Skip to main content

The intimate lives of older adults living with HIV: a qualitative study of the challenges associated with the intersection of HIV and ageing


Older adults living with human immunodeficiency virus (HIV) are at risk of experiencing difficulties in their intimate lives due to the combined effects of HIV and ageing. To date, little research has focused on the lived experience of sexuality. This article seeks to fill in the gap by documenting the challenges faced by this population with respect to their intimate relationships and sexual lives. Based upon the results of a qualitative study conducted in Montreal (2010–2012) using semi-structured interviews with a diverse sample of 38 people aged 50–73 and living with HIV, this study revealed several difficulties, including those related to their social location, whereby HIV and ageing intersect with other social determinants (including gender, sexual orientation and drug use). Difficulties that were identified include lower sexual desire linked to ageing, erectile changes, difficulty in using condoms, stigma related to HIV and/or ageism, changes in appearance caused by HIV and/or ageing, along with the impact of their lifecourse experiences. Our results shed light on the specific nature of the difficulties experienced by older adults living with HIV with regard to their intimate lives, as well as on the importance of using an analysis that combines the theoretical approaches of intersectionality and lifecourse to enhance our capacity for understanding complex and unique experiences.

Corresponding author
Address for correspondence: Isabelle Wallach, Département de sexologie, Université du Québec à Montréal, C.P. 8888, succ. Centre-ville, Montréal (QC), H3C 3P8, Canada E-mail:
Hide All
Allen, K. R. and Roberto, K. A. 2009. From sexism to sexy: challenging young adults’ ageism about older women's sexuality. Sexuality Research and Social Policy, 6, 4, 1324.
Asboe, D., Catalan, J., Mandalia, S., Dedes, N., Florence, E., Schrooten, W., Noestlinger, C. and Colebunders, R. 2007. Sexual dysfunction in HIV-positive men is multi-factorial: a study of prevalence and associated factors. AIDS Care, 19, 8, 955–65.
Bajos, N. and Bozon, M. 2012. Les transformations de la vie sexuelle après cinquante ans: un vieillissement genré. Gérontologie et Société, 140, 1, 95108.
Bilge, S. 2009. Théorisations féministes de l'intersectionnalité. Diogène, 1, 225, 7088.
Bilge, S. 2010. De l'analogie à l'articulation: théoriser la différenciation sociale et l'inégalité complexe. L'Homme et la Société, 2, 176/7, 4364.
Blanco, J., Jarrín, I., Vallejo, M., Berenguer, J., Solera, C., Rubio, R., Pulido, F., Asensi, V., del Amo, J. and Moreno, S. 2012. Definition of advanced age in HIV infection: looking for an age cut-off. AIDS Research and Human Retroviruses, 28, 9, 800–6.
Brener, L., Wilson, H., Slavin, S. and de Wit, J. 2013. The impact of living with HIV: differences in experiences of stigma for heterosexual and homosexual people living with HIV in Australia. Sexual Health, 10, 4, 316–9.
Brennan, D. J., Emlet, C. A. and Eady, A. 2011. HIV, sexual health, and psychosocial issues among older adults living with HIV in North America. Aging International, 36, 3, 313–33.
Brennan, M. and Karpiak, S. E. 2009. HIV stigma and disclosure of serostatus. In Brennan, M., Karpiak, S. E., Shippy, A. and Cantor, M. H. (eds), Older Adults with HIV: An In-depth Examination of an Emerging Population. Nova Science Publishers, New York, 5160.
Brotman, S., Ferrer, I., Sussman, T., Ryan, B. and Richard, B. 2015. Access and equity in the design and delivery of health and social care of LGBTQ older adults: a Canadian perspective. In Orel, N. A. and Fruhauf, C. A. (eds), The Lives of LGBT Older Adults: Understanding Challenges and Resilience. American Psychological Association, Washington DC, 111–40.
Brotman, S. and Lévy, J. J. 2008. Intersections: Cultures, sexualités et genres. Presses de l'Université du Québec, Québec, Canada.
Brotman, S., Ryan, B. and Cormier, R. 2003. The health and social service needs of gay and lesbian elders and their families in Canada. The Gerontologist, 43, 2, 192202.
Calasanti, T. and Slevin, K. 2001. Gender, Social Inequalities, and Aging. AltaMira Press, Oxford.
Calasanti, T. and Slevin, K. 2006. Age Matters: Re-aligning Feminist Thinking. Routledge, New York.
Caradec, V. 2008. Sociologie de la Vieillesse et du Vieillissement. Second edition, Armand Colin, Paris.
Carpenter, L. M. 2010. Gendered sexuality over the life course: a conceptual framework. Sociological Perspectives, 53, 2, 155–78.
Carpenter, L. M. and DeLamater, J. 2012. Sex for Life: From Virginity to Viagra, How Sexuality Changes Throughout Our Lives. New York University Press, New York.
Clarke, H. L. and Korotchenko, A. 2011. Aging and the body: a review. Canadian Journal on Aging, 30, 3, 495510.
Collins, P. 2000. Black Feminist Thought: Knowledge, Consciousness, and the Politics of Empowerment. Routledge, New York.
Cooperman, N. A., Arnsten, J. H. and Klein, R. S. 2007. Current sexual activity and risky sexual behavior in older men with or at risk for HIV infection. AIDS Education and Prevention, 19, 4, 321–33.
Crenshaw, K. 1995. Mapping the margins: intersectionality, identity politics, and violence against women of color. In Crenshaw, K., Gotanda, N., Peller, G. and Thomas, K. (eds), Critical Race Theory: The Key Writings that Formed the Movement. The New Press, New York, 357–83.
Creswell, J. W. 2012. Qualitative Inquiry and Research Design: Choosing Among Five Approaches. Third edition, Sage, Thousand Oaks, California.
Creswell, J. W. and Miller, D. L. 2000. Determining validity in qualitative inquiry. Theory into Practice, 39, 3, 124–30.
Dannefer, D. 2003. Cumulative advantage/disadvantage and the life course: cross-fertilizing age and social science theory. Journals of Gerontology: Psychological Sciences and Social Sciences, 58B, 6, S32737.
Davidson, K. 2001. Gender differences in new partnership choices and constraints for older widows and widowers. Aging International, 27, 4, 4360.
De Jong Gierveld, J. 2004. Remarriage, unmarried cohabitation, living apart together: partner relationships following bereavement or divorce. Journal of Marriage and Family, 66, 1, 236–43.
DeLamater, J. and Hyde, J. S. 2004. Conceptual and theoretical issues in studying sexuality in close relationships. In Harvey, J. H., Wenzel, A. and Sprecher, S. (eds), The Handbook of Sexuality in Close Relationships. Lawrence Erlbaum Associates, Hillsdale, New Jersey, 730.
DeLamater, J. and Koepsel, E. 2015. Relationships and sexual expression in later life: a biopsychosocial perspective. Sexual and Relationship Therapy, 30, 1, 3759.
Effros, R. B., Flechter, C. V., Gebo, K., Halter, J. B., Hazzard, W. R., Horne, F. M., Huebner, R. E., Janoff, E. N., Justice, A. C., Kuritzkes, D., Nayfield, S. G., Plaeger, S. F., Schmader, K. E., Ashworth, J. R., Campanelli, C., Clayton, C. P., Rada, B., Woolard, N. F. and High, K. P. 2008. Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions. Clinical Infectious Disease, 47, 4, 542–53.
Elder, G. 1994. Time, human agency, and social change: perspectives on the life course. Social Psychology Quarterly, 57, 1, 415.
Ferrer, I., Grenier, A., Brotman, S. and Koehn, S. 2017. Understanding the experiences of racialized older people through an intersectional life course perspective. Journal of Aging Studies, 47, 1017.
Fisher, L. L. 2010. Sex, Romance, and Relationships: AARP Survey of Midlife and Older Adults. American Association of Retired Persons (AARP), Washington DC.
Flyckt, R. and Kingsberg, S. A. 2011. Sexuality and ageing. In Stuart-Hamilton, I. (ed.), An Introduction to Gerontology. Cambridge University Press, Cambridge, 283316.
Furman, F. 1997. Facing the Mirror: Older Women and Beauty Shop Culture. Routledge, New York.
Gagnon, M. 2010. Femmes vivant avec le VIH/sida et lipodystrophie. Aporia, 2, 3, 3240.
Gagnon, M. and Holmes, D. 2012. Women living with HIV/AIDS and the bodily transformation process known as the lipodystrophy syndrome: a grounded theory study. Journal of Research in Nursing, 17, 3, 215–28.
George, L. 1993. Sociological perspectives on life transitions. Annual Review of Sociology, 19, 1, 353–73.
Golub, S. A., Botsko, M., Gamarel, K. E., Parsons, J. T., Brennan, M. and Karpiak, S. E. 2011. Dimensions of psychological well-being predict consistent condom use among older adults living with HIV. Aging International, 36, 3, 346–60.
Golub, S. A., Grov, C. and Tomassilli, J. 2009. Sexual behavior among HIV+ older adults. In Brennan, M., Karpiak, S. E., Shippy, A. and Cantor, M. H. (eds), Older Adults with HIV: An In-depth Examination of an Emerging Population. Nova Science Publishers, New York, 4350.
Gott, M. 2005. Sexuality, Sexual Health and Ageing. Open University Press, Buckingham, UK.
Gott, M. and Hinchliff, S. 2003. Sex and ageing: a gendered issue. In Arber, S., Davidson, K. and Ginn, J. (eds), Gender and Ageing: New Directions. Open University Press, Buckingham, UK, 6378.
Grenier, A. 2012. Transitions and the Lifecourse: Challenging the Constructions of ‘Growing Old’. Policy Press, Bristol, UK.
Grenier, A. and Brotman, S. 2010. Les multiples vieillissements et leurs représentations. In Charpentier, M., Guberman, N., Billette, V., Lavoie, J. P., Grenier, A. and Olazabal, I. (eds), Vieillir au Pluriel: Perspectives Sociales. Presses de l'Université du Québec, Québec, Canada, 2354.
Grodensky, C. A., Golin, C. E., Jones, C., Mamo, M., Dennis, A. C., Abernethy, M. G. and Patterson, K. B. 2015. ‘I should know better’: the roles of relationships, spirituality, disclosure, stigma, and shame for older women living with HIV seeking support in the south. Journal of the Association of Nurses in AIDS Care, 26, 1, 1223.
Hancock, A.-M. 2007. Intersectionality as a normative and empirical paradigm. Politics & Gender, 3, 2, 248–54.
Heaphy, B. 2009. Choice and its limits in older lesbian and gay narratives of relational life. Journal of GLBT Family Studies, 5, 1/2, 119–38.
Herdt, G. and de Vries, B. 2004. Gay and Lesbian Aging: Research and Future Directions. Springer, New York.
Hooyman, N. R. and Kiyak, H. A. 2008. Love, intimacy, and sexuality in old age. In Hooyman, N. R. and Kiyak, H. A. (eds), Social Gerontology: A Multidisciplinary Perspective. Eighth edition, Allyn and Bacon, Boston, 271300.
Hughes, J. 2011. Are older men taking sexuality as prescribed? The implications of the competing influences on ageing male heterosexuality. Australian Feminist Studies, 26, 67, 89102.
Illa, L., Brickman, A., Saint-Jean, G., Echenique, M., Metsch, L., Eisdorfer, C., Bustamante-Avellaneda, V. and Sanchez-Martinez, M. 2008. Sexual risk behaviors in late middle age and older HIV seropositive adults. AIDS and Behavior, 12, 6, 935–42.
Karlsson, S. G. and Borell, K. 2002. Intimacy and autonomy, gender and ageing: living apart together. Ageing International, 27, 4, 1126.
Keegan, A., Lambert, S. and Petrak, J. 2005. Sex and relationships for HIV-positive women since HAART: a qualitative study. AIDS Patient Care and STDs, 19, 10, 645–54.
Klein, H. 2012. A comparison of HIV risk practices among unprotected sex-seeking older and younger men who have sex with other men. The Aging Male, 15, 3, 124–33.
Lagrave, R.-M. 2009. Ré-enchanter la vieilesse. Mouvements, 59, 3, 113–22.
Lindau, S. T., Schumm, L. P., Laumann, E. O., Levinson, W., O'Muircheartaigh, C. A. and Waite, L. J. 2007. A study of sexuality and health among older adults in the United States. New England Journal of Medicine, 357, 8, 762–74.
Lodge, A. and Umberson, D. 2012. All shook up: sexuality of mid- to later life married couples. Journal of Marriage and Family, 74, 3, 428–43.
Loe, M. 2004. The Rise of Viagra: How the Little Blue Pill Changed Sex in America. New York University Press, New York.
Lovejoy, T. I., Heckman, T. G., Sikkema, K. J., Hansen, N. B., Kochman, A., Suhr, J. A., Garske, J. P. and Johnson, C. J. 2008. Patterns and correlates of sexual activity and condom use behavior in persons 50-plus years of age living with HIV/AIDS. AIDS and Behavior, 12, 6, 943–56.
Maes, C. A. and Louis, M. 2003. Knowledge of AIDS, perceived risk of AIDS, and at-risk sexual behaviors among older adults. Journal of the American Academy of Nurse Practitioners, 15, 11, 509–16.
Malta, S. and Farquharson, K. 2014. The initiation and progression of late-life romantic relationships. Journal of Sociology, 50, 3, 237–51.
Marshall, B. L. 2006. The new virility: Viagra, male aging and sexual function. Sexualities, 9, 3, 345–62.
Marshall, B. L. and Katz, S. 2002. Forever functional: sexual fitness and the ageing male body. Body & Society, 8, 4, 4370.
Maticka-Tyndale, E., Adam, B. D. and Cohen, J. 2002. Sexual desire and practice among people living with HIV and using combination anti-retroviral therapies. Canadian Journal of Human Sexuality, 11, 1, 3340.
McCormick, M. 2008. Women's bodies aging: culture, context, and social work practice. Affilia: Journal of Women and Social Work, 23, 4, 312–23.
Ménard, A. D., Kleinplatz, P. J., Rosen, L., Lawless, S., Paradis, N., Campbell, M. and Huber, J. D. 2015. Individual and relational contributors to optimal sexual experiences in older men and women. Sexual and Relationship Therapy, 30, 1, 7893.
Minichiello, V., Hawkes, G. and Pitts, M. 2011. HIV, sexually transmitted infections, and sexuality in later life. Current Infectious Disease Reports, 13, 2, 182–7.
Neundorfer, M. M., Harris, P. B., Britton, P. J. and Lynch, D. A. 2005. HIV-risk factors for midlife and older women. The Gerontologist, 45, 5, 617–25.
Nevedal, A. and Sankar, A. 2016. The significance of sexuality and intimacy in lives of older African Americans with HIV/AIDS. The Gerontologist, 56, 4, 762–71.
Nokes, K. M., Nicholas, P. K., Rivero, M., Rosa, M. E., Kirksey, K., Moezzi, S., Corless, I. B., Maryland, M., Willard, S., Robinson, L., Hamilton, M. J., Sefcik, E., Wantland, D., Holzemer, W. L. and Portillo, C. 2011. Sexual function in younger and older HIV+ adults in the United States and Puerto Rico. Ageing International, 36, 3, 334–45.
Önen, N. F., Shacham, E., Stamm, K. E. and Overton, E. T. 2010. Comparisons of sexual behaviors and STD prevalence among older and younger individuals with HIV infection. AIDS Care, 22, 6, 711–7.
O'Rand, A. 1996. The precious and the precocious: understanding cumulative disadvantage and cumulative advantage over the life course. The Gerontologist, 36, 2, 230–8.
Paillé, P. and Mucchielli, A. 2012. L'analyse Qualitative en Sciences Humaines et Sociales. Armand Colin, Paris.
Potts, A., Grace, V. M., Vares, T. and Gavey, N. 2006. ‘Sex for life’? Men's counter-stories on ‘erectile dysfunction’, male sexuality and ageing. Sociology of Health & Illness, 28, 3, 306–29.
Prati, G., Mazzoni, D. and Zani, B. 2014. Psychosocial predictors and HIV-related behaviors of older adults versus late middle-aged and younger adults. Journal of Aging and Health, 27, 1, 123–39.
Psaros, C., Barinas, J., Robbins, G. K., Bedoya, C. A., Safren, S. A. and Park, E. R. 2012. Intimacy and sexual decision making: exploring the perspective of HIV positive women over 50. AIDS Patient Care and STDs, 26, 12, 755–60.
Russel, C. 2007. What do older women and men want? Gender differences in the ‘lived experience’ of ageing. Current Sociology, 55, 2, 173–92.
Sandberg, L. 2011. Getting Intimate: A Feminist Analysis of Old Age, Masculinity and Sexuality. Linköping University Electronic Press, Linköping, Sweden.
Sandberg, L. 2013. Just feeling a naked body close to you: men, sexuality and intimacy in later life. Sexualities, 16, 3/4, 261–82.
Schiltz, M.-A., Bouhnik, A.-D., Préau, M. and Spire, B. 2006. Sexuality of HIV positive people: the impact of a sexual transmitted infection. Sexologies, 15, 3, 157–64.
Schope, R. D. 2005. Who's afraid of growing old? Gay and lesbian perceptions of aging. Journal of Gerontological Social Work, 45, 4, 2339.
Schwartz, P., Diefendorf, S. and McGlynn-Wright, A. 2014. Sexuality in aging. In Tolman, D. L. and Diamond, L. M. (eds), APA Handbook of Sexuality and Psychology. Volume 1: Person-based Approaches. American Psychological Association, Washington DC, 523–51.
Settersen, R. A. 2006. Aging and the life course. In Binstock, R. H. and George, L. K. (eds), Handbook of Aging and the Social Sciences. Sixth edition, Academic Press, San Diego, California, 319.
Siegel, K. and Schrimshaw, E. W. 2003. Reasons for the adoption of celibacy among older men and women living with HIV/AIDS. Journal of Sex Research, 40, 2, 189200.
Smit, P. J., Brady, M., Carter, M., Fernandes, R., Lamore, L., Meulbroek, M., Ohayon, M., Platteau, T., Rehberg, P., Rockstroh, J. K. and Thompson, M. 2012. HIV-related stigma within communities of gay men: a literature review. AIDS Care, 24, 4, 405–12.
Sontag, S. 1972. The double standard of aging. Saturday Review of Literature, 39, 29–8.
Strauss, A. and Corbin, J. 1998. Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory. Second edition, Sage, Thousand Oaks, California.
Taylor, T. N., Munoz-Plaza, C. E., Goparaju, L., Matrinez, O., Holman, S., Minkoff, H. L., Karpiak, S. E., Gandhi, M., Cohen, M. H., Golub, E. T., Levine, A. M., Adedimeji, A. A., Gonsalves, R., Bryan, T., Connors, T., Schechter, G. and Wilson, T. E. 2016. ‘The pleasure is better as I've gotten older’: sexual health, sexuality, and sexual risk behaviors among older women living with HIV. Archives of Sexual Behavior, 46, 4, 1137–50.
Vares, T. 2009. Reading the ‘sexy oldie’: gender, age(ing) and embodiment. Sexualities, 14, 4, 503–24.
Vespa, J. 2009. Gender ideology construction: a life course and intersectional approach. Gender & Society, 23, 3, 363–87.
Wallach, I. 2013. De l'acceptation à la résistance: expériences et gestion des changements de l'apparence chez les femmes vieillissant avec le VIH. Recherches féministes, 26, 2, 145–63.
Wallach, I., Ducandas, X., Martel, M., Trottier, B. and Thomas, R. 2013. Le VIH et le vieillissement au Québec. Une recherche qualitative sur les expériences, les difficultés et les besoins des personnes vivant avec le VIH de 50 ans et plus. Rapport de recherche. Available online at [Accessed 07 April 2017].
Walz, T. 2002. Crones, dirty old men, sexy seniors: representations of the sexuality of older persons. Journal of Aging and Identity, 7, 2, 99112.
Watson, W. K., Bell, N. J. and Stelle, C. 2010. Women narrate later life remarriage: negotiating the cultural to create the personal. Journal of Aging Studies, 24, 4, 302–12.
Weeks, D. J. 2002. Sex for the mature adult: health, self-esteem and countering ageist stereotypes. Sexual and Relationship Therapy, 17, 3, 231–40.
Wentzell, E. and Salmerón, J. 2009. You'll ‘get viagraed’: Mexican men's preference for alternative erectile dysfunction treatment. Social Science & Medecine, 68, 10, 1759–65.
Zablotsky, D. and Kennedy, M. 2003. Risk factors and HIV transmission to midlife and older women: knowledge, options, and the initiation of safe sexual practices. Journal of Acquired Immune Deficiency Syndromes, 33, 2, S122–30.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Ageing & Society
  • ISSN: 0144-686X
  • EISSN: 1469-1779
  • URL: /core/journals/ageing-and-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed