Older women's attitudes, behavior, and communication about sex and HIV: a community-based study.

Objectives: To examine the effects of race and marriage on the sexual attitudes, behavior, and patient-physician communication about sexuality and HIV/AIDS among older women.

Methods: This was a cross-sectional survey of 55 community-residing women aged 58-93.

Results: 57% of respondents had engaged in sexual activity since the 60th birthday. Nearly 60% of single women who had been sexually active in the previous 10 years reported that they had not used a condom; 21% of women with a current sexual partner agreed that condom use is not necessary "if you can no longer get pregnant." African American women were significantly more likely to report making changes in their sexual behavior due to HIV (53% vs. 19% white, p = 0.02). Married and African American women were more likely to discuss sex with a physician (80% vs. 47%; p = 0.03 and 75% vs. 46%, p = 0.05, respectively). African Americans were more likely to have had a physician initiate such a discussion (69% vs. 38%, p = 0.04).

Conclusions: Older women in this sample were sexually active, engaged in potentially risky sexual behavior, and believed that physicians should address issues of sexuality. Older African American women were significantly more likely than white women to report HIV-related changes in their behavior and to discuss sex with a physician. This community-based study corroborates clinical research and suggests both a gap and a disparity in older women's dialogue with physicians. It also indicates the need for more broadly generalizable data on issues pertinent to older women's sexual health.