March 27, 2009
News flash: Older people are having sex, and increasingly open about wanting to enjoy it. But with pleasure comes complications. Today's seniors are learning they are vulnerable to STDs and HIV; this week, Stanford University and Veterans Affairs researchers released a study demonstrating the cost-effectiveness of HIV/AIDS testing for adults age 75 and up.
Add disease to the list of other challenges - learning how to work with an aging body, navigating a romantic realm that now includes online dating and sex toys - and suddenly it's a whole new world for seniors.
"I think as seniors get older, they need a lot more information," said Larry Saltman, 73, of San Jose, Calif., "because we're not dead yet."
Saltman was among the seniors who attended a "Sexuality and Aging" seminar sponsored by the San Jose Office on Aging. Today, representatives will discuss offering similar talks at all the city's senior centers.
Already, signs suggest the sessions will be popular. Pfizer claims Viagra has helped 25 million men. Baby boomers, the same folks who led the sexual revolution in the 1960s, now are becoming senior citizens.
After marching for sex, "They're thinking, 'Wait a minute, maybe I still deserve to have some,' " said Bryna Barsky-Ex, a psychologist and sex therapist with Kaiser Permanente Santa Teresa, who has counseled couples in their late 90s about how to enjoy their sexuality.
But generations like Saltman's did not grow up with the same comprehensive sex education offered today in most schools; these men and women were at least in their 40s and 50s when AIDS appeared on the scene.
In 2005, the Centers for Disease Control and Prevention reported 15 percent of new HIV cases in the United States were among people over 50.
Saltman, who sits on the San Jose Senior Citizens Commission in California, suggested a sexuality session after he and his wife, Linda, saw a program about the rising rates of STDs and HIV in older adults.
The program, led by Barsky-Ex, was a reminder that seniors can have fun but also need to protect themselves, he said.
"Sexuality is not just for the young or the pretty or for penises working perfectly," Barsky-Ex said. "It's for everybody."
Saltman still speaks in the accent of his native Boston, where he said it was a "no-no to talk about anything like this" when he was young.
But the conversations are becoming easier. Nearly 40 people - some with canes and ranging from 60 to 90 years old - attended the seminar.
"Sometimes it was really quiet, like, 'Ooh,' " said Linda Saltman, 69, describing the session, which covered everything from lubrication to vibrators. "And then, when it was over, everybody was smiling."
But the topic can make some a little antsy.
"To be honest with you, this is the first time I've even given it thought," said Nasario Gutierrez, a gerontology specialist with Gardner Senior Center.
Dr. Susan Kegeles, co-director for the Center for AIDS Prevention Studies at the University of California-San Francisco, said people are often uncomfortable talking about sexuality; discussing the sexual proclivities of the elderly is even harder.
While the prevalence of sexual activity decreases with age, men and women still have sex well into their 80s and 90s, according to a study last year in the New England Journal of Medicine.
But as more people divorce now, the chance of contracting diseases through multiple partners increases.
Jane Fowler's HIV-positive diagnosis at age 55 came as a shock. The few times she had sex after her marriage ended, condoms seemed unnecessary; she thought of them only as contraception.
"There is this denial among older people that this can happen to them," said Fowler, now 73 and the founder of HIV Wisdom for Older Women, based in Kansas City, Kan.
In Santa Clara County, Calif., people older than 60 make up only 1.2 percent of the total number of HIV or AIDS patients. Those 50 to 59 years old make up 8.8 percent of the county's HIV/AIDS population, said Joy Alexiou, county public health department spokeswoman.
Experts said sex education is key to ensuring the percentages stay down. Just as important: learning that sex is about more than intercourse.
"Seniors need companionship," Saltman said. "Even if it's just touch, feel, the idea that somebody gives a hoot."
"It's part of life," said his wife, Linda. "Why keep it a secret?"
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