HIV and STI testing in older adults: An integrative review

Aims and objectives: To examine the frequency of human immunodeficiency virus testing and sexually transmitted infection testing among older adults (50 years and older), present factors related to human immunodeficiency virus and sexually transmitted infection testing among older adults, and summarise the perspectives and practices of older adults and health care providers related to sexual health communication. Background: Reported cases of sexually transmitted infections and human immunodeficiency virus among older adults have increased, therefore refuting the stereotype of the sexually inactive older adult. Design: Integrative review. Methods: Database searches in PubMed, EMBASE, CINAHL, and Web of Science; manual reference list searches; and database searches for articles that cited previously identified articles. Results: There is limited research on this topic and considerable diversity in the populations studied and outcomes measured. The search process yielded 20 articles meeting the eligibility criteria. Human immunodeficiency virus and sexually transmitted infection testing of older adults are infrequent. Human immunodeficiency virus testing among older adults is associated with perceived risk of contracting human immunodeficiency virus and influenced by encouragement from health care providers. Sexually transmitted infection testing due to genital symptoms is more likely than asymptomatic screening. Few providers collect routine sexual histories from older adult patients, although older adults are receptive to sexual history taking. Conclusions: There are missed opportunities to identify sexually transmitted infections and human immunodeficiency virus in older adults. Stereotypes and assumptions have hindered providers from identifying and testing older adults at risk for human immunodeficiency virus and sexually transmitted infections. Relevance to clinical practice: Sexual health assessment is essential to comprehensive health care. A sexual history provides information that may indicate human immunodeficiency virus and sexually transmitted infection testing. Detection and treatment of human immunodeficiency virus and sexually transmitted infections will break the chain of infection and improve quality of life.