Sexual needs still exist among older adults
In recent years, the numbers of older patients suffering from STD has increased rapidly in China. By the end of 2012, the proportion STD/HIV infection in older people already reached those reported four years ago in Europe and the USA 10. The differences between China and Western countries in terms of local, social and cultural attitudes, as well as different perceptions of sex and different behavior, all put older Chinese people at a higher risk of STD/HIV infection, but this situation is rarely reported. Our results showed that sexual activity still exists among older adults, and that men tended to have stronger sexual needs, consistent with previous studies at home and abroad 11,12. Yao found people over 45 years old who had no interest in sex were only 16.8% and 25.9%, in men and women respectively13. Gao’s survey results also supported the idea that sexual needs of the elderly population still exists 14.
However, understanding intimate relationships among older adults is not an easy task. Among sexually active respondents, about half of both men and women reported at least one bothersome problem, such as changes in body shape and changes in sexual functioning, such as vaginal dryness after menopause in women and erectile difficulties in men, so some of them would like to take medication or supplements to improve sexual function and performance 7,15. Regarding the elderly in society, old people’s sexual appeal are often subject to the conditions of social consciousness and social morality. Moreover, elderly who are widowed or have a partner with sexual dysfunction are usually dissatisfied with sex in their life for over a long period of time, which may lead to social problems such as crime and prostitution. Consequently, this can promote further spread of sexually transmitted diseases in the elderly 16.
Social problem behind sexual activity of senior citizens
A non-negligible proportion of patients engaged in casual sexual encounters, often with sexual workers. social changes, as the rise of divorce and new relationships among older people also affects the likelihood of engaging in risky sexual behavior 17. Furthermore, low-paying female sex workers were usually less likely to practice safe sex, in other words, were associated with the rate of inconsistent condom use compared with their peers who worked in a high-paying region. For this reason, they are at a higher risk of contracting STD 18,19,20. Low condom use rate and awareness of the relevant knowledge, as well as multiple partners and prostitution, resulted in an epidemic of HIV and syphilis, which increased year-by-year 21. With the increasing popularity of people accepting antiretroviral therapy (ART), the life expectancy of HIV patients is greatly prolonged. In addition, this problem relating to the elderly population in China is becoming more serious, and the number of elderly PLWH patients, in the next few decades, may further rise. Therefore, it is necessary to strengthen the HIV prevention and control work of older adults.
More attention should be paid to STD in the elderly
In recent years, chronic disease has gradually replaced infective disease, which has become a first risk factor that threatens old people’s health. However, they are vulnerable to contract infections owing to poor physical well-being, weaker immunity and deterioration of organ function. In addition, the existing knowledge about regarding infection disease and prevention behaviors was not significantly high 22,23. As a result, older people should be treated as important population during the process of preventing and curing infection disease. Although it is not the only important point, but it is however a challenging issue. A foreign study showed the increasing frequency of sexual activity in people over 50 years old, which led to the rapid prevalence of STD, including HIV , syphilis, gonorrhea and chlamydial infection 24.
Even though the HIV-positive population in China is aging, the health needs of this group remains understudied and likely under served. Older PLWH individuals may continue to engage in unprotected or inconsistent safe sexual activity. Educated people are more likely to pay attention to their health and screen for sexually transmitted infections by their own initiative 25. Therefore, related education projects for the elderly need to be promoted in communities. The Community Action for Preventing HIV/AIDS Project’ was implemented in four provinces in Cambodia, for instance, it achieved a high level of consistent condom use with commercial sex in all groups, which demonstrated the vital importance of decentralized planning, management and accountability, with government institutions playing the leading role 26. On the other hand, social networking technologies could be an important and useful tool for HIV and STD prevention 27. Consequently, considering the cultural level and living habits that older people have , importance is given to sexual health. Moreover, education regarding the prevention and control of STD in the by means of television, radio or leaflets will ensure that the elderly have access to real and effective information. Furthermore, children working far away from home should also show more concerns for the parents.