Sexual Health Among Lesbian, Gay, Bisexual, and Heterosexual Older Adults: An Exploratory Analysis

Brennan-Ing, Mark; Kaufman, Jennifer; Larson, Britta; Gamarel, Kristi E.; Seidel, Liz; Karpiak, Stephen E.

doi:10.1080/07317115.2020.1846103

Cited by 20 publications

(8 citation statements)

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“…For example, some gay men may perceive themselves as older adults earlier than non-gay adults due to the prioritization of youthfulness and masculinity in the gay community ( Schope, 2005 ). Our age cut-off is consistent with prior research with older sexual minority adults (e.g., Brennan-Ing et al, 2021 ; Dai & Meyer, 2019 ; Travers et al, 2022 ). We excluded older adult participants who identified their sexual orientation as something else, missing, or refused to answer ( n = 319).…”

Section: Methodssupporting

confidence: 85%

“…The same study revealed that gay and bisexual men were twice as likely to be diagnosed with depression and anxiety than heterosexual men ( Guasp, 2011 ). In addition to mental health disparities, research has documented higher rates of sexual, physical, and behavioral health problems in older LGB adults than in older non-LGB adults ( Brennan-Ing et al, 2021 ; Dragon et al, 2017 ).…”

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confidence: 99%

“…The cumulative experience of stigma and discrimination confronted by older LGB adults underscores the significance of investigating differences in mental health outcomes among older adults by sexual minority status. Although prior studies examined similar research questions, many studies are not based on a nationally representative sample ( Brennan-Ing et al, 2021 ; Guasp, 2011 ; Rowan et al, 2022 ). To our knowledge, the study by Dai and Meyer (2019) is the most recent published research that examined mental health status among older sexual minority adults using 2014–2016 survey data collected from a probability sample of older adults in select U.S. regions.…”

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confidence: 99%

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Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey

Masa,

Inoue,

Prieto

et al. 2023

J Appl Gerontol

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This study explored differences among older adults in mental health by sexual minority status. Data came from the 2021 U.S. National Health Interview Survey. The study sample included older adults (or those aged ≥50 years, N = 15,559), and of those, two percent ( n = 380) self-identified as lesbian, gay, or bisexual (LGB). Older LGB adults had significantly higher odds of reporting a diagnosis of depression and anxiety and experiencing serious psychological distress than older non-LGB adults. Additionally, older LGB adults reported higher odds of experiencing depression and anxiety more frequently than older non-LGB adults. Significant covariates included age, sex, housing, food security, and social support. Increased risk for mental illness may be long-term consequences of stigma and discrimination that this population has experienced over the life course. The combination of structural interventions and affirming mental healthcare that recognizes the cumulative negative experience among older LGB adults is necessary to achieve mental health equity.

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Section: Methodssupporting

confidence: 85%

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confidence: 99%

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confidence: 99%

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Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey

Masa,

Inoue,

Prieto

et al. 2023

J Appl Gerontol

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“…Our review findings suggested that older LGBTQIA+ adults have different sexual health priorities than younger, non-LGBTQIA+ adults. Providers were not found to adequately acknowledge and address older LGBTQIA+ adults' specific concerns, a complaint observed in other studies [61]. Ensuring that healthcare providers have adequate training and resources that meet LGBTQIA+ needs, particularly when embedded in routine non-sexual clinical services, may improve the acceptability of services.…”

Section: Discussionmentioning

confidence: 84%

Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis

Conyers

Kpokiri

et al. 2023

Sex. Health

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The number of older adults identifying as lesbian, gay, bisexual, transgender and other sexual and gender diverse identities (LGBTQIA+) is growing as populations age and social environments become more accepting. This study uses a global evidence synthesis to understand perceived barriers and facilitators to access to sexual healthcare globally for older LGBTQIA+ adults. We used a scoping review and qualitative evidence synthesis. Embase, PubMed and PsycInfo were searched with terms related to LGBTQIA+ populations, adults aged 45 years, and sexual health care. We used the Cochrane Handbook and the review protocol was registered. Primary and secondary textual data were coded and grouped into themes using PRISMA-SCR and the Minority Stress Model. The certainty of review findings was assessed using the GRADE-CERQual approach. We identified 19 studies and 15 were included in the qualitative evidence synthesis. All studies were from high-income countries. Heterocentricity and male-centricity of sexual healthcare services contributed to feelings of exclusion for older LGBTQIA+ adults. Both anticipated and enacted stigma from healthcare providers resulted in older LGBTQIA+ adults, especially those with chronic conditions, avoiding health services (seven studies each, low certainty). Older LGBTQIA+ adults have unique sexual health needs and may feel their age empowers them to access appropriate care (four studies, low certainty). This review highlights the need for additional research and interventions to improve sexual health services for older LGBTQIA+ adults. Practical strategies to make sexual health less heterocentric (e.g. gender neutral signage) may increase uptake of essential sexual health services.

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“…The older population with or at risk for HIV is often left out of these initiatives [25]. In part, this situation stems from the idea that older people do not have sex – the primary mode of HIV transmission – and are therefore not at risk for HIV [26]. Providers rarely discuss sexual health with older patients [27].…”

Section: Improving Health Equitymentioning

confidence: 99%

Aging with HIV: Working to Ensure Equity and Inclusion

Brennan-Ing¹,

Mattas²

2023

Gerontology

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Due to effective anti-retroviral therapy (ART), the people with HIV are aging, and this is observed globally wherever ART is readily available. While this represents the success of HIV treatment, those aging with HIV face several health challenges that emphasize the importance of access to health care and health equity. These challenges include changes to the immune system, chronic inflammation, and higher rates of multimorbidity at younger ages compared to people without HIV. Intersectional identities impact health care access and health equity and include age, sexual orientation, gender identity, race/ethnicity, socioeconomic position, and HIV serostatus. Intersectional identities are also associated with psychosocial burdens among older adults with HIV such as depression, social isolation, and HIV stigma. Social integration of older people with HIV can mitigate some of these burdens and is associated with better psychological well-being, better physical functioning, and greater sufficiency of informal social supports. There are several grassroots and advocacy initiatives to improve health equity and social integration which bring greater visibility to HIV and aging. These efforts should be coupled with a systematic and sustained policy response to the aging of this population that prioritizes human needs and is grounded in principles of social justice. Action must be taken, and this responsibility falls on policymakers, healthcare professionals, researchers, and community advocates alike.

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Sexual Health Among Lesbian, Gay, Bisexual, and Heterosexual Older Adults: An Exploratory Analysis

Cited by 20 publications

References 50 publications

Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey

Mental Health of Older Adults by Sexual Minority Status: Evidence From the 2021 National Health Interview Survey

Barriers and facilitators to accessing sexual health services for older LGBTQIA+ adults: a global scoping review and qualitative evidence synthesis

Aging with HIV: Working to Ensure Equity and Inclusion

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