Older Adults, Sexual Health, and HIV/AIDS: Associations between Patient-Provider Communication, Perceived Risks and Preventative Behaviors

Background and Purpose: Older adults account for 50% of people living with HIV and 20% of new HIV infections in the U.S. This may partly be attributed to older adults’ limited knowledge of personal risk factors, especially as they are engaging in new sexual relationships later in life. Inadequate communication with a healthcare provider has been identified as a contributing factor, as stigma surrounding older adults, sex, and HIV/AIDS is persistent. To date, very little research exists that investigates the relationship between provider communication and older adults’ perceptions of their HIV risks or preventive behaviors. The purpose of this study was to investigate: 1) the relationship between provider communication about sexual health and HIV/AIDS and perceived risk of HIV/AIDS; and 2) the relationship between provider communication about sexual health and HIV/AIDS and intentions to discuss condom use with new sexual partners.

Methods: Data were collected using a cross-sectional survey design. Participants (N=427) were asked about their communication with healthcare providers related to sexual health and HIV/AIDS since turning 50 years of age, perceived risk of HIV/AIDS (susceptibility and severity), and intentions to discuss condom use with new sexual partners. Participants ranged in age from 50 to 84 years (M=58; SD=6.3), and were predominately white (94%) and female (73%).

Descriptive statistics were evaluated to describe the sample. Two multiple linear regression models were fitted to determine the relationships between provider communication (i.e. sexual health and HIV/AIDS) and two outcomes (i.e., perceived risk and behavioral intention to discuss condoms) controlling for demographic covariates.

Results: A large proportion (89%) of the respondents had discussed with their healthcare provider about issues related to sexual health at least once since turning 50 years of age, whereas 47% discussed HIV/AIDS with providers. The average perceived susceptibility to encounter HIV infection was 1.36 (SD=0.86, Range=1-6), indicating responses between “Strongly Disagree” and “Disagree”. The average perceived seriousness was 5.75 (SD=0.79, Range=1-6), indicating responses between “Agree” and “Strongly Agree”.  Eighty-seven percent reported intentions to discuss condoms with a new sexual partner with a mean of 4.89 (SD=1.47, Range=1-6) indicating “Somewhat Agree” and “Agree”.

Results of the multivariate models indicate that provider communication of sexual health was associated with intentions to discuss condom use with a new sexual partner (β=0.665, p<.05) but not associated with perceived risk. Provider communication of HIV/AIDS was associated with perceived susceptibility of HIV (β=0.182, p<.01), but not with behavioral intention.

Conclusions and Implications: The findings suggest that provider communication of sexual health and HIV/AIDS are both important. Communication of information specifically related to HIV/AIDS is important in order to activate an individual’s perception of risk for the disease. A broader conversation about older adults and their sexual health may be required in order to motivate intentions to engage in a preventative behavior, such as intentions to discuss condom use with a new sexual partner. The vast majority of this sample reported talking with providers about sexual health, therefore including additional HIV-specific information about personal risk factors may assist in decreasing new infections among older adults.