GCU researchers find risk of STIs from older adults sexual behaviours

16 August 2016

Glasgow Caledonian University (GCU) researchers have conducted the first UK study analysing why middle-aged people engage in sexual risk-taking, which is leading to a rising incidence of sexually transmitted infections (STIs) among older adults.

Published in the BMJ’s Sexually Transmitted Infections journal, the study analysed the findings from individual interviews with heterosexual men and women aged between 45 and 65.

The study aimed to increase the knowledge of the psychosocial factors influencing sexual risk-taking for STIs among adults in late middle age. The research was led by Dr Jenny Dalrymple, Clinical Academic Research Fellow working in GCU’s School of Health and Life Sciences and as a nurse in NHS Greater Glasgow and Clyde’s Sandyford sexual health service.

Findings revealed that middle-aged adults of both genders value intimacy in relationships, representing a convergence of age and gender. Most men spoke of letting go the pleasure-based focus on sex in favour of more relational, intimate engagements with women.

However, by associating intimate sexual relationships with monogamy, love and trust, these adults often excluded concerns about risk of STIs, instead associating STIs with casual sex. Participants tended to view young people as sexually irresponsible and more at risk of STIs. Being older was associated with an expectation of increased maturity, resulting in self-blame and barriers to seeking STI care when things went wrong.

Most of the participants in the study had experienced divorce, bereavement or separation. As a result, reassurance about their partner’s sexual health came from indications that a new partner would have had few previous partners, been in long previous relationships or had recently spent time alone.

Prior to unprotected sex with a new partner, most participants, both men and women, relied on a range of factors which fostered feelings of reassurance. These included experiences of feeling cared for, good communication, perceptions of fidelity and expectations of low risk arising from their partners’ history. Very few men and women interviewed used condoms for sex with a new partner, or tested for STIs prior to sex.

Unwanted pregnancy was identified by both men and women as the major overriding risk associated with unprotected sex. As pregnancy risk diminishes with age, older adults are engaging in unprotected sex with a higher risk of STIs.

Dr Dalrymple said: “Heterosexual adults in mid-life and beyond have been underserved in terms of research, clinical practice and public-health focused interventions in response to rising rates of STIs. In the light of the increasing population age, this is an area requiring attention.

“Although within this study, perceptions of age appropriateness served to impact on sexual risk-taking, other factors including intimacy, transitioning from relationships and pregnancy concerns are in evidence across the life course. Collectively, these findings pose problems for some health promotion approaches that merely present facts to older adults; such an approach may not be enough to reduce sexual risk-taking.”