Online Program

Racial/ethnic variations in sexual behaviors, healthcare interaction characteristics, and HIV-related perceptions among adults age 60 years and older

Tuesday, November 5, 2013 : 8:30 a.m. - 8:42 a.m.

Jonathan Glaude-Hosch, BA, College of Public Health, The University of Georgia, Athens, GA
Matthew Lee Smith, PhD, MPH, CHES, Department of Health Promotion and Behavior, Workplace Health Group, University of Georgia, Athens, GA
Timothy G. Heckman, Ph.D., College of Public Health, University of Georgia, Athens, GA
Marcia Ory, PhD, MPH, Health Promotion and Community Health Sciences, Texas A&M HSC School of Rural Public Health, College Station, TX
Background: Older adults are remaining sexually active for longer periods of time, which emphasizes the need to assess their sexual activity patterns and identify differences by race/ethnicity.

Methods: Using 2010 National Social Life, Health, and Aging Project data, this study examined responses of 1,429 adults 60-plus years of age. Multinomial logistic regression compared sexual behaviors, health-related indicators, interactions with healthcare professionals, and HIV-related perceptions across participants' race/ethnicity.

Results: Approximately 81% of participants self-reported as non-Hispanic white, 10.6% as African American, and 8.1% as Hispanic. On average, participants were 69.9 years of age (+/-6.9). In the previous year, 49.3% of participants engaged in sexual intercourse; only 3% used condoms. The majority of participants (83.1%) visited a physician at least twice in the previous year, 30.9% had discussed sex with a physician since turning 50, and 14.2% had ever been tested for HIV. Relative to non-Hispanic whites, African Americans were more likely to: (1) be divorced [OR=3.23, p<0.001] or widowed [OR=2.90, p<0.001]; (2) have more lifetime sexually transmitted infection (STI) diagnoses [OR=1.67, p=0.030]; and (3) have paid for sex [OR=2.83, p=0.002]. Although African Americans had greater perceived risk for HIV infection [OR=1.66, p=0.046], they were less likely to have discussed sex with a physician since turning 50 [OR=0.45, p=0.009].

Conclusions: There is a clear need for contextualized interventions to improve patient-provider communication and proactive screening behaviors in aging African Americans. Interventions are also needed to increase providers' ability to identify and screen patients at elevated risk for STI and HIV transmission.

Learning Areas:

Assessment of individual and community needs for health education
Diversity and culture
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
Identify three race-based differences in terms of risky sexual behavior among this sample of middle-aged and older adults. Discuss barriers associated with patient-provider communication concerning sexual issues among African American participants. Describe strategies to improve STI and HIV screening among African Americans in clinical settings.

Keyword(s): Sexual Behavior, Minority Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have served as a sexuality education and researcher for over a decade. Much of my research agenda also surrounds aging populations and disparity issues.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.