Well Being — 04 April 2019
The sex talk: Why older adults might be due for a refresher course

By Robyn A. Friedman

City & Shore PRIME

It’s time to get the kids out of the room — and when we say “kids,” we mean those under 50 — because the topic we’re about to discuss is one that used to be risqué, spoken about in hushed tones between spouses in a dark bedroom.

It’s sex. And not just any kind of sex. We’re going to be talking about the sexual habits of older adults.

That’s right. Those over 50 are just as active — or, in some cases, even more active — than younger folks these days. Retirement and the advent of long, lazy, stress-free days, a changing definition of “sex,” and, yes, Viagra and other advances to help men maintain erections, have all allowed older adults to remain sexually active as long as they’re physically able.

But while many older adults welcome their continued ability to engage in sexual activity, that activity brings with it a host of problems.

“South Florida has the highest per capita incidence rates of HIV/AIDS in the nation — and that includes those over 50 years old,” says William Spencer, chief social enterprise officer at 2-1-1 Broward, a live, 24-hour comprehensive helpline that provides crisis, health and human services support and connects callers to resources in the community.

Here are some sobering statistics Spencer provided:

  • Out of 2,044 persons who received an AIDS diagnosis in Florida in 2017, 674 (33 percent) were older adults (50+).
  • Out of 4,949 persons who received an HIV diagnosis in Florida in 2017, 1,114 (23 percent) were older adults.
  • Out of 116,944 persons in Florida living with HIV/AIDS at year-end 2017, 60,888 (52 percent) were older adults.
  • For every seven people who know they are infected with HIV/AIDS, there is one who does not know.

South Florida is also experiencing above-average rates of syphilis, gonorrhea and chlamydia. “It would be easy to suggest that we have an STD epidemic in Broward County,” Spencer says.

“You don’t want to be alarmist by saying we’re number one per capita in the country for HIV/AIDS and thinking it’s a dismal situation,” Spencer adds. “It’s true that this many people are testing positive, so that’s not a good situation, but a fair amount of that came from massive efforts on the part of the State of Florida to test people. If you test more people, you get more positives.”

The good news: Broward County has one of the most comprehensive and accessible systems of care — including prevention, testing and treatment — in the nation, Spencer says. Just call 2-1-1 in Broward County or visit aidsvu.org to find information and available testing and care services near you.

A host of factors are contributing to the rise in HIV/AIDS and STDs among older adults. Viagra, Levitra, Cialis, implants and other tools are allowing men to be sexually active longer in life — and with the launch of websites like Getroman.com, men who are embarrassed talking to their physician about erectile dysfunction issues can seek medical care online and get medication delivered right to their door. Many older adults came of age before AIDS was an issue, so they never learned about safe sex or, if they were in a monogamous long-term relationship, they didn’t care.

Another major factor in the rise of HIV/AIDS and STDs in older adults: Many couples fail to use condoms because pregnancy is no longer a risk.

“For the most part, older people identify condoms with staving off reproduction, so when they’re not able to get pregnant, they tend to not use condoms,” says Pepper Schwartz, Ph.D., a professor of sociology at the University of Washington in Seattle and the author of Dating Over 50 for Dummies. “But all you need is one person carrying herpes or HPV or AIDS, and you start to get some diseases passed around pretty quickly.”

Communication may be challenging for older adults as well, since many grew up in an era when sex wasn’t openly discussed. “You’re a different human being than you were [when you were younger], and you may have assumptions of what sex will be like, but particularly if you’ve been in a long-term marriage, you haven’t thought about how you measure up on the dating scene, who will find you attractive, what are the new norms of how long you wait and what is acceptable given that everyone knows you’ve had a full sex life at some point,” Schwartz says. “You simply don’t know the dance steps, so it’s a challenge because the rules, if they ever were clear, are even less so at this point.”

Why do older adults need to communicate, get tested and educate themselves about safe sex in the 21st century? Because the risk is very real.

Spencer’s stepmother remarried after his dad passed away. Over age 60, she lived in a small town in Connecticut and was in a monogamous marriage when she contracted HIV — from her husband. He had been a drug user many years before, had shared a needle and was HIV positive for years, but didn’t know it, and he infected his wife. She passed away due to complications from cancer and HIV.

So, what are the new rules for older adults who plan to remain sexually active?

  • Educate yourself. If you don’t feel comfortable talking with your doctor, check reputable sites on the Internet, such as AARP.org.
  • Get tested. Spencer says that everyone between 13 and 64 years of age should get tested at least once annually.
  • Remember that it may take up to three months for HIV to show in your bloodstream once you’re infected, Spencer says. So, continue to use condoms until both parties test negative over a three-month period.
  • Use condoms. Don’t assume you don’t need one because there’s no risk of pregnancy. “Be a grownup,” Schwartz says. “If you’re thinking of having sex, go buy them and put them next to your bed. Put one in your wallet like you did when you were 16. There’s a big difference between knowing what you should do and what you do.”
  • “If you can’t talk about sex with your partner, you’re not ready to do it,” Schwartz says. “We tell that to teenagers, and the rule doesn’t go away.” Be honest about not only your needs and expectations but also any physical limitations you may have due to the aging process.
  • Have realistic expectations. “Sex” now may mean something totally different than it used to. For some older adults, touching and being touched may be all they want at this point. “When you’re younger, the endpoint is orgasm,” Schwartz says. “When you’re older, the endpoint may be just being together sexually. That’s a big difference.”

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