Hostname: page-component-7d684dbfc8-7nm9g Total loading time: 0 Render date: 2023-09-24T07:28:34.435Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "coreDisableSocialShare": false, "coreDisableEcommerceForArticlePurchase": false, "coreDisableEcommerceForBookPurchase": false, "coreDisableEcommerceForElementPurchase": false, "coreUseNewShare": true, "useRatesEcommerce": true } hasContentIssue false

Sexual health and sexual activity in later life

Published online by Cambridge University Press:  19 March 2015

Paul Nash*
Centre for Innovative Ageing, Swansea University, Wales, UK
Paul Willis
Centre for Innovative Ageing, Swansea University, Wales, UK
Andrea Tales
Department of Psychology, Swansea University, Wales, UK
Thomas Cryer
Department of Psychology, Swansea University, Wales, UK
Address for correspondence: Dr Paul Nash, Centre for Innovative Ageing, Swansea University, Singleton Park, SwanseaSA2 8PP. Email:


The population is ageing and the rights, welfare and wellbeing of this age cohort are becoming more globally prominent and the focus of much policy development. Whilst research is leading the way and informing this in many spheres of an older person's life, this is not the case for sexual health. Campaigns of sexual health literacy and intervention are targeted at ‘at-risk’ cohorts, largely ignoring those over 60 years of age. With increases in sexually transmitted infections (STIs) in this age group and the potentially serious nature of untreated conditions, this review highlights the need for increased research, health literacy and targeted interventions. Social, societal and physical barriers preventing older adults engaging with safer sex have been identified, highlighting the extent of the attitudinal and policy shifts required to provide age parity.

Review Article
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


World Health Organisation. Sexually Transmitted Infections (STIs). Available at: (accessed 28 November 2014).Google Scholar
World Health Organisation. HIV/AIDS Fact Sheet No. 360. Available at: (accessed 28 November 2014).Google Scholar
Poynten, IM, Grulich, AE, Templeton, DJ. Sexually transmitted infections in older populations. Curr Opin Infect Dis 2013; 26: 8085.CrossRefGoogle ScholarPubMed
Health Protection Agency. Health Protection Report: Weekly Report. Infection Report 2014; 8: 118. Available at: (accessed 18 November 2014).Google Scholar
Health Protection Agency. STI Annual Data Tables. Available at: (accessed 18 November 2014).Google Scholar HIV and AIDS in Western and Central Europe. Available at: (accessed 18 November 2014).Google Scholar
White, P, Ward, H, Garnett, G. Is HIV out of control in the UK? An example of analysing patterns of HIV spreading using incidence-to-prevalence ratios. AIDS 2006; 20: 1898–901.CrossRefGoogle ScholarPubMed
Chena, SY, Weideb, D, McFarlanda, W, San Francisco Department of Public Health, The STOP AIDS Project. Are the recent increases in sexual risk behavior among older or younger men who have sex with men? Answer: Both. AIDS 2003; 17: 942–43.CrossRefGoogle Scholar
Lim, SH, Christen, CL, Marshal, MPet al.Middle-aged and older men who have sex with men exhibit multiple trajectories with respect to the number of sexual partners. AIDS and Behaviour 2012; 16: 590–98.CrossRefGoogle Scholar
National AIDS Trust. HIV rates for older adults. Available at: (accessed 18 November 2014).Google Scholar
American College of Rheumatology. Exacerbating factors for reactive arthritis. Available at: (accessed 18 November 2014).Google Scholar
Bulford, S, Singh, S. Qualitative exploration of sexual health in old age. Sex Transm Infect 2012; 88: 557.CrossRefGoogle Scholar
Willis, P, Maegusuku-Hewett, T, Raithby, M, Miles, P. Swimming upstream: the provision of inclusive care to older lesbian, gay and bisexual (LGB) adults in residential and nursing environments in Wales. Ageing Society 2014; 1469–1779: 125.Google Scholar
Gott, M, Hinchliff, S. How important is sex in later life? The views of older people. Social Sci Med 2003; 56: 1617–28.CrossRefGoogle ScholarPubMed
Lindau, S, Schumm, L, Laummann, E, Muicheartaigh, C, Waite, L. A study of sexuality and health among older adults in the United States. New Eng J Med 2007; 357: 762–74.CrossRefGoogle ScholarPubMed
Somes, J, Donatelli, N. Sex and the Older Adult. J Emergency Nursing 2012; 38: 168–70.CrossRefGoogle ScholarPubMed
Mercer, CH, Tanton, C, Prah, Pet al.Changes in sexual attitudes and lifestyles in Britain through the life course and over time: findings from the National Surveys of Sexual Attitudes and Lifestyles (NATSAL). The Lancet 2013; 382: 1781–94.CrossRefGoogle Scholar
Ward, R, Pugh, S, Price, E. Don't look back? Improving health and social care service delivery for older LGB users. Manchester: Equality and Human Rights Commission; 2010. Available at: (accessed 18 November 2014).Google Scholar
Memory, Cohen G. In Roth, I (ed), The Open University's Introduction to Psychology, vol 2, pp. 570620. Milton Keynes, Lawrence Eribaum; 1990.Google Scholar
Bauer, M, Geront, R. The use of humor in addressing the sexuality of elderly nursing home residents. Sexuality Disability 1999; 17: 145–55.CrossRefGoogle Scholar
Doll, G. Sexuality and Long-Term Care: Understanding and Supporting the Needs of Older Adults. Baltimore, Health Professions Press; 2012.Google Scholar
Gott, CM, Rogstad, KE, Riley, V, Ahmed-Jushef, I, Green, T. Exploring the sexual histories of older GUM clinic attenders. Int J STD AIDS 2000; 11: 714–18.CrossRefGoogle ScholarPubMed
Slinkard, MS, Kazer, MW. Older adults and HIV and STI screening: the patient perspective. Geriatric Nursing 2011; 32: 341–49.CrossRefGoogle ScholarPubMed
Abel, T, Werner, M. HIV risk behaviour of older persons. Eur J Public Health 2003; 13: 350–35.CrossRefGoogle ScholarPubMed
Department of Health. A Framework for Sexual Health Improvement in England. Available at: (accessed 18 November 2014).Google Scholar
Duerson, M, Thomas, J, Chang, J, Stevens, B. Medical students’ knowledge and misconceptions about ageing: responses to Palmore's Facts on Ageing Quizzes. The Gerontologist 1992; 32: 171–74.CrossRefGoogle ScholarPubMed
Fox-Seaman, G.HIV and other STDs in older adults. Greater awareness leads to better prevention. Advanced Healthcare Network 2005; 13: 61.Google ScholarPubMed
Holden, J, Trachtman, L. Increase in primary and secondary syphilis cases in older adults in Louisiana. J La State Med Soc 2011; 163: 308–11.Google ScholarPubMed
Nash, P, Stuart-Hamilton, I. The effects of specific education and direct experience on implicit and explicit measures of ageism. J Nutrition Health Ageing 2009; 13: 68.Google Scholar
Nash, P, Stuart-Hamilton, I, Mayer, P. The effects of higher level education on implicit and explicit attitudes towards older people. Aging Clin Exp Res 2011; 23: 282.Google Scholar
Nash, P, Stuart-Hamilton, I, Mayer, P. The continuation of prejudice: addressing negative attitudes in nurse training and continuing professional education. Educational Gerontology 2014; 40: 5360.CrossRefGoogle Scholar
Smith, KP, Christakis, NA. Association between widowhood and risk of diagnosis with a sexually transmitted infection in older adults. Am J Public Health 2009; 99: 2055–62.CrossRefGoogle ScholarPubMed
Crosby, R, Shrier, LA, Charnigo, Ret al.Negative perceptions about condom use in a clinic population: comparisons by gender, race, and age. Int J STD & AIDS 2013; 24: 100105.CrossRefGoogle Scholar
Schick, V, Herbenick, D, Reece, Met al.Sexual behaviours, condom-use, and sexual health of Americans over 50: implications for sexual health promotion for older adults. J Sex Med 2010; 7: 315–29.CrossRefGoogle ScholarPubMed
Office for National Statistics. Older People Divorcing. Available at: (accessed 18 November 2014).Google Scholar
Tan, HH, Wong, ML, Chan, RK. An epidemiological and knowledge, attitudes, beliefs, and practices study of sexually transmitted infections in older men. Singapore Med J 2006; 47: 886–91.Google ScholarPubMed
Fish, J. Social work and lesbian, gay, bisexual and trans people: making a difference. Bristol: Policy Press; 2012.CrossRefGoogle Scholar
Stonewall, . Lesbian, gay and bisexual people in later life. Available at: (accessed 18 November 2014).Google Scholar
Jacobs, RJ, Kane, MN, Ownby, RL. Condom use, disclosure, and risk for unprotected sex in HIV-negative midlife and older men who have sex with men. Am J Men's Health 2013; 7: 186–97.CrossRefGoogle ScholarPubMed
Pearline, RV, Tucker, JD, Yuan, LFet al.Sexually transmitted infections among individuals over fifty years of age in China. AIDS Patient Care STDs 2010; 24: 345–47.CrossRefGoogle Scholar
Sherrard, J, Wainwright, E. Sexually transmitted infections in older men. Maturitas 2013; 74: 203–5.CrossRefGoogle ScholarPubMed
Wilson, MG. Sexually transmitted diseases. Clinics Geriatric Med 2003; 19: 637–55.CrossRefGoogle ScholarPubMed
Mehrabian, S, Raycheva, M, Petrova, E, Tsankov, N, Traykov, L. Neurosyphilis presenting with dementia, chronic chorioretinitis and adverse reactions to treatment: a case report. Cases J 2009; 1: 8334.CrossRefGoogle Scholar
Wendelken, LA, Valcour, V. Impact of HIV and aging on neuropsychological function. J Neurovirol 2012; 18: 256–63.CrossRefGoogle Scholar
Arnold, S, Kumar, A. Reversible dementias. Med Clin North Am. 1993; 77: 215–30.CrossRefGoogle ScholarPubMed
Parsonage, MJ, Wilkins, EG, Snowden, N, Issa, BG, Savage, MW. The development of hypophosphataemic osteomalacia with myopathy in two patients with HIV infection receiving tenofovir therapy. HIV Med. 2005; 6: 341–46.CrossRefGoogle Scholar
Rivers, J. Sexually transmitted infections in the older patient: an unlikely event-or is it? J Cutan Med Surg 2014; 18: 14.Google Scholar
Jeffers, LA, DiBartolo, MC. Raising healthcare provider awareness of sexually transmitted disease in patients over age 50. Medsurg Nurs 2011; 20: 285–89.Google Scholar
Dentato, M, Orwat, J, Spira, M, Walker, B. Examining cohort differences and resilience among the aging LGBT community: implications for education and practice among an expansively diverse population. J Human Behav Social Environment 2014; 24: 316–28.CrossRefGoogle Scholar
Neundorfer, N, Britton, P, Lynch, D. HIV risk factors for midlife and older women. Gerontologist 2005; 45: 617–25.CrossRefGoogle ScholarPubMed
Matiluko, A, Crystal, A. Chlamydia in colposcopy clinics: to screen or not to screen? J Obstetrics Gynaecol 2006; 26: 454–56.CrossRefGoogle Scholar
Minicucci, EM, Vieira, RA, Oliviera, DT, Marques, SA. Oral manifestations of secondary syphilis in the elderly – a timely reminder for dentists. Aust Dent J 2013; 58: 368–70.CrossRefGoogle ScholarPubMed
Poggiali, S, Pisani, C, De Padova, LA, Ghilardi, M, Bilenchi, R. Sexually transmitted scabies in elderly people. J Eur Acad Dermatol Venereol 2006; 20: 341–42.CrossRefGoogle ScholarPubMed