Who says old people don’t have sex? A study by American researchers has found that older men and women in South Africa do maintain sexual relationships even into their 80s and beyond. Since older adults are often ignored in sexual health education, the possibility for HIV transmission is heightened.
They found that older adults are sexually active, and that older adults report sexual risk behaviours—low condom use, casual sex and multiple recent partners — that are consistent with sexual transmission of disease. This marks a huge potential for ongoing HIV transmission in older South Africans, and highlights the need for expanded HIV testing and counselling that can change behaviour and help reduce new HIV transmission.
Researchers analysed data from 5,059 men and women age 40 and older in South Africa. Older adults receive little attention when it comes to HIV prevention research and interventions, although growing evidence shows they make up a fast-increasing proportion of people living with HIV, in part because of the impact of large-scale HIV treatment on reducing deaths from the disease.
Overall, HIV prevalence among people in the study was high, at 23 percent, and did not differ between men and women. About one-third of respondents reported never having been tested for HIV, and among those with confirmed infections, nearly half did not yet know they were living with HIV.
Regarding sexual activity, more than half of participants reported at least one sex partner within the past two years. Men tended to maintain sexual partnerships at relatively high rates across older ages, only dropping to 52 percent at age 80 and older. The proportion of women with recent sexual partners decreased more steeply with age, dropping to 6 percent at age 80 and older.
Individuals who reported condom use decreased with age in both men and women, as did those reporting casual or anonymous sex. Condom use was highest, at 75 percent, among those who were HIV positive, but only if they knew their status. Of those who were HIV positive but unaware of their status, only 27 percent regularly used condoms.
One in 10 participants also reported that their most recent sex partners were casual or anonymous. Casual sex was lowest among HIV-negative adults, at 9 percent, and higher among both HIV-positive groups (29 percent of those aware of their HIV status and 18 percent of those who were unaware).
The study calls for inclusion of older adults in HIV prevention, with messages created directly for that demographic, and intensified counselling and motivation about sexual transmission risk and universal HIV testing.