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Over-45s at higher risk of contracting STIs due to negative attitudes on sex of middle-aged

Society’s reluctance to talk about older people having sex has led to increased numbers of STIs in age group.

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Mother Leony – in his 80s; and is one of the regulars of Home for the Golden Gays (HGG) – loves sharing about his sexual experiences. “Sa edad kong ito (At my age),” he says, somewhat jokingly, “malakas pa rin benta ko (I can still attract).”

Mother Leony, of course, belies the ill-conceived notion that members of the mature-aged population become asexual or at least have inactive sexual lives. But exactly because of the still-held stereotype that mature-aged people do not want to or are unable to have active, satisfying sex lives, people like him are among those not getting sexual health services.

This has been studied before; but it is now emphasized by yet another study undertaken by the University of Chichester, alongside organizations in the UK, Belgium and Netherlands. This study revealed negative attitudes and limited knowledge towards over-45’s sexual health needs, which is therereby associated with a generation unaware of the dangers of unprotected intercourse.

Stressing that over-45s are at a higher risk of contracting STIs than ever before because of society’s unwillingness to talk about middle-aged and older people having sex, the report also found that over-45s living in socially and economically-disadvantaged areas are at particularly risk of contracting STIs with little awareness of available healthcare services and limited access to doctors and nurses.

University of Chichester senior lecturer Dr. Ian Tyndall, who led the study, said that major changes in sexual behavior in recent decades has seen increasing numbers of sexually active older-people.

“Over-45s at most risk are generally those entering new relationships after a period of monogamy, often post-menopause, when pregnancy is no longer a consideration, but give little thought to STIs,” he said. “Given improvements in life expectancy, sexual healthcare needs to improve its intervention for older adults and vulnerable groups to provide a more utilized, knowledgeable, compassionate, and effective service.”

In the UK, there is a three-year SHIFT study, which was launched in 2019 to address the growing rates of STIs in over-45s and improve engagement of older people in sexual health services, including those facing socioeconomic disadvantage.

The latest SHIFT report included around 800 participants across the south coast of England and northern regions of Belgium and the Netherlands, nearly 200 of which face socioeconomic disadvantage.

Initial findings highlighted four critical areas where, the researchers believe, an intervention can address the gaps in current healthcare provision: awareness, access, knowledge, and stigma.

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  • Awareness: The results showed that a significant number of participants were unaware of the risks of STI, while 46% did not know the location of their nearest healthcare center. Researchers did, however, find that social media was the most effective tool for encouraging engagement with sexual health services – ahead of leaflets or GP appointments.
  • Knowledge: The participants highlighted that their health professionals, including doctors and nurses, lacked sufficient sexual health knowledge – and consequently only half had a recent STI test. There is therefore an “urgent need” to create a tailored training program to increase understanding in the wider healthcare workforce, the researchers wrote.
  • Stigma: Shame was identified as the biggest barrier to accessing sexual healthcare services, according to the report. A number of participants felt that sexual health has become a “dirty” term which is discouraging people from attending regular check-ups.
  • Access: Limited information around the location of sexual health centers and restricted opening times were a consistent problem for many participants. Others living in more rural locations also mentioned that growing costs of public transport was a barrier to appointments.

Fellow SHIFT researcher Dr Ruth Lowry said: “It is clear from the numbers reporting fear of being judged by important others who know them and by health professionals that stigma remains a crucial barrier to address in any sexual health promotion intervention.”

Lowry also said that “the findings have also shown that groups with one or more socio-economic disadvantages, such as homeless people, sex workers, non-native language speakers and migrants, are at even greater risk of being unaware of their sexual health and unable to access the appropriate services.”

In the Philippines, an earlier study by Michael David Tan, John Ryan Mendoza and Raine Cortes (2012) – with the study also involving Mother Leony – highlighted that this is also an issue here.

At least for Tan, Mendoza and Cortes, recommendations include: broadening of existing HIV and AIDS programs for prevention and sexual health education to also target the mature-aged gay men population because they are also at risk given that they also practice MSM behavior; the need to inform government policy makers of the specific needs of mature-aged gay men, since existing laws “fail to consider the variations of the experiences of the sub-populations within the generalized mature-aged population”; and the need to “indiginize” the solutions provided to this population.


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