Understanding the preference for clinic-based sexual health testing in older adults

Attitudes to sexual health can differ greatly between the generations.

It’s widely known that younger people, in general, are far more open than older generations about speaking about their sexual health and seeking testing.

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These preferences and behaviours can have downstream consequences for how people seek testing and treatment if they become infected.

A recent study that appeared in the British Medical Journal tested the preference for sexual health services among middle-aged and older adults in the UK.

The study’s objectives were to shed more light on this area, as researchers suspected that the sexual health needs of older individuals are not widely known and are often disregarded, both by the wider public and by clinicians. The aim was to understand the sexual health service preferences of adults aged 45 and older to help improve accessibility.

The study found that participants who were 45 or older preferred face-to-face interactions at sexual health clinics and were willing to pay for private services. Extra support and the consultation style played minor roles in the decision-making process. No differences in preferences were identified among disabled people.

The study highlights older peoples’ preference for face-to-face consultations and comfort with a clinic environment.

STI testing in younger and older people

STIs are more prevalent in younger people between the ages of 15-24. Younger people tend to be more sexually active than older people, have a wider variety of sexual partners, and are less consistent in their use of contraception.

As a result, younger people, encouraged by a more liberal and open attitude towards sexual health, are far more incentivised to talk about and be open about their sexual health and seek testing where possible.

Younger people are more likely to seek online and home-based testing than older people. Several factors contribute to this trend, including:

Convenience and privacy: Home testing kits offer discreet and convenient ways for young people to get tested without visiting a clinic.
Digital savvy: Younger generations are generally more comfortable with using online services and digital health solutions.
Targeted campaigns: Public health campaigns often promote home testing to younger demographics to increase testing rates. Younger people tend to spend more time online and are more likely to be exposed to online marketing campaigns that promote such products and services.

However, STIs can also be an issue in the older generation, but this is not widely discussed.

In recent years, older people have seen a sharp rise in the number of contracted STIs.

Many older people may find themselves dating after a divorce or the death of a spouse and haven’t had to worry about STIs for decades. They may enter the dating scene with beliefs, instincts, and knowledge about sexual health absorbed decades ago. Doctors also may not even think of testing older people for STIs when they go for their routine appointments.

Condom use among older people also tends to be inconsistent, especially among men who already struggle with erectile dysfunction.

So, older people are at similar risk for contracting STIs, but their testing preferences differ. What’s going on here?

The human touch

Nothing beats the personal touch.

Going into a clinic to get tested means spending time with a medical professional, whether a nurse, doctor, or other healthcare specialist. This individual can discuss testing options with their patients and provide advice and guidance about the best treatment options. This individualised advice is usually not available in fully online testing services.

Online testing services, while very convenient and effective, lack the input of a trained professional. If left to their own devices, a patient may seek out testing for infections that may not be appropriate for their situation or may not get tested at all.

Trust and authority

The trust that most people have towards medical professionals is unparalleled.

A nurse or doctor’s expertise and knowledge give many patients more confidence and peace of mind about the tests, guidance, and procedures these professionals recommend.

Older individuals might interact more regularly with healthcare providers due to other health concerns, making accessing STI testing services in a clinic setting easier.

Sexual health education

Older generations may hold onto sexual health knowledge that is outdated and may experience more stigma and shame around contracting sexual health conditions. People in these situations may be more likely to seek the guidance of a medical professional rather than seeking testing themselves.

Final thoughts

Mike Asher, CEO of Better2Know, says:

“STIs don’t discriminate and can affect anyone who’s sexually active. As a service provider, we want to give our patients the testing options that make them feel most comfortable and give them the most reliable and accurate test results. We provide our patients with the test results they need, whether through home testing or in a clinic. Remember: it’s always Better 2 Know.”

While older people may not have the most sexually transmitted infections, their sexual health is no less important. Indeed, it is incumbent upon service providers to do all they can to address the concerns of older people in accessing sexual health testing.

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