Sexually transmitted diseases in the elderly--issues and recommendations

Sexual behavior and sexually transmitted infection in the elderly population of South Korea

Purpose

To study the sexual behavior and status of sexually transmitted urethritis (STU) in the elderly population of South Korea.

Materials and Methods

Congregating places for elderly population, which were selected on the expected risk of sexually transmitted infections, were visited to study their sexual behavior, awareness on sexually transmitted diseases (STDs), and STU status using a specially developed survey and urine polymerase chain reaction (PCR) test. In addition, analysis of the Health Insurance Review & Assessment Service (HIRA) database was done to study the nationwide status and trends of STU of the elderly population.

Results

The study found that approximately 42% of elderly South Koreans were sexually active. Elderlies in the high-risk group showed a higher percentage of multiple sexual partners and prostitution than elderlies in the low-risk group. Only 3% and 14% in the low-risk group and high-risk group used condoms, showing a very low rate of condom use. Both the urine PCR results and HIRA database analysis showed that the prevalence of STU was not high and it remained stable in recent years, implying that currently, STU is not a significant burden on public health in the elderly population of South Korea.

Conclusions

The current study presented the sexual behavior in the elderly population of South Korea, as well as the recent prevalence and trend of STU in the elderly population. These results may be used as baseline data for future study, education, prevention and public campaign plan for STDs in the elderly population.

Educational Strategies and Interventions Targeting Adults Age 50 and Older for HIV/AIDS Prevention

This article discusses the need for targeting adults age 50 and older for HIV/AIDS prevention education. First, the authors consider a variety of educational strategies that can address both primary prevention (risk reduction) and secondary prevention (prompt identification and treatment) with regard to older adults. Examples of existing prevention education programs designed for older adults are presented together with a discussion of what has been learned about effective educational strategies and interventions among other targeted groups. Finally, suggestions are made for future research needed to help design and implement effective HIV/AIDS education programs for older adults.

Nursing practice related to sexuality: A review and recommendations

Sexuality is an important aspect of patient care, but research consistently demonstrates that nurses do not address sexuality unless the client asks specific questions. Review of research on sexuality-related practice suggests that nurses acknowledge their professional responsiblity to address sexuality with clients, but may not feel comfortable doing so. Continuing education on sexuality is of questionable value in improving practice. Recommendations for improving sexuality-related practice include requiring multiple experiences addressing sexuality of nursing students and new staff, as well as increased research to identify more specific nursing strategies for addressing clients' sexual concerns.

STI epidemiology in the global older population: emerging challenges

This paper reviews the evidence concerning the epidemiology of sexually transmitted infections (STIs) with a particular focus on older people. Evidence from North America, Australia, China and Korea clearly shows increasing rates of many STIs in the population group aged 50 years and older. Similar changes are identified in three studies conducted in sub-Saharan Africa. There is a significant lack of detailed epidemiological data from Asia-Pacific and many African countries. There is also a lack of health education and health programmes directed towards older people. It is likely that sexual ageism is the dynamic that underpins this lack of focus and resources for older people.

HIV & AIDS in older adults

Many Americans mistakenly believe that older adults are not at risk for HIV/AIDS. Older people do not perceive themselves to be at risk for HIV infection, either. In reality, approximately 10% of AIDS cases are among people older than 50. Many health care providers lack an awareness of the risk of HIV/AIDS in the elderly population, and as a result, many older people with these conditions are misdiagnosed with other ailments. Major manifestations of HIV/AIDS in elderly adults include Pneumocystis carinii pneumonia, herpes zoster, tuberculosis, cytomegalovirus, oral thrush, Mycobacterium avium complex, and HIV dementia. Elderly HIV-positive women have special health concerns, such as cervical cancer. Nurses and nurse practitioners can heighten their colleagues' awareness of the existence of HIV/AIDS in the elderly population and educate their older patients on HIV/AIDS. Furthermore, information about sexuality and sexual practices of older adults should be incorporated into all health science curricula. Additional research is needed to determine the extent of the problem and how health care providers can best serve their older patients' needs.

Current nursing practice related to sexuality

Nurses' practices related to sexuality were examined using the Survey on Sexuality in Nursing Practice (SSNP). The sample consisted of 155 practicing, registered nurses from a variety of practice settings. Twenty percent of subjects indicated they were never involved in any sexuality-related activities and only about 12% addressed sexuality with a majority of their clients. Although subjects consistently identified sexuality as a necessary part of nursing practice, few addressed sexual concerns with clients. Weighted least squares analysis of 12 variables revealed that only those variables measuring practice setting and area, nurses' knowledge, responsibility, and comfort were useful predictors of nurses' practice related to sexuality.

HIV prevention: a dramaturgical analysis and practical guide to creating safer sex interventions

Safer sex is currently a major strategy for preventing HIV transmission. We examine safer sex interventions using an interactionist form of dramaturgical analysis. This approach yields a dynamic model with which to generate novel safer sex interventions highly sensitive to changing individual, cultural, and social variables. Our goal is to help medical anthropologists, applied social scientists, health educators, community outreach specialists, and those who are sexually active apply safer sex strategies more effectively.

A literature review: HIV seropositivity in the elderly

1. AIDS affects all segments of the population, including the elderly. Elders at risk are recipients of blood products prior to 1985 and their spouses; and persons having unprotected anal or vaginal intercourse outside of a mutually monogamous relationship. 2. Because of stereotyping and lack of awareness, health-care professionals have underserved the needs of the elderly for AIDS care. 3. Elderly persons experience the manifestations of HIV in unique ways, and the consequences of the infection are particularly destructive to their lifestyles and support systems. 4. There is an acute need for nursing intervention in the area of AIDS education targeted to the elderly population. In addition, nurses should be at the forefront of development of a comprehensive home health plan geared specifically for the elderly AIDS client.

Attitudes toward nurses discussing sexual concerns with patients

Attitudes toward nurses discussing sexual concerns with clients were examined in 73 healthy subjects using Section A of the Sexual Adjustment Questionnaire. The variables of age, sex, race, occupation, educational level, marital status, importance of sexual activity, frequency of discussing sexual relationship with partner, and number of others with whom sexual concerns are discussed were examined to determine influence on subject's attitudes. Ninety-two per cent of subjects thought that nurses should discuss sexual concerns with clients. Weighted least squares analysis showed that only two variables (number of others with whom sexual concerns are discussed and race) were significant predictors of attitudes.