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RESEARCH ARTICLE (Open Access)

Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis

Michel Nunez A § , Yoshiko Sakuma https://orcid.org/0009-0004-3751-0837 B § , Hayley Conyers https://orcid.org/0000-0002-2059-0402 B , Suzanne Day C , Fern Terris-Prestholt D , Jason J. Ong https://orcid.org/0000-0001-5784-7403 E F , Stephen W. Pan G , Tom Shakespeare H , Joseph D. Tucker https://orcid.org/0000-0003-2804-1181 B C , Eneyi E. Kpokiri https://orcid.org/0000-0003-1180-1439 B and Dan Wu https://orcid.org/0000-0003-0415-5467 B I *
+ Author Affiliations
- Author Affiliations

A MSc Public Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.

B Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.

C Institute for Infectious Diseases and Global Health, University of North Carolina at Chapel Hill, Chapel Hill, USA.

D Warwick Medical School, University of Warwick, Coventry, UK.

E Central Clinical School, Monash University, Melbourne, Vic, Australia.

F Melbourne Sexual Health Centre, Alfred Health, Melbourne, Vic, Australia.

G Department of Public Health, The University of Texas at San Antonio, San Antonio, TX, USA.

H Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.

I Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing 210093, China.

* Correspondence to: danwu@njmu.edu.cn

§ Co-first authors

Handling Editor: Ian Simms

Sexual Health 21, SH24143 https://doi.org/10.1071/SH24143
Submitted: 12 July 2024  Accepted: 18 October 2024  Published: 21 November 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Background

Sexual health is an essential component of health and well-being across the life course. However, sexual health research often focuses on young adults and excludes those aged 45 years and older. We organized a national crowdsourcing open call and co-creation events to identify recommendations to improve sexual health service provision for middle-aged and older adults in the United Kingdom (UK).

Methods

We conducted a crowdsourcing open call and seven co-creation events consisting of workshop-style meetings and one-to-one in-depth interviews. Open call submissions and qualitative data from the co-creation events were analyzed using a thematic approach. A social-ecological framework was used to code deductively, but new codes were allowed to emerge. Thematic categories were organized to describe factors influencing the accessibility and inclusivity of sexual health services for middle-aged and older adults.

Results

We received 22 submissions in total; of those, 35% of participants reported a disability, 40% of individuals were aged 45–65 years, and 6% of submissions came from individuals that identified as gay/lesbian. Five key themes highlighted that improving sexual health services for adults aged 45 years and over requires a multi-leveled approach: increase sexual health education, enhance patient and provider relationships, utilize community-led sexual health promotion efforts and delivery of reliable sexual health information, improve inclusive sexual health services, and break down sexual health taboos against adults aged 45+ years.

Conclusions

Our data suggest that middle-aged and older adults can co-create compelling strategies to enhance sexual health services for middle-aged and older adults in the UK. Further implementation research is needed to pilot these strategies.

Keywords: barriers, co-creation, crowdsourcing, facilitators, middle-aged and older adults, qualitative, sexual health, United Kingdom.

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