WELCOME to our Webinar: “Older Adults and Sexual Health Guide Training” Mon. Feb. 6, 2017, at 12:30 – 1:30 PM To Join us and listen along with reading the slides: Please DIAL IN to hear this webinar Click the “I will call in –blue button” on your WebEx screen Dial: 1-518-549-0500 OR 1-844-633-8697 Enter this Meeting ID Number: 634 587 108 5. Enter this Password: # (pound sign or your attendee ID)

WELCOME to: “Older Adults and Sexual Health” NYSADSA Conference Wednesday, October 25, 2017

Today’s Presenters Erin Purcell, NYSOFA Robert Curry, NYS DOH AIDS Institute Reference Materials Provided by ACRIA

Older Adults and Sexual Health: A Guide for Aging Services Providers Older Adults and Sexual Health: A Guide for Aging Services Providers was developed by ACRIA with support from the New York State Department of Health (NYSDOH) AIDS Institute and in collaboration with the New York State Office for the Aging (NYSOFA).

The Issue Older adults are becoming infected in the same ways younger people are becoming infected by HIV and STIs. Providers do not always discuss safe sex practices or HIV and STI testing with older adults

Background Older Adults and Sexual Health: A Guide for Aging Services Providers ACRIA and the New York State Office for the Aging had a chance to meet with senior center staff & seniors themselves to hear their concerns and what they would like to know more about. Those conversations helped inform the content of the guide. Senior centers, congregate meal sites, and community centers are some of the places that wellness, health promotion, and disease prevention programs for older adults are offered. Training on “The Guide” was first delivered via webinars in 2016.

The number of AIDS cases among people over 50 in the US has remained steady over time. A.) True B.) False

USA AIDS Cases Over Age 50 - CDC 130000 120000 110000 100000 90000 80000 70000 60000 50000 40000 30000 20000 10000 1995 2005 11 11

As people age, they are more likely to have a concurrent HIV & AIDS diagnosis upon being tested. The percentage rises significantly over time – among those aged 40-49 in the US who are living with HIV, 44% also have an AIDS diagnosis, among those aged 50-59 in the US who are living with HIV, 49% also have an AIDS diagnosis. Among those aged 60+ in the US who are living with HIV, 55% also have an AIDS diagnosis. These statistics are according to CDC surveillance data between 2008-2011. Concurrent Diagnoses

What percentage of people in their mid 50s to mid 60s reported having sex at least twice a month? A.) 0% B.) 25% C.) 50% D.) 75%

Sex in Later Life This is the most comprehensive study of its type with a large N (sample size) of over 3000 adults over age 57. National Social Life, Health and Aging Project (NSHAP) 2005-2006 Lindau ST, Schumm LP, Laumann EO, Levinson W, O’Muircheartaigh CA, Waite LJ. A study of sexuality and health among older adults in the United States. N Engl J Med. 2007;357(8):762-774 People are continuing to have sex later in life, contrary to the beliefs of many healthcare providers. As people age, they generally become less sexually active for a variety of reasons. According to the study, 73% of people aged 57-64 reported being sexually active According to the study, 53% of people aged 65-74 reported being sexually active According to the study, 26% of people aged 75-85 reported being sexually active National Social Life, Health and Aging Project (NSHAP) 2005-2006

National Survey of Sexual Health & Behavior, Indiana University, 2010 National Survey of Sexual Health and Behavior (NSSHB). Findings from the National Survey of Sexual Health and Behavior, Centre for Sexual Health Promotion, Indiana University. Journal of Sexual Medicine, Vol. 7, Supplement 5. National Survey of Sexual Health & Behavior, Indiana University, 2010

Older women & younger women are at equal risk for HIV transmission. True False

Older Women at Higher Risk After menopause, a natural thinning of the vaginal walls occurs in many women and lubrication reduces -- causing an increased risk of tearing during intercourse which makes older women more susceptible to HIV infection. 

Older Women at High Risk Many post-menopausal women feel that since they do not need to prevent pregnancy, that there is no real reason to wear a condom…

Older Adults and Sexual Health: A Guide for Aging Services Providers: Response to rising rates of Sexually Transmitted Infections (STIs) among older adults, including HIV. Supportive resource for New York State older adults service providers recognizing older adults are having sex at all ages. Provide context around healthy aging & sex and to provide ideas on how to address some concerns aging service providers may have about these issues. This guide encourages providers to consider how important information on sexual health for older adults can be provided in these and other community settings.

Why a Sexual Health Guide for Older Adults? Senior Center Social Worker: “They will never want to talk about sex, it’s embarrassing!” ACRIA conducted interviews and focus groups with older adults service providers to find out the needs of older adults and to develop a sexual health guide for seniors…. Here are a few responses from providers. What have you heard? Senior Center Nurse: “The information may not help them, but they can share it with their grandkids…” Senior Center Director: “We only have two married couples in this center, there is no need for a guide…”

“Although sexuality has long been thought to deteriorate inevitably with age, we found that health is a more important indicator for many aspects of sexuality than is age alone…” -Lindau Stacy Lindau: University of Chicago Assistant Professor of Obstetrics/Gynecology & Medicine-Geriatrics National Social Life, Health & Aging Project (NSHAP) http://www-news.uchicago.edu/releases/07/pdf/070822.sexualattitudes.pdf

If well managed, older adults can live long lives with HIV If well managed, older adults can live long lives with HIV. The presence of HIV disease may be a predictor of accentuated aging. If well managed, older adults can live long lives with HIV. The presence of HIV disease may be a predictor of accentuated aging. 22

Older Adults and Sexual Health: A Guide for Aging Services Providers: Content Aging and Sexual Health Challenges Sex and Aging Sexually Transmitted Infections (STIs) & Aging HIV and Aging LGBT Aging & Sexual Health Condoms PrEP and PEP HIV Testing Preparing to Conduct Sexual Health Discussion Groups for Older Adults Checklist to Plan a Successful Discussion Session Sample Training / Workshop Outline 101 Resources

Discussion Questions What kind of responses do you get when you bring up sexual health with older adults? What will be the challenges of doing sexual health workshops with older adults? What are some ways to get past these challenges? What’s your comfort in “talking about sex and sexuality” ?

How are you planning to incorporate the “Older Adults Sexual Health Guide” into your work? Here you can talk about examples for how to use the guide

Questions, Answers, Resources & Contact Information ACRIA training@acria.org AIDS Institute -- HIV Education and Training Robert.Curry@health.ny.gov (518) 474-3045 NYSOFA Erin.Purcell@aging.ny.gov (518) 474-5478

“The Older Adults Sexual Health Guide”   https://aging.ny.gov/nysofa/publications.cfm