Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection
Wendy Heywood A G , Anthony Lyons A , Bianca Fileborn A , Victor Minichiello A B C , Catherine Barrett A , Graham Brown A , Sharron Hinchliff D , Sue Malta E F and Pauline Crameri AA Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia.
B School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia.
C School of Justice, Faculty of Law, Queensland University of Technology, GPO Box 2434, Brisbane, Qld 4001, Australia.
D School of Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK.
E National Ageing Research Institute, University of Melbourne, PO Box 2127, Royal Melbourne Hospital, Vic. 3050, Australia.
F Swinburne Institute of Social Research, Swinburne University of Technology, Hawthorn, Vic. 3122, Australia.
G Corresponding author. Email: w.heywood@latrobe.edu.au
Sexual Health 14(2) 139-146 https://doi.org/10.1071/SH16075
Submitted: 2 May 2016 Accepted: 27 October 2016 Published: 5 December 2016
Abstract
Background: Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. Methods: A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n = 805, 38%). Results: Less than one in three reported a STI test in the past 5 years (n = 241, 30%) while 6% (n = 51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. Conclusions: STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients.
Additional keywords: STI testing. ageing, aging, sexuality.
References
[1] Bodley-Tickell AT, Olowokure B, Bhaduri S, White DJ, Ward D, Ross JDC, Smith G, Duggal HV, Goold P. Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sex Transm Infect 2008; 84 312–7.| Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1cvmvVCkug%3D%3D&md5=f4f325d457c2d26bf507fa279294546dCAS |
[2] Minichiello V, Rahman S, Hawkes G, Pitts M. STI epidemiology in the global older population: emerging challenges. Perspect Public Health 2012; 132 178–81.
| STI epidemiology in the global older population: emerging challenges.Crossref | GoogleScholarGoogle Scholar |
[3] Poynten IM, Grulich AE, Templeton DJ. Sexually transmitted infections in older populations. Curr Opin Infect Dis 2013; 26 80–5.
| Sexually transmitted infections in older populations.Crossref | GoogleScholarGoogle Scholar |
[4] Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2013. Atlanta: U.S. Department of Health and Human Services; 2014.
[5] The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. Annual surveillance report. Sydney: The Kirby Institute, UNSW; 2014.
[6] Tillman JL, Mark HD. HIV and STI testing in older adults: an integrative review. J Clin Nurs 2015; 24 2074–95.
| HIV and STI testing in older adults: an integrative review.Crossref | GoogleScholarGoogle Scholar |
[7] Schick V, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, Fortenberry JD. Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. J Sex Med 2010; 7 315–29.
| Sexual behaviors, condom use, and sexual health of Americans over 50: implications for sexual health promotion for older adults.Crossref | GoogleScholarGoogle Scholar |
[8] Harawa NT, Leng M, Kim J, Cunningham WE. Racial/ethnic and gender differences among older adults in nonmonogamous partnerships, time spent single, and HIV testing. Sex Transm Dis 2011; 38 1110–7.
| Racial/ethnic and gender differences among older adults in nonmonogamous partnerships, time spent single, and HIV testing.Crossref | GoogleScholarGoogle Scholar |
[9] Grulich AE, de Visser RO, Badcock PB, Smith AM, Richters J, Rissel C, Simpson JM. Knowledge about and experience of sexually transmissible infections in a representative sample of adults: The Second Australian Study of Health and Relationships. Sex Health 2014; 11 481–94.
| Knowledge about and experience of sexually transmissible infections in a representative sample of adults: The Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |
[10] Dougan S, Payne LJ, Brown AE, Evans BG, Gill O. Past it? HIV and older people in England, Wales and Northern Ireland. Epidemiol Infect 2004; 132 1151–60.
| Past it? HIV and older people in England, Wales and Northern Ireland.Crossref | GoogleScholarGoogle Scholar |
[11] Girardi E, Sabin CA, Monforte ADA. Late diagnosis of HIV infection: epidemiological features, consequences and strategies to encourage earlier testing. J Acquir Immune Defic Syndr 2007; 46 S3–8.
| Late diagnosis of HIV infection: epidemiological features, consequences and strategies to encourage earlier testing.Crossref | GoogleScholarGoogle Scholar |
[12] Mukolo A, Villegas R, Aliyu M, Wallston KA. Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward. AIDS Behav 2013; 17 5–30.
| Predictors of late presentation for HIV diagnosis: a literature review and suggested way forward.Crossref | GoogleScholarGoogle Scholar |
[13] Brown G, Croy S, Johnston K, Pitts M, Lewis V. Rapid review: reducing sexually transmissible infections in young people. Melbourne: Australian Institute for Primary Care & Ageing (AIPCA) and Australian Research Centre in Sex, Health & Society (ARCSHS), La Trobe University; 2013.
[14] Kirkman L, Kenny A, Fox C. Evidence of absence: midlife and older adult sexual health policy in Australia. Sex Res Soc Policy 2013; 10 135–48.
| Evidence of absence: midlife and older adult sexual health policy in Australia.Crossref | GoogleScholarGoogle Scholar |
[15] Grulich AE, de Visser RO, Smith A, Rissel CE, Richters J. Sex in Australia: sexually transmissible infection and blood-borne virus history in a representative sample of adults. Aust N Z J Public Health 2003; 27 234–41.
| Sex in Australia: sexually transmissible infection and blood-borne virus history in a representative sample of adults.Crossref | GoogleScholarGoogle Scholar |
[16] Hosmer DW Jr, Lemeshow S, Sturdivant RX. Applied logistic regression, 3rd edn. Hoboken: John Wiley & Sons; 2013.
[17] Syme ML, Cohn TJ, Barnack-Tavlaris J. A comparison of actual and perceived sexual risk among older adults. J Sex Res 2016;
| A comparison of actual and perceived sexual risk among older adults.Crossref | GoogleScholarGoogle Scholar |
[18] Gott M, Hinchliff S, Galena E. General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 2004; 58 2093–103.
| General practitioner attitudes to discussing sexual health issues with older people.Crossref | GoogleScholarGoogle Scholar |
[19] Loeb DF, Lee RS, Binswanger IA, Ellison MC, Aagaard EM. Patient, resident physician, and visit factors associated with documentation of sexual history in the outpatient setting. J Gen Intern Med 2011; 26 887–93.
| Patient, resident physician, and visit factors associated with documentation of sexual history in the outpatient setting.Crossref | GoogleScholarGoogle Scholar |
[20] Bourne C, Minichiello V. Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic. Australas J Ageing 2009; 28 32–6.
| Sexual behaviour and diagnosis of people over the age of 50 attending a sexual health clinic.Crossref | GoogleScholarGoogle Scholar |
[21] Richters J, Badcock PB, Simpson JM, Shellard D, Rissel C, de Visser RO, et al Design and methods of the Second Australian Study of Health and Relationships. Sex Health 2014; 11 383–96.
| Design and methods of the Second Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |
[22] Smith AMA, Rissel CE, Richters J, Grulich AE, Visser RO. Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships. Aust N Z J Public Health 2003; 27 106–17.
| Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships.Crossref | GoogleScholarGoogle Scholar |
