HIV transmission is dependent on the route of acquisition, the infecting viral load and the presence of inflammation and activated immune system cells below mucosal surfaces.8 Addressing these factors lowers HIV transmissibility. Unprotected, especially receptive, anal sex remains a high-risk behaviour for HIV transmission with a transmission risk about 18 times higher than for penile-vaginal sex, and is a major driver of high HIV rates among MSM.9 IDUs who inject themselves with HIV-contaminated needles provide a direct access point for HIV, and established infection can therefore occur with relatively lower viral loads. CSWs are likely to transmit HIV if they become infected themselves because of the greater number of sex partners that they encounter. All these population groups benefit from targeted HIV programmes.
Everyone knows life doesn’t stop at 45, yet many people think sex does.
As we mature, many gay men feel distanced from or unwelcome at some social venues such as clubs or bars that cater to a younger crowd. Even on gay websites, some younger guys make older men feel unwelcome or make us feel as if we have become unattractive or simply invisible. Gay men sometimes treat each other as mere physical objects and we may feel judged purely on the basis of our age and our appearance, leaving us feeling socially and sexually undesirable.
Many safer sex campaigns focus on younger guys, perhaps forgetting that we remain sexual beings as we get older.
What You Should Know
- Having sex at a mature age carries the same health risks as it does for younger guys. We remain susceptible to contracting HIV and other sexually transmitted infections (STIs), especially if we are receptive (bottom) for oral or anal sex. We can also transmit such infections to our partners.
- HIV and other STIs are sometimes overlooked in older people; healthcare providers forget that we may still be sexually active, and the symptoms of HIV may be similar to the natural effects of the ageing process. It is therefore important that you get tested for HIV and other STIs.
- Conditions attributed to ageing, such as diabetes, cardiovascular problems and arthritis may occur earlier in men who are HIV positive, who may also be more prone to forgetfulness and depression.
What Can You Do?
- There are many reasons to stop smoking and drinking, including the fact that nicotine and alcohol contribute to erectile dysfunction (ED). Cholesterol can also be a contributing factor. HIV itself can cause ED, as can taking medication (including ARVs).
- Some healthcare providers are uncomfortable talking about sex, especially with an older person. If you have concerns or questions and need to talk about sex, raise the subject yourself.
- Don’t use any products to boost your sexual functioning without your healthcare provider’s consent.