Aging, Sexuality, and HIV Issues among Older Gay Men

Article excerpt

ABSTRACT: This study reports on one-on-one interviews with gay and bisexual men age forty and over, concerning their sexuality in the context of HIV. Respondents report a range of age-related issues that impact on safer sex decision-making including decreased attractiveness, widowerhood, loss of support networks from AIDS, and anticipated future quality of life, as well as strengths and satisfactions that decrease their risk. Respondents typically attributed unsafe sex in other men to popular discourses around (1) condom fatigue, (2) treatment optimism, and (3) inserter invulnerability, but deny that these ideas explain their own behaviour. They identify their own risk situations with: depression, impending mortality, "trading off" safe sex, and the effect of condoms in keeping erections. Community-building projects that begin to address risk situations have followed from this research with the AIDS Committee of Toronto.

Key words: Aging Gay men HIV risk

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A large majority of HIV/AIDS prevention efforts aimed at the gay community have emphasized younger gay men. Attention has been focused on the vulnerability of gay youth to HIV infection. HIV/ AIDS prevention materials and outreach prevention efforts have, thus, tended to reflect, and be oriented towards, the needs and social-cultural environment of younger gay men. However, gay men aged 40 and over represent a large segment of the population who have become HIV positive (HIV+). As of the end of 2000, men aged 40 and over made up 29% of the positive HIV test results reported among males in Canada and men having sex with men (MSM) is the largest exposure category in this age group (Health Canada, 2001). Similarly, in the United States, men aged 40 and over made up 26% of infection cases among males reported through June 2001 (CDC, 2002). Given these statistics, it is clear that older gay men, like people in other HIV risk categories, require HIV/AIDS risk reduction information and services that are directly pertinent to their group specific needs and circumstances. A fundamental principle that has emerged from the past decade and a half of HIV/AIDS prevention efforts is that in order to be effective, prevention programs cannot be generic but must be tailored to the demographic profile of the target audience and the socio-cultural environment in which they live. This may be particularly the case for adult gay men for whom a key part of their identity may be tied to the socio-sexual norms, beliefs, and practices of their environment (Kertzner, 2001).

The topic of older gay and bisexual men has received some attention in the social science literature (e.g., Berger, 1996; Grossman, D'Augelli & Hershberger, 2000; Lee, 1989; Vacha, 1985). However, research on aging and sexuality among older gay men with respect to how these issues relate to HIV risk and prevention is limited. Kooperman (1994), in a study of gay and bisexual men age 50 and over from the United States, Canada, and Australia found that nearly three quarters had been sexually active in the previous thirty days and most felt that the AIDS epidemic had had some degree of impact on their sexual behaviour. However, the study did not examine how contextual factors related to sexuality and aging might be related to HIV risk in these men. Kertzner (2001) interviewed 30 men, with an average age of 46, about their perceptions of the adult life course as it relates to homosexual identity. As a group, these men showed high levels of commitment to homosexual identity, self-esteem, and life satisfaction. However, some men expressed the view that gay life was "the province of the young and the beautiful" thus excluding or alienating older gay men. In the current study, we pursued a similar avenue of research but with a specific focus on how life course factors relate to HIV issues among older gay men.

The AIDS Committee of Toronto (ACT) initiated a series of interviews and focus groups among gay and bisexual men over forty to gain some insight into their HIV prevention needs and concerns. …