SRH service utilization among older PLHIV in China was low, with utilization significantly correlated with sex, education, income, physical health conditions, employment, sexual orientation, and psychosocial factors.
Overall SRH service utilization among older PLHIV in China was low across all four measured service types.
Female sex, higher education, higher income, and having a physical health condition were independently associated with greater likelihood of receiving a reproductive health examination.
Employment, physical health condition, homosexual orientation, and reported sexual desire were independently associated with greater likelihood of receiving STI testing.
Urban residence, higher education, depression, bisexual orientation, and sexual satisfaction were positively associated with seeking sexual life counseling.
Among female participants, higher education, higher income, and having a physical health condition were associated with greater likelihood of cervical cancer screening.
The study population was predominantly male and relatively older, reflecting the demographic of older PLHIV enrolled at HIV/AIDS treatment hospitals in China.
This research examined how often older people living with HIV (age 50 and above) in China use sexual and reproductive health (SRH) services, and what factors are associated with using those services. The study surveyed 680 people at HIV/AIDS treatment hospitals across China and asked about four services: reproductive health exams, STI testing, sexual health counseling, and cervical cancer screening. The findings revealed that use of these services was quite low — fewer than 1 in 5 participants had a reproductive health exam, and fewer than 1 in 10 had STI testing. The study found that several social and health factors were linked to higher service use. People with more education and higher incomes were more likely to use most types of SRH services. Having an existing physical health condition was consistently associated with greater service use across all four categories, possibly because those individuals already have more contact with the healthcare system. For STI testing specifically, being employed, identifying as homosexual, and reporting sexual desire were associated with higher use. Notably, depression was associated with seeking sexual life counseling, and urban residence was a strong predictor of counseling use, suggesting rural older PLHIV may face significant access barriers. This research suggests that older people living with HIV in China are underserved when it comes to sexual and reproductive health care, and that gaps in service use are linked to socioeconomic disadvantage, rural location, and specific demographic characteristics. The authors conclude that tailored SRH messaging and services for this population could help improve utilization, particularly for those who are less educated, lower income, or living outside of urban areas.
Peng X, Li X, Wang B, Wang Y, Xu P, Lu Y, et al.. (2025). Correlates of the sexual and reproductive health service utilization among older people living with HIV in China: Findings from the sexual well-being (SWELL) Study.. Public health. https://doi.org/10.1016/j.puhe.2025.105729