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Sexuality and Intimacy Among Older Women Living with HIV: a Systematic Review

  • Female Sexual Dysfunction and Disorders (T Lorenz and R Nappi, Section Editors)
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Abstract

Purpose of Review

Sexual well-being and intimacy are critical to overall quality of life and retain a high degree of significance for aging individuals, even though these considerations are often overlooked in older populations. Sexual health may be particularly impacted in older individuals living with HIV, especially women, as a result of both physical and psychosocial disease-specific factors. Despite this, sexuality research related to HIV has traditionally focused on risk reduction, rather than on other elements of sexual wellness. In this review, we examine several aspects of sexual well-being that may be important to older women living with HIV (OWLH).

Recent Findings

This review summarizes existing literature on sexuality in OWLH over the age of 50 and explores five themes related to sexual health: physical and emotional intimacy, desire/interest, satisfaction/pleasure, frequency of sexual activity, and abstinence. Reduced intimacy among OWLH was reported across most studies, due to stigma and disclosure concerns, lack of opportunity for relationships, and difficulty communicating sexual preferences. Data on sexual desire/interest and satisfaction/pleasure among OWLH were mixed. Frequency of sexual activity varied widely across studies, and abstinence emerged as both an intentional and inadvertent decision for OWLH. Factors related to menopause as it relates to sexuality and HIV are also discussed.

Summary

Sexual health and well-being are important to women living with HIV over 50, though key components such as intimacy, desire, and pleasure remain poorly understood. As this population continues to grow, comprehensive and age-specific interventions are needed to examine positive aspects of sexuality and promote sexual wellness among OWLH.

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Funding

This work was supported by a T32 training grant (5T32MH116140-02).

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Authors and Affiliations

  1. Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    Amelia M. Stanton, Georgia Goodman & Christina Psaros

  2. The Fenway Institute, Fenway Health, Boston, MA, USA

    Amelia M. Stanton & Georgia Goodman

  3. Program in Nutritional Metabolism, Massachusetts General Hospital, Boston, MA, USA

    Sara E. Looby

  4. Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, Boston, MA, USA

    Sara E. Looby

  5. Division of Infectious Diseases, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA

    Gregory K. Robbins

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  1. Amelia M. Stanton
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Correspondence to Amelia M. Stanton.

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Conflict of Interest

Dr. Stanton, Dr. Looby, and Dr. Goodman each declare no conflicts of interest.

Dr. Robbins declares grants from Gilead, Emergent Solutions, Citius Pharmaceuticals, Inc., and Pfizer, outside of the submitted work.

Dr. Psaros reports personal fees in consultation with collaborators at Brown University. In this role, she supervises interventionists on an HIV medication adherence trial.

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Stanton, A.M., Goodman, G., Looby, S.E. et al. Sexuality and Intimacy Among Older Women Living with HIV: a Systematic Review. Curr Sex Health Rep 11, 320–330 (2019). https://doi.org/10.1007/s11930-019-00227-6

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