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This article reports on older women's experiences and advice on condom use, male-female relationships, HIV risk, and prevention education. It reports on findings from five written, open-ended questions with 110 ethnically and economically diverse women, 40-80 years old. Analysis revealed four themes: (a) Gap between condom use advice and condom use behavior; (b) invisibility with age; (c) negative expectations of men; and (d) desire for education that breaks the silence on sex. The article discusses the meaning of the findings as they relate to current knowledge about HIV prevention education and midlife and older women and offers recommendations for research and education.


Third, declines in immigration have reduced population momentum by limiting the number of young adults of reproductive age who are moving to the United States and starting families. The number of women ages 25 to 44 increased by 35 percent (from 31.8 million to 42.9 million) from 1980 to 2017, but is projected to increase by only 15 percent between 2017 and 2060 (to 49.3 million). Slower growth in the number of women of reproductive age, in combination with falling fertility rates, is resulting in fewer births and children relative to the number of older adults in the population.


Women live longer on average than men in the United States and in nearly every country in the world. But in the United States, the gender gap among older adults has shifted during the past century. At the turn of the 20th century, there were 102 older men (ages 65 and older) per 100 older women. By 1990, the sex ratio among the older adult population had fallen to 67, its lowest recorded level.5 Since then, the sex ratio among adults ages 65 and older has rebounded and is projected to increase to 81 by 2020 and to 86 by 2060.


In an older woman-younger man relationship, the woman is sometimes called a 'cougar,' in reference to the animal's predatory behavior. While some women embrace the term, most view it negatively or have mixed feelings about it.


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Eighteen percent of older men and 3 percent of older women say they've taken medications or supplements to improve sexual function in the past two years. But only 17 percent of older adults said they have talked with their doctor or other health care provider about sexual health in the past two years. Most who had engaged in such discussions said they brought the topic up, suggesting the need for more proactive conversations by clinicians with their older patients.


But the biggest gender difference was the percentage of those who said they were extremely or very interested in sex. Half of men aged 65 to 80 said they had this level of interest, compared with just 12 percent of women in the same age range.


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Lobo RA. Menopause and care of the mature woman: endocrinology, consequences of estrogen deficiency, effects of hormone therapy, and other treatment options. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 14.


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Before the pandemic, roughly half of older persons in some developing countries lacked access to essential health services. And the scaling back of critical health services unrelated to COVID-19 have further increased risks to the lives of older persons. Two in five older women (40%) had difficulty accessing sanitary and health products, and a third (34%) had trouble accessing medical care. Considering that older women are likely to have chronic illnesses, their restricted access to medical care is especially worrisome since it can have serious consequences.


Through the Women Count programme, UN Women is intensifying its efforts to systematically collect and analyse data on specific subgroups of women, to intentionally apply an intersectional lens. This is key to making sure that all women are counted and visible.


Ghida Ismail is a statistics consultant with UN Women's Women Count programme. Since 2017, she has been working with international organizations on using data and evidence to optimize policy-making on social and economic issues in the Middle East, East Africa, and South Asia, including women's economic empowerment, social protections for informal workers, social cohesion of displaced populations, and farmers empowerment.


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