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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

A Special Wellness-Inspired Abstinence-Only Program For Seniors

Friday December 14, 2007

An article entitled "A Warning On Safe Sex At Any Age" by P.J. Huffstutter (11/26/07) in the Los Angeles Times described a risky HIV generation gap that has left many seniors infected with sexually transmitted diseases, including AIDS. To close this gap, the Times writer suggested that efforts be made to encourage kids to explain the facts of life to their grandmothers and grandfathers. 

Actually, older folks know the facts about sexuality. The greater problems are that, like most Americans, religious dogmas and strictures and other unfortunate elements of the culture have rendered many seniors (and others) sexually repressed, sexually frustrated, guilt-laden about desiring sex and even guiltier on those happy occasions they actually manage to satisfy their natural human desires for sex. Given these and similar dysfunctional aspects of sexuality, an absence of frank discussions about sex and a less than full appreciation of the need for protections should not be surprising. Also to be expected are the fateful consequences of this perfect storm of ignorance, suppression and guilt.

Though the younger set may not want to think about it, the reality is that grandparents do, for the most part, remain sexually active. A 2006 NIH-funded survey described in the NEJM of 3,005 US adults aged 57 to 85 indicated that seniors have sex two to three times monthly. Yet, they infrequently discuss sexual matters (38% of the time for men; only 22% of the time for women), even with a doctor. 

Older people, just like college kids, run the risks of contracting sexually transmitted diseases when they fail to use condoms or other protections. California and a few other states have recognized this situation, and are funding programs to promote safe sex for elders. These efforts are not abstinence-based, thank goodness, though they would be if they wanted to obtain federal assistance. In the latter case, elder sex education programs would have to hue to Bush Administration guidelines that promote abstinence-only messages - until marriage! Presumably, even then only for procreation. Hopefully, instructors in faith-based abstinence program for seniors (and others, for that matter) will find ways to ignore or circumvent such insane requirements, but doing so risks loss of funding. Imagine telling granny and grandpop to save themselves for marriage -- and then only to go at it if they intend to have more babies. Most seniors have spent themselves in this fashion long ago and probably don't care to marry again in their 80's just to whoop it up under circumstances consistent with Bush Administration teachings. Then again, the lunatic Righteous Right might insist that seniors do just that. I would not put it past them. 

While there is a problem with HIV and seniors, it's nothing like the problem in younger, more sexually active groups. There are four times as many HIV diagnoses among 25 to 44 year-olds as in those 50 and older, according to a 2005 report by the Centers for Disease Control and Prevention. Yet, that there is a problem at all with older folks comes as a shock to many. This shock is probably most intense in those seniors who are given the horrific news that they have contracted HIV or other STDs.

I propose that special wellness-inspired abstinence-only programs be set up for seniors all across the land, incorporated whenever possible into facilities that already serve seniors. Wellness-inspired is construed to mean making sexuality responsible, informed, a choice and a joy. Education should focus on portraying sex realistically, free of any constrictions that are not evidence-based shown to be harmful or hazardous. Sexuality should, like wellness, be expressed in positive ways, for pleasure and joy and without recriminations or guilt. Such efforts should be abstinence-based, by which I mean "abstain from unprotected sex" unless you are sure of your partner (in other words, long-term monogamous with you and you alone). Here are some additional tips:

• If needed, try hormone therapy and erectile dysfunction drugs. For that matter, if you need them, use toys, devices (handcuffs, chains, whips) and dungeons - just kidding but, hey, live and let live.
  
  
• Stay informed. Getting old is not a precaution against any of the hazards of unprotected sex, except maybe pregnancy and even then, you never know. 
  
  
• Use condoms and, if you can afford it, give them (and sound information, if requested) to your senior friends.
  
  
• Don't be shy to talk about sex or, for that matter, asking for it. Just boost your chances by becoming or remaining fit, being a sincere charmer, and developing the high art of sexually appropriate attitudes and behaviors. The latter must be somewhat consistent with the culture of which you are a part. If you live in the Middle East or Alabama, nothing in this essay is appropriate to try at home.
  
  
• Don't take "no" as a personal rejection, even if it is.
  
  
• Become an expert on sex. It's a great topic. Furthermore, the applications of the art of sexuality can be quite rewarding. Spreading sound information is also a terrific public service. In Broward County, Fla., a "Senior HIV Intervention Project" trains randy old goats for just this kind of role. Accredited "safe-sexperts" urge others to be cautious and to get tested for STDs. As far as I know, the program leaders have not included my kind of abstinence-only educational features, but the future lies ahead. 

There is much more to consider for a full-blown wellness-inspired abstinence-only program for seniors, but this might be enough to start some discussion about the concept.

All the best, be well and happy sexuality. Always look on the bright side of life.

Domain: mental
Subdomain: factual knowledge

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