Safe Sex for Grown-Ups

The questions you can't afford not to ask if you're dating after 50.

By Jennifer Soong
WebMD Feature

Reviewed by Louise Chang, MD

When dance instructor Joan Price of Sebastopol, Calif., met the love of her life at 57 in her line dancing class, she was already wise to the steps and spins of modern dating, especially when it came to sex. She had been dating for years following her divorce, mostly short-term relationships, and was always careful to use condoms in bed.

Price, author of Better Than I Ever Expected: Straight Talk about Sex After Sixty, explains that when she and her now husband were ready to get intimate, she asked him point blank: "Shall I get the condoms or will you?"

Not all single women or men over 50 are so forthright. Some, perhaps divorced or widowed, find themselves newly single after years of marriage. The last time they had to deal with meeting potential partners, they were more worried about getting pregnant than catching sexually transmitted infections (STIs) like herpes and (HIV). So talking openly about safe sex and a partner's past may be unfamiliar territory for the over-50 crowd.

Even if it's not making the evening news or getting featured in a trendy sitcom, the sex life of the 50-plus set is alive and well. "Society's view of aging women as sexless is wrong, wrong, wrong," Price writes. "Many of us are having the best sex of our lives. We're the Love Generation. We practically invented sex."

At monthly gatherings called "Sex on the Porch," Katherine Forsythe, MSW, a sex educator and sex coach in San Francisco, hosts an open forum for women 50 and older to discuss sexuality. She urges these women to ask their partners to prove they've been tested for STIs.

"Many of them say, 'I can't ask that,'" Forsythe says. "I ask them how they'll feel telling every sexual partner for the rest of your life you have HIV. These women have to realize it's a matter of protecting their most precious possession - their bodies."

Forsythe wants to educate the generation who was taught good girls don't have to ask. "Good girls really will finish last," she says. "This is no time for coyness, pleasing, and unbartered trust."

She drills into them the same message she taught teenagers in sex ed classes: "If you're going to play grown-up games, you have to play by grown-up rules. Today, that means a condom until you see the paperwork and have been monogamous for three months. No papers, no naked penis."

Even though safe sex for older adults doesn't garner much media attention, the risks are real. Nationwide, an estimated 16% of new HIV/AIDS cases are among those age 50 and older and 25% of people living with HIV/AIDS are over 50, according to the CDC. And about 10% of gonorrhea cases and 9% of chlamydia cases across the nation are reported by the 55-64 age bracket, Scott Bryan, a spokesman with the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, tells WebMD in an email.

Younger adults are seen as the highest risk groups for HIV and STIs, so most messages in public health campaigns skew younger. But a number of sex education programs are now targeting older adults.

In Florida's Broward County, the Senior HIV Intervention Project recruits older peer educators to explain HIV risks to seniors. The University of Michigan Health System runs a Sex Matters clinic specifically for individuals and couples 60 and older.

"Regardless of age, prevention efforts must continue to focus on changing risk behaviors that lead to infection and helping those living with HIV learn their status," Bryan says.

Nancy Orel, PhD, a gerontology professor at Bowling Green State University, works with senior centers in northwest Ohio to promote HIV/AIDS prevention education. She encourages everyone to get HIV testing, which is now covered by Medicare.

"We try to remove the stigma by saying, 'Be a living example,'" Orel says. "You may think this doesn't apply to you. Do it for yourself, for your children and grandchildren."

Talking about sex and protection before you get to the bedroom is important, says Terri Orbuch, PhD, research scientist at University of Michigan's Institute for Social Research and relationship expert at SeniorPeopleMeet.com.

"Is that something that creates a lot of anxiety? Absolutely," Orbuch says. "It's the timing that's important and how you talk about it. If you share something about your current situation or your past, then your partner feels more comfortable with doing that with you."

Always own it first, agrees Forsythe. "You can say, 'I've had tests for STIs and I'm clean. What tests have you had? Let's share information.'"

Knowing the rules of the game today should make women feel empowered, says Forsythe. "Women who are 50-plus are coming into a secure time in their lives full of wisdom and strength. It should also apply to their sexuality."

QUESTION

Condoms are the best protection from sexually transmitted diseases (STDs). See Answer