Middle-aged and older adults can co-create compelling strategies to enhance sexual health services, with findings suggesting a multi-leveled approach is required to improve accessibility and inclusivity of sexual health services for adults aged 45 and over in the UK.
Key Findings
Results
A crowdsourcing open call and co-creation events identified five key themes for improving sexual health services for adults aged 45 and over in the UK.
The five themes were: increase sexual health education, enhance patient and provider relationships, utilize community-led sexual health promotion and delivery of reliable information, improve inclusive sexual health services, and break down sexual health taboos against adults aged 45+
Data were collected via a national crowdsourcing open call and seven co-creation events consisting of workshop-style meetings and one-to-one in-depth interviews
A social-ecological framework was used for deductive coding, with new codes allowed to emerge inductively
Thematic categories were organized to describe factors influencing accessibility and inclusivity of sexual health services for middle-aged and older adults
Results
The study received 22 total submissions, with notable representation from people with disabilities and middle-aged adults.
35% of participants reported a disability
40% of individuals were aged 45–65 years
6% of submissions came from individuals who identified as gay/lesbian
The sample was drawn from a national UK crowdsourcing open call
Background
Sexual health research has historically focused on young adults, creating a gap in knowledge and services for those aged 45 and older.
The authors note that 'sexual health research often focuses on young adults and excludes those aged 45 years and older'
Sexual health is described as 'an essential component of health and well-being across the life course'
The study was designed specifically to address the underrepresentation of middle-aged and older adults in sexual health research and service design
Results
A multi-leveled approach is necessary to improve sexual health service provision for middle-aged and older adults.
The five themes collectively indicate that improvements are needed at individual, interpersonal, community, and structural levels
Themes included both provider-level changes (enhancing patient-provider relationships) and systemic changes (improving inclusive services)
Community-led efforts were identified as a key mechanism for sexual health promotion and information delivery
Breaking down taboos was identified as a distinct and necessary component of improving services
Conclusions
Middle-aged and older adults were found capable of co-creating strategies to enhance sexual health services for their own demographic.
The authors conclude that 'middle-aged and older adults can co-create compelling strategies to enhance sexual health services for middle-aged and older adults in the UK'
Co-creation events used participatory workshop-style meetings and one-to-one in-depth interviews
The authors call for 'further implementation research to pilot these strategies'
The community-engaged methodology (crowdsourcing and co-creation) was central to generating actionable recommendations
What This Means
This research suggests that adults aged 45 and older are largely overlooked in sexual health research and services, even though sexual health remains important throughout life. To address this gap, researchers in the UK organized a national open call for ideas and a series of co-creation workshops and interviews, inviting middle-aged and older adults—including people with disabilities and LGBTQ+ individuals—to help identify ways to improve sexual health services for their age group. In total, 22 people participated and contributed to the analysis.
The study identified five main areas where improvements are needed: better sexual health education for this age group, stronger and more respectful relationships between patients and healthcare providers, community-led efforts to promote sexual health and share reliable information, more inclusive services that account for diverse needs and identities, and active efforts to reduce the stigma and taboos that discourage older adults from seeking sexual health care. These findings point to the need for changes at multiple levels—from individual attitudes to healthcare systems.
This research suggests that meaningful improvements to sexual health services for older adults require involving those adults in designing the solutions. The participatory approach used in this study demonstrated that middle-aged and older adults have valuable insights and can contribute actionable recommendations. The authors call for future studies to test and implement these strategies in real-world settings, highlighting that this work is an important step toward more age-inclusive sexual healthcare in the UK.
Nunez M, Sakuma Y, Conyers H, Day S, Terris-Prestholt F, Ong J, et al.. (2024). Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis.. Sexual health. https://doi.org/10.1071/SH24143