Sexual health in older Nigerians is shaped by a complex interplay of cultural norms, structural neglect, and limited policy attention, with older adults remaining sexually active but facing significant barriers to sexual wellbeing.
Key Findings
Methods
Seventeen studies published between 2003 and 2024 met inclusion criteria for this systematic review of sexual health among Nigerians aged 60 years and over.
Studies were identified from PubMed, Web of Science, and Scopus databases
The review followed PRISMA 2020 guidelines and was registered on PROSPERO (CRD420251064655)
Eligible studies reported on sexual activity, dysfunction, satisfaction, condom use, STI and HIV knowledge, or health service use
Data were synthesised using narrative synthesis and an aggregative approach from Synthesis Without Meta-analysis (SWiM)
Results
Older Nigerians remain sexually active despite facing significant barriers to sexual wellbeing.
Sexual activity among adults aged 60 and over was documented across the included studies
Barriers identified included cultural taboos, gender norms, and health system neglect
The review covered a 21-year span of evidence (2003–2024)
Results
Gendered expectations privilege male sexuality while discouraging female sexual expression among older Nigerians.
Cultural norms were identified as a key theme shaping sexual health outcomes
Female sexual expression was actively discouraged by prevailing social norms
Older women were identified as underrepresented in the literature, suggesting a compounded research gap
Results
Misconceptions around HIV transmission persist among older Nigerians despite widespread awareness of HIV.
HIV knowledge was one of the eligible outcome domains for included studies
Awareness of HIV did not translate into accurate understanding of transmission
Condom use remained low among this population
Results
Cultural norms and provider discomfort inhibit uptake of sexual and reproductive health services among older Nigerians.
Health system neglect was identified as a structural barrier to sexual health services
Provider discomfort with discussing sexual health in older adults was noted as a specific barrier
Traditional healers were often preferred by older adults for their perceived respectfulness
This preference for traditional healers over formal health services was identified as a key finding
Results
Older women, rural populations, and people with disabilities remain underrepresented in the Nigerian older adult sexual health literature.
These subgroups were identified as having insufficient representation across the 17 included studies
This underrepresentation was categorised as a gap in knowledge
The finding points to inequities in research attention that may reflect broader structural neglect
Conclusions
Integrating age-sensitive and gender-sensitive approaches into geriatric care and sexual and reproductive health programming is identified as essential to meet the needs of Nigeria's growing older population.
The recommendation addresses gaps in both policy and clinical practice
The review identified limited policy attention to older adult sexual health as a structural gap
The growing size of Nigeria's older adult population was cited as a driver of urgency for intervention
What This Means
This research synthesised 17 studies published over more than two decades (2003–2024) to understand what is known about the sexual health of Nigerians aged 60 and older. The studies were identified through a rigorous systematic review process across major scientific databases. The review found that older Nigerians are sexually active but face a range of obstacles that harm their sexual wellbeing, including cultural taboos, gender-based double standards that allow men to express sexuality while discouraging women, low condom use, and persistent misunderstandings about how HIV is transmitted — even among those who are aware that HIV exists.
The research also found that older adults often avoid formal healthcare settings when it comes to sexual health, partly because healthcare providers themselves are uncomfortable discussing the topic with older patients. Many older Nigerians instead turn to traditional healers, who are seen as more respectful. Certain groups — particularly older women, people living in rural areas, and people with disabilities — are almost entirely absent from the existing research, meaning even less is known about their specific needs and experiences.
This research suggests that Nigeria's health system and policymakers need to pay much more attention to the sexual health of older adults. This includes training healthcare providers to address sexual health sensitively across age groups, developing health programmes that account for gender inequalities, and conducting more research that includes the most overlooked populations. As Nigeria's older adult population continues to grow, addressing these gaps becomes increasingly important for overall public health.
Lukwa A, Akinsolu F, Abodunrin O, Okova D, Koledowo A, Hassan S, et al.. (2026). Sexual health among older adults in Nigeria: a systematic review of evidence, gaps, and opportunities for intervention.. Sexual health. https://doi.org/10.1071/SH25089