Talking about sex with friends: perspectives of older adults from the Sex, Age & Me study in Australia.

This qualitative study explored the barriers and facilitators to sexual communication between older adults and friends. Fifty-three women and men aged 58 and older were interviewed about their intimate relationships and sexual behaviours and attitudes. Findings indicated that talking about sex with friends played an important role in providing support and sharing information. The privacy of the topic meant that trust and confidentiality had to be in place before sexual conversations occurred, and that discretion was required for those married or in a relationship due to potential breaches of privacy. Stereotypes associated with older age made talking about sex 'risky' as participants were vulnerable to scrutiny. Growing-up during a time when sex was taboo influenced willingness and comfort in talking about sex today. Among those who did talk with friends, women tended to talk to women and men to men. These findings are significant in the context of an increasing global population of older adults and silence around sex and ageing. By exploring sexual communication outside of the healthcare context, where previous research has focused, the findings indicate novel ways to support the sexual health and well-being of older adults.

Sexual Satisfaction Among Older Australian Heterosexual Men and Women: Findings from the Sex, Age & Me Study.

This study explored sexual satisfaction in older heterosexual Australians using data from a national sample of 1,583 men and women aged 60+ who hoped or planned to have sex in the future. Data collection took place in 2015; participants were recruited using a variety of online and offline advertisements. Less than half the sample (46%) reported they were very or extremely satisfied with their sexual lives. Those who had sex more often and were more interested in sex were more likely to be satisfied, while those who wanted sex more often in the future were less likely to be satisfied, as were men who had experienced sexual difficulties. Sexual satisfaction was also associated with life satisfaction in men and positive mental health in women. Factors associated with satisfaction in this study will help guide strategies to support older people in realizing the sexual lives they desire.

Experiences of ageism and the mental health of older adults.

OBJECTIVES: This article examines relationships between experiences of ageism and four specific mental health outcomes among older Australian adults, including whether these relationships vary depending on age, gender, and sexual orientation. METHODS: A survey was conducted nationwide involving 2137 participants aged 60 years and older. Mental health variables included depressive symptoms, anxious symptoms, general stress, and positive mental health or flourishing. RESULTS: Recent experiences of ageism were found to be strongly related to poorer mental health on all four mental health variables. However, experiences of ageism appeared to have a greater effect on the mental health of those who were younger in age (specifically depression), of men more so than women (specifically depression), and of those who identified as heterosexual as opposed to other sexual orientations (specifically general stress). CONCLUSION: These findings suggest that experiences of ageism may be an important factor in the health and well-being of older adults, especially for those who are younger, male, and heterosexual, and may need to be taken into account when devising strategies for supporting healthier and happier ageing.

The Importance of Sex and the Meaning of Sex and Sexual Pleasure for Men Aged 60 and Older Who Engage in Heterosexual Relationships: Findings from a Qualitative Interview Study.

That many older individuals continue to engage in various forms of sexual expression well into later life is now well established in the literature. To date, however, only a small body of qualitative research has examined older men's experiences and understandings of sex in later life. Likewise, the ways in which older men's discussions on sex may be used as an avenue for "doing" masculinity remain underexplored. Older men are particularly interesting in this regard, as they inhabit an increasingly subordinated position in relation to hegemonic masculine ideals because of their age. To what extent might this limit or, alternatively, open up the possibilities for sexual expression and subjectivity in later life? Drawing on a subset of findings from Sex, Age, and Me: A National Study with Australian Women and Men Aged 60 and Older, data from qualitative interviews with 27 Australian men were explored in this article. The first Australian study of its kind, we argue that older men who engage in heterosexual relationships draw on a diverse and complex array of discursive positions regarding sex, relationships, and masculinity in making sense of their experiences of sex in later life. Older men are a heterogeneous group, and their experiences and understandings of sex do not simplistically follow "decline" or "success" narratives of aging. The findings of this research build upon and extend emerging research illustrating the centrality of intimacy to older men's sexual lives, while simultaneously highlighting the ways in which the body and discursive constructions of sex intersect to shape older men's sexual subjectivities.

The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population.

Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult's understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study's recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.

Sex, desire and pleasure: considering the experiences of older Australian women.

Older age is often associated with asexuality. That is, older individuals are not viewed as desiring of sex, nor as sexually desirable to others. Broader social and cultural norms that downplay women's sexual desire and agency further compound these phenomena. Whether this popular image accurately reflects older women's sexual desires, behaviour and capacity to experience pleasure is unclear. Drawing on semi-structured interviews with 43 partnered Australian women aged 55-81, this article considers women's sexual experiences and desires in older age. The findings of our research confirm that older women's experiences of sex and sexual desire are diverse and fluid. Some of the factors that influenced participants' sexual behaviour and desire will be considered in this article, as will their understandings of what "counts" as sexual satisfaction and "successful sex". The factors affecting sexual behaviour and desire also influence the way in which women are able to negotiate sexual interaction with their partners. Participants expressed a need for education and resources in order to gain greater control and to make autonomous choices over their sexual experiences, desire and ability to give and receive pleasure. The implications of these findings for practitioners are also considered.

From "Ghettoization" to a Field of Its Own: A Comprehensive Review of Street Harassment Research.

Street harassment represents one of the most pervasive forms of sexual violence. While it is commonly understood as a gender-based harm, it also intersects with racist, homophobic, transphobic, ableist, and other forms of abuse. Although it is rarely responded to through government policy, research illustrates that street harassment can have profoundly negative impacts of those who experience it. This article provides a comprehensive review of the current "state of the field" of street harassment research. We undertook two extensive searches of the EBSCO Discovery database in 2015 and 2020, followed by the use of reference snowballing and a Google Scholar search in order to triangulate results. Studies included in the sample were published in English, peer-reviewed and centrally focused on street harassment. Dissertations and nongovernmental organization reports were also included due to the small number of studies in this field. One hundred eighty-two sources were included in the final sample. Findings show that publications on this topic have increased substantially across the two reviews. We provide a thematic overview of key research findings to date and argue throughout that current research suffers from conceptual and typological slippage and does not consistently take into account the need for an intersectional analysis. We close with suggestions for future directions in research and practice, given the emergent nature of the field.

Gendered Responses to Gendered Harms: Sexual Violence and Bystander Intervention at Australian Music Festivals.

Bystander intervention has shown promise in preventing sexual violence in certain social contexts. Despite emerging evidence of pervasive sexual violence at music festivals, no research has considered bystander intervention in this setting. Drawing on an online survey conducted with 371 Australian festival attendees, we explore the role of gender on bystander intervention at music festivals. Findings point to significant gender differences, with women more willing and likely to intervene in a broader range of scenarios. We argue that responses to sexual violence are a collective responsibility shared by both women and men, as well as festival organizers and industry bodies.

Naming the Unspeakable Harm of Street Harassment: A Survey-Based Examination of Disclosure Practices.

Street harassment may be considered an "unspeakable" harm on account of the routine silencing and trivialization of victims' experiences. Disclosing street harassment is vital in making its harms visible and in working to transform social and cultural attitudes. Despite a recent resurgence of interest in street harassment via online activist groups, there is scant research on disclosure practices. Drawing on findings from an online, mixed-methods survey with 292 participants who have experienced street harassment, I examine disclosure practices using an intersectional lens. I argue that disclosure is an epistemological process, through which a limited and partial understanding of street harassment is produced.

Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex.

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood "safer sex," the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.

Sexual Assault and Justice for Older Women: A Critical Review of the Literature.

This article provides a critical review of current literature on the sexual assault of older women-including an exploration of the specific features and emotional and physical impacts of older women's experiences-and highlights current gaps and future directions for research, practice, and theory. A review of the literature indicates that older women constitute only a small proportion of victim/survivors. However, there is evidence to suggest that existing research underestimates the extent of this issue. Older women face particular barriers to disclosure and accessing the justice system, resulting in their experiences remaining hidden. Many of these barriers also contribute toward older women's experiences being ignored, dismissed, or downplayed by potential bystanders. These barriers are explored in depth in this article and include cultural context, ageism, cognitive and health impairments, and living in a residential care setting. Responding to, and preventing, the sexual assault of older women requires a tailored approach-and we currently lack sufficient insight to develop appropriate responses. In closing, this article considers how we might work toward achieving "justice" for older women victim/survivors.

Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection.

BACKGROUND: Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. METHODS: A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n=805, 38%). RESULTS: Less than one in three reported a STI test in the past 5 years (n=241, 30%) while 6% (n=51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. CONCLUSIONS: STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients.

Talking to healthcare providers about sex in later life: Findings from a qualitative study with older Australian men and women.

OBJECTIVE: Healthcare providers (HCPs) can play an important role in supporting the sexual health of older adults; however, we know little about the experiences of older people in talking to HCPs about sex. This article examines older adults' experiences and perceptions of talking to HCPs about sex. METHODS: Semi-structured interviews were conducted with 30 men and 23 women aged 60 and older recruited from a national, online survey of older Australians. Data were analysed using a thematic approach. RESULTS: Most participants did not discuss sex with their HCP, and their HCP did not raise it. For those who did discuss sex with a HCP, negative and stigmatising responses were common. Positive responses could facilitate access to sexual health care. CONCLUSION: Older people benefit when HCPs are proactive and ask about sexual health. Education in how to talk about sex with older people would also be beneficial for HCPs.

Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices.

OBJECTIVE: Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older people's knowledge of STIs and safer sexual practices. METHODS: A total of 2,137 Australians aged 60 years and older completed the survey, which included 15 questions assessing knowledge of STIs and safer sexual practices. We examined both levels of knowledge and factors associated with an overall knowledge score. RESULTS: In total, 1,652 respondents reported having sex in the past five years and answered all knowledge questions. This group had good general knowledge but poorer knowledge in areas such as the protection offered by condoms and potential transmission modes for specific STIs. Women had better knowledge than men. Men in their 60s, men with higher education levels, and men who thought they were at risk of STIs reported better knowledge than other men. Knowledge was also better among men and women who had been tested for STIs or reported 'other' sources of knowledge on STIs. CONCLUSIONS: Many older Australians lack knowledge of STIs and safer sexual practices. Implications for public health: To reverse current trends toward increasing STI diagnoses in this population, policies and education campaigns aimed at improving knowledge levels may need to be considered.

Improving the sexual lives of older Australians: Perspectives from a qualitative study.

OBJECTIVE: To examine older Australian's perspectives on how their sexual lives can best be supported and/or improved. METHODS: Fifty-three, semi-structured interviews were conducted with Australian men (n = 30) and women (n = 23) aged 60 and over. RESULTS: Participants identified a range of key issues and areas where their sexual lives could be further supported or improved upon, including normalising the occurrence of sex and sexual desire in later life; increasing and improving on the quality of, cultural representations of older adults; introducing policy, educational and practice-based changes in age care facilities to support the consensual sexual expression of residents; and ensuring that sexual health campaigns and education are inclusive of older people. CONCLUSION: Our findings present clear implications for further developing sexuality education and public health campaigns, training and education of health-care professionals, and generating social and cultural change pertaining to the acceptability of the diversity of sexual expression in later life.

HIV cure research: print and online media reporting in Australia.

OBJECTIVES: While still in its early stages, recent scientific research towards a cure for HIV has generated widespread media interest. The aim of this paper was to explore the ways in which this research has been represented in Australian print and online media and discuss implications of this. METHODS: A search of databases from four selected media outlets was conducted to identify published articles that directly discussed HIV cure research. Content analysis was used to explore the discursive framing of HIV cure research and identify the presence or absence of people living with HIV in articles. RESULTS: In total, 95 articles were identified that had been published in print or online between 2007 and 2015. Media reports tended to focus on research breakthroughs or the future potential of HIV cure research, rather than more immediate implications of research findings. While not inaccurate, this focus often implied the field of HIV cure research was more advanced than was generally the case. There was a notable absence of commentary from people living with HIV or community advocates in media reporting. CONCLUSIONS: Media reporting may generate unrealistic expectations of HIV cure research. This raises ethical concerns that media reporting may inadvertently contribute to therapeutic or curative misconceptions among potential participants in HIV cure-related trials. To address this, scientists, HIV advocates and people living with HIV will need to work collaboratively to engage with reporters and media outlets to provide more consistent input and guidance into reporting about research towards a cure for HIV.

Sex and the (older) single girl: experiences of sex and dating in later life.

This study explored the sexual subjectivities of older Australian women. In this article we present findings from 15 qualitative interviews with Australian women aged 55-81 who were single at the time of interview. The majority of these women were single following divorce or separation, with a smaller number of women who were widowed or never in a long-term relationship. We found that these women's sexual desire and sexual activity were fluid and diverse across their life course. Although some participants desired a romantic or sexual relationship, they were also protective of their independence and reluctant to re-enter into a relationship in later life. Our findings indicate that these women's sexual subjectivities were shaped by dominant norms of ageing, sex, and gender. At the same time, older women are challenging and resisting these norms, and beginning to renegotiate sexuality in later life.