evidence on sexual health needs and sexual health promotion in later life. METHODS We undertook two rapid reviews, drawing on systematic review evidence. Searches were conducted in Epistemonikos. Studies were eligible if they reported evidence about the sexual health needs of, or sexual health promotion interventions for, people aged 50+ years. Evidence was quality assessed and summarised in a narrative synthesis. RESULTS Fifteen systematic reviews were included in Review 1 (sexual health needs) and 12 in Review 2 (interventions). Key concerns and needs of older adults included the impacts of cultural stigma/misperceptions, barriers to sexual expression, and a need for tailored support in a welcoming environment. Key concerns and needs of health and social care professionals included mixed attitudes towards and knowledge of later-life sexuality and a need for more training and education. Approaches to promoting sexual health in later life included training and workshops for care home professionals, education for older people at risk of/living with HIV, and interventions to address sexual health-related symptoms of menopause. Gaps in the evidence from current reviews and methodological issues in primary studies were identified. CONCLUSION Older people have specific needs relating to their sexual health. Health and social care professionals working with older people may benefit from education/training around sexuality in later life. Evidence on effective interventions and strategies is limited.
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Affiliation(s)
- Melanie Stowell
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
| | - Alex Hall
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Stephanie Warwick
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Catherine Richmond
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Claire H Eastaugh
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Barbara Hanratty
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Jane McDermott
- School of Health Sciences, University of Manchester, Manchester M13 9NT, UK
| | - Dawn Craig
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
| | - Gemma Frances Spiers
- Population and Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK
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2
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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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The related factors of new HIV infection among older men in Sichuan, China: A case-control study. Epidemiol Infect 2022; 150:e156. [PMID: 35968710 PMCID: PMC9472032 DOI: 10.1017/s0950268822001352] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Human immunodeficiency virus (HIV) has been widely prevalent among older men (aged ≥50 years old) in Sichuan Province. The study aimed to discover associated factors with the new HIV infection in older men, and provide a scientific basis for the prevention and control of acquired immunodeficiency syndrome (AIDS) in this group. A cross-sectional survey study of newly reported HIV/AIDS and general male residents aged 50 years and older was conducted between April and June 2019, with a resample of respondents to identify cases and controls, followed by a case–control study. Logistic regression was applied to analyse the association between the selected factors and new HIV infection among older men. At last, 242 cases and 968 controls were included. The results of multiple logistic regression suggested that many factors including living alone/concentrated (OR 1.56, 95% CI 1.20–2.04, P = 0.001), have a history of migrant worker (OR 2.10, 95% CI 1.61–2.73, P < 0.001), have commercial sexual behaviour (OR 1.71, 95% CI 1.32–2.22, P < 0.001), married (OR 0.48, 95% CI 0.37–0.64, P < 0.001), have a history of HIV antibody testing (OR 0.73, 95% CI 0.56–0.96, P = 0.026), HIV-related knowledge (OR 0.55, 95% CI 0.42–0.72, P < 0.001) were associated with new HIV infection among older men. The present study revealed some potential risky/protective factors altogether. The results highlighted the direction of HIV/AIDS prevention and control among older men, and it is a social issue that requires the joint participation of the whole society.
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Conner LR, Fernández Y, Junious E, Piper C, Rowan D. Evaluating HIV Educational Materials for Older People. J Int Assoc Provid AIDS Care 2019; 18:2325958219849054. [PMID: 31131670 PMCID: PMC6748553 DOI: 10.1177/2325958219849054] [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] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/25/2019] [Accepted: 03/28/2019] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To address the gap in knowledge about HIV risk reduction materials that target older adults. This review offered a comprehensive and rigorous examination of HIV risk reduction education materials that targeted older adults in the United States, assessing the gap in their coverage and content. METHOD A cross-sectional review of both print and Internet sources from state departments of public health, state and area agencies on aging, and web resources that targeted older populations was performed. RESULTS Of 29 health departments and 13 state and area agencies on aging that responded to the request, there were 9 HIV education materials identified that targeted older people. Of those materials, only 2 addressed the majority of aging-specific recommendations made from a previous study that described important HIV risk reduction information. DISCUSSION Recommendations are made about dissemination ideas to increase awareness and utilization of HIV educational materials.
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Affiliation(s)
| | - Yohansa Fernández
- Silver School of Social Work, New York University, New York, NY, USA
| | - Eric Junious
- Department of Criminal Justice and Criminology, The University of North
Carolina at Charlotte, Charlotte, NC, USA
| | - Crystal Piper
- Department of Public Health Sciences, The University of North Carolina at
Charlotte, Charlotte, NC, USA
| | - Diana Rowan
- School of Social Work, The University of North Carolina at Charlotte,
Charlotte, NC, USA
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Mtowa A, Gerritsen AA, Mtenga S, Mwangome M, Geubbels E. Socio-demographic inequalities in HIV testing behaviour and HIV prevalence among older adults in rural Tanzania, 2013. AIDS Care 2017; 29:1162-1168. [DOI: 10.1080/09540121.2017.1308462] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Sally Mtenga
- Ifakara Health Institute, Dar Es Salaam, Tanzania
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Eaton LA, Kalichman SC, Price D, Finneran S, Allen A, Maksut J. Stigma and Conspiracy Beliefs Related to Pre-exposure Prophylaxis (PrEP) and Interest in Using PrEP Among Black and White Men and Transgender Women Who Have Sex with Men. AIDS Behav 2017; 21:1236-1246. [PMID: 28108878 DOI: 10.1007/s10461-017-1690-0] [Citation(s) in RCA: 176] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The HIV/AIDS epidemic in the US continues to persist, in particular, among race, sexual orientation, and gender minority populations. Pre-exposure prophylaxis (PrEP), or using antiretroviral medications for HIV prevention, is an effective option, but uptake of PrEP has been slow. Sociocultural barriers to using PrEP have been largely underemphasized, yet have the potential to stall uptake and, therefore, warrant further understanding. In order to assess the relationships between potential barriers to PrEP (i.e., PrEP stigma and conspiracy beliefs), and interest in PrEP, Black men and transgender women who have sex with men (BMTW, N = 85) and White MTW (WMTW, N = 179) were surveyed at a gay pride event in 2015 in a large southeastern US city. Bivariate and multivariate logistic regression analyses were completed to examine factors associated with PrEP interest. Among the full sample, moderate levels of PrEP awareness (63%) and low levels of use (9%) were observed. Believing that PrEP is for people who are promiscuous (stigma belief) was strongly associated with lack of interest in using PrEP, and individuals who endorsed this belief were more likely to report sexual risk taking behavior. Conspiracy beliefs related to PrEP were reported among a large minority of the sample (42%) and were more frequently reported among BMTW than WMTW. Given the strong emphasis on the use of biomedical strategies for HIV prevention, addressing sociocultural barriers to PrEP access is urgently needed and failure to do so will weaken the potential benefits of biomedical prevention.
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Affiliation(s)
- Lisa A Eaton
- Human Development and Family Studies, University of Connecticut, Storrs, CT, USA.
| | - Seth C Kalichman
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Devon Price
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Stephanie Finneran
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Aerielle Allen
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jessica Maksut
- Human Development and Family Studies, University of Connecticut, Storrs, CT, USA
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HIV-Risk Related Attitudes and Behaviors Among Older Impoverished Women Living in Puerto Rico. J Immigr Minor Health 2017; 17:1791-802. [PMID: 25762115 DOI: 10.1007/s10903-014-0094-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
HIV has increasingly impacted older adults regarding sero-prevalence and sero-incidence as long-term survivors of HIV/AIDS are living longer. This study examines the relationship between age and HIV-related attitudes and risk behaviors among female public housing residents in Puerto Rico. Using a self-administered survey instrument, 1,138 female public housing residents were surveyed between April and August 2006. Bivariate results showed that older women (aged 50+ years) were significantly less likely to report HIV testing and to discuss safer sex with their most recent "steady" sex partner than women under the age of 50 years. Older women were also more likely to express anxiety associated with condoms and more barriers to using condoms. The older versus younger groups did not significantly differ regarding condom use, which was extremely low across the groups. In the past three and 12 months, older women were less likely than younger women to report having (a) multiple sex partners and; (b) oral and anal sex with their most recent steady sex partner; (c) oral sex with their most recent non-steady sex partner and, (d) engaging in sexual activity in the previous three and 12 months. Age-specific messages concerning their increased risk of HIV among other interventions would likely curtail the increase in the number of new HIV cases being reported among members of this sub-population.
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8
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Rosenberg MS, Gómez-Olivé FX, Rohr JK, Houle BC, Kabudula CW, Wagner RG, Salomon JA, Kahn K, Berkman LF, Tollman SM, Bärnighausen T. Sexual Behaviors and HIV Status: A Population-Based Study Among Older Adults in Rural South Africa. J Acquir Immune Defic Syndr 2017; 74:e9-e17. [PMID: 27926667 PMCID: PMC5147032 DOI: 10.1097/qai.0000000000001173] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/16/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify the unmet needs for HIV prevention among older adults in rural South Africa. METHODS We analyzed data from a population-based sample of 5059 men and women aged 40 years and older from the study Health and Aging in Africa: Longitudinal Studies of INDEPTH Communities (HAALSI), which was carried out in the Agincourt health and sociodemographic surveillance system in the Mpumalanga province of South Africa. We estimated the prevalence of HIV (laboratory-confirmed and self-reported) and key sexual behaviors by age and sex. We compared sexual behavior profiles across HIV status categories with and without age-sex standardization. RESULTS HIV prevalence was very high among HAALSI participants (23%, 95% confidence interval [CI]: 21 to 24), with no sex differences. Recent sexual activity was common (56%, 95% CI: 55 to 58) across all HIV status categories. Condom use was low among HIV-negative adults (15%, 95% CI: 14 to 17), higher among HIV-positive adults who were unaware of their HIV status (27%, 95% CI: 22 to 33), and dramatically higher among HIV-positive adults who were aware of their status (75%, 95% CI: 70 to 80). Casual sex and multiple partnerships were reported at moderate levels, with slightly higher estimates among HIV-positive compared to HIV-negative adults. Differences by HIV status remained after age-sex standardization. CONCLUSIONS Older HIV-positive adults in an HIV hyperendemic community of rural South Africa report sexual behaviors consistent with high HIV transmission risk. Older HIV-negative adults report sexual behaviors consistent with high HIV acquisition risk. Prevention initiatives tailored to the particular prevention needs of older adults are urgently needed to reduce HIV risk in this and similar communities in sub-Saharan Africa.
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Affiliation(s)
- Molly S. Rosenberg
- Department of Epidemiology and Biostatistics, School of Public Health—Bloomington, Indiana University, Bloomington, IN
- Center for Population and Development Studies, Harvard University, Cambridge, MA
| | - Francesc X. Gómez-Olivé
- Center for Population and Development Studies, Harvard University, Cambridge, MA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Julia K. Rohr
- Center for Population and Development Studies, Harvard University, Cambridge, MA
| | - Brian C. Houle
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Demography, Australian National University, Canberra, Australia
| | - Chodziwadziwa W. Kabudula
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Ryan G. Wagner
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
| | - Joshua A. Salomon
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Lisa F. Berkman
- Center for Population and Development Studies, Harvard University, Cambridge, MA
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
- Departments of Epidemiology
- Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
| | - Stephen M. Tollman
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- INDEPTH Network, Accra, Ghana
- Division of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå Centre for Global Health Research, Umeå University, Umeå, Sweden
| | - Till Bärnighausen
- Center for Population and Development Studies, Harvard University, Cambridge, MA
- School of Demography, Australian National University, Canberra, Australia
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA
- Africa Health Research Institute, Somkhele, KwaZulu-Natal, South Africa; and
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MacDonald J, Lorimer K, Knussen C, Flowers P. Interventions to increase condom use among middle-aged and older adults: A systematic review of theoretical bases, behaviour change techniques, modes of delivery and treatment fidelity. J Health Psychol 2016; 21:2477-2492. [PMID: 25921479 DOI: 10.1177/1359105315580462] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This systematic review collates, examines and syntheses condom use interventions for middle-aged and older adults. Associations between effectiveness and theoretical basis, behaviour change techniques, mode of delivery and treatment fidelity were explored. Five interventions were included; one was effective. Compared to interventions with non-significant findings, the effective telephone-administered intervention used theory to a greater extent, had a higher number of behaviour change techniques and employed more treatment fidelity strategies. There is a need to develop theory-based interventions targeting condom use among this population and evaluate these in randomised controlled trials that are rigorously designed and reported. Health psychologists have a key role in this endeavour.
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Davis T, Teaster PB, Watkins JF, Thornton AC, Alexander L, Zanjani F. A Qualitative Approach to Increasing HIV Prevention in Primary Care Settings for Older Adults: Perspectives From Primary Care Providers. J Appl Gerontol 2016; 37:840-855. [PMID: 27384046 DOI: 10.1177/0733464816658749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this research was to explore primary care providers' willingness and ability to increase HIV prevention efforts among older adults and to gain recommendations for improving HIV prevention in primary care settings. Data were collected through 24 semistructured interviews with primary care providers. The results of the study reveal that the majority of providers find it necessary to increase HIV prevention efforts in primary care settings and are willing to do so; however, they cannot do so without assistance. Providers suggested strategies to increase HIV prevention in primary care, for instance, expanding the use of electronic reminders to include HIV prevention and increasing collaboration among providers of different specialties. As a result of the interviews, additional recommendations for increasing HIV prevention have been identified. These findings will aid in improving the quality of care provided to individuals older than 50 in primary care settings.
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Ebor M, Murray A, Gaul Z, Sutton M. HIV Awareness and Knowledge among Viewers of a Documentary Film about HIV among Racial- or Ethnic-Minority Older Adults. HEALTH & SOCIAL WORK 2015; 40:217-224. [PMID: 26285361 DOI: 10.1093/hsw/hlv041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A documentary film on HIV was developed based on social cognitive theory and entertainment educational methods in an effort to increase awareness and encourage protective behavior change related to HIV among older adults. The documentary includes perspectives from racial- or ethnic-minority older adults who are living with HIV and those of health care providers, and was screened in several venues. Authors of this article conducted thematic content analysis of anonymous, written, open-ended responses from 341 film viewers (clinicians and laypeople) who described what they learned about HIV after viewing the film. Four key themes emerged from the analysis: (1) increased awareness about the epidemiology of HIV among older, minority groups and about sexuality among older people; (2) improved general HIV knowledge, including risk reduction strategies and details about HIV testing; (3) awareness of lack of sexual health education among health care providers, and that a call to action is needed; and (4) awareness that HIV reinfection can occur in certain circumstances with people who are already infected. Findings suggest that an educational documentary can be used to effectively increase awareness and knowledge about the impact of HIV among minority older adults, and may also encourage HIV prevention action steps by providers.
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Nevedal A, Sankar A. The Significance of Sexuality and Intimacy in the Lives of Older African Americans With HIV/AIDS. THE GERONTOLOGIST 2015; 56:762-71. [PMID: 26035889 DOI: 10.1093/geront/gnu160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 11/26/2014] [Indexed: 11/13/2022] Open
Abstract
PURPOSE OF THE STUDY Aging and HIV/AIDS research focuses primarily on standardized clinical, social, and behavioral measures, leaving unanswered questions about how this chronic and stigmatizing condition affects life course expectations and the meaning of aging with the disease. Utilizing Gaylene Becker's (1997) life course disruption theory, we explored older African Americans' experiences of living with HIV/AIDS. DESIGN AND METHODS A purposive sample (N = 43) of seropositive African Americans aged 50 and older was selected from a parent study. Thirteen participants completed one semi-structured in-depth interview on life course expectations and experiences of living with HIV/AIDS. Interview transcripts were analyzed using standard qualitative coding and thematic analysis. RESULTS Responding to broad, open-ended questions about the impact of HIV on life course expectations, participants emphasized how HIV limited their ability to experience sexuality and intimacy. Two major themes emerged, damaged sexuality and constrained intimacy. IMPLICATIONS Older African Americans' discussions of living with HIV focused on the importance of and the challenges to sexuality and intimacy. Researchers and clinicians should be attentive to significant and ongoing HIV-related challenges to sexuality and intimacy facing older African Americans living with HIV/AIDS.
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Affiliation(s)
- Andrea Nevedal
- Center for Innovation to Implementation, Veterans Affairs Palo Alto Health Care System, Menlo Park, California.
| | - Andrea Sankar
- Department of Anthropology, Wayne State University, Detroit, Michigan
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Prati G, Mazzoni D, Zani B. Psychosocial Predictors and HIV-Related Behaviors of Old Adults Versus Late Middle-Aged and Younger Adults. J Aging Health 2014; 27:123-39. [DOI: 10.1177/0898264314538664] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: We investigated the psychosocial predictors and HIV-related behaviors of old adults versus late middle-aged and younger adults. Method: A demographically representative sample of residents in Italy aged 18 to 75 years ( n = 2,018) was subdivided into three age groups: (a) younger adults (18-49 years), (b) late middle-aged adults (50-59 years), and (c) old adults (60-75 years). Interviews were conducted using computer-assisted telephone survey methodology. Results: Despite reporting similar levels of sexual risk behaviors, late middle-aged and old adults were less likely to use condoms and to have ever had an HIV test. The levels of HIV/AIDS knowledge, risk perception, perceived behavioral control, and behavioral intentions toward condom use were lower among old adults compared with younger adults. Old adults were less likely to have discussed HIV/AIDS with friends, relatives, or health professionals. Discussion: Old adults should be included in prevention efforts targeting knowledge, perceptions, and intentions toward condom use. Future studies should be cautious when overgeneralizing the results to all individuals aged 50 and older.
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Affiliation(s)
- Gabriele Prati
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Davide Mazzoni
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Bruna Zani
- Department of Psychology, University of Bologna, Bologna, Italy
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