Sue Malta is a sociologist with research interests in ageing, sexual health and wellbeing, technology, social connection/isolation, and ageism amongst others. Her PhD investigated love, sex and intimacy in new late-life romantic relationships, online and offline. She currently works in the Sexual Health Unit, MSPGH, University of Melbourne, on the Sexual Health and Ageing, Perspectives and Education (SHAPE) project investigating sexual health discussions in primary care and how to facilitate such discussions occurring. She is also a Research Fellow/Stream Leader, Social Connections and Relationships, at the National Ageing Research Institute where she works on projects involving the care and wellbeing of older adults. In addition, she is an Adjunct Research Fellow at Swinburne University where she collaborates on projects addressing sexual health promotion and ageing; and is a collaborator on the La Trobe University project, Sex, Age & Me. As an early career researcher she has published widely and in 2012 contributed a chapter entitled “Using online methods to interview older adults about their romantic and sexual relationships” in Researching Later Life and Ageing – Expanding Qualitative Research Horizons (Palgrave). Her new chapter “Older people as cyber-sexual beings: Online and internet dating” was published in ‘Addressing the Sexual Rights of Older People’ (Routledge 2017), which is the subject of a Masterclass at this year’s IFA conference. She is a member of the Australian Association of Gerontology, The Australian Sociological Association and the Sexual Health Society of Victoria and a new IFA member.
“[They think] nothing happens between my neck and my knees”: Facilitating sexual health discussions between older patients and healthcare professionals in primary care
Introduction: Due to rising numbers of later life divorces, many older adults in Western countries are re-partnering in later life and looking to online dating websites to do so. While not a problem in itself, new late life daters are more likely than younger people to have sex on the first date and are less likely to use condoms. The reasons for this are unclear, but it appears low levels of knowledge and inadequate sex education historically means few older adults are cognizant of safer sex practices and the protection condoms provide. Consequently, sexually transmissible infections (STIs) in older populations are rising. Risk of sexual difficulties also increases in older adults, which can negatively impact on their overall health/well-being. The symptomatology of STIs is such they can go unrecognised in older patients and, due to difficulties older adults and healthcare practitioners both face in discussing late life sexual health issues, older patients may not receive the care they need. To break this nexus, we investigated what kinds of tool would be acceptable to ensure these discussions occur.
Method: Stage 1: Semi-structured face-to-face interviews were conducted with 21 older adults and 36 healthcare professionals, who identified that a paper-based or digital tool in Checklist format would be preferred. Stage 2: The content and language of the Checklist was tested during telephone interviews with 13 older adults and four clinical staff (3 GPs/1 practice nurse/manager). All interviews were digitally recorded, transcribed and thematically analysed.
Results: Older adults identified the terminology of sexual health as ‘too clinical’ and suggestive of disease/dysfunction. They preferred broad terms/statements, which would allow healthcare professionals to address a range of sexual wellbeing matters. Older participants welcomed the Checklist, because they felt it was important to normalise sexual health issues in later life, eg: “in the GP world there seems to be a view that… nothing happens between my neck and my knees… we’re still sexual beings… it’s just a normal part of who we are (Female, aged 60-69). Based on these recommendations, a draft paper-based and digital (WebApp) Checklist was developed, and the language/statements were verified by a group of clinical key informants.
Conclusion: The need for GPs to initiate sexual health discussions with their older patients is compelling. The Checklist provides a practical/easy solution to facilitate these discussions occurring and will help empower older adults to ensure their sexual health and wellbeing needs are met.