Risky heterosexual practices amongst women over 30: Gender, power and long term relationships

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Abstract
Statistics suggest that older and younger people are about equally at risk for HIV infection, yet existing research on heterosexuality and safer sexual practices has tended to focus on people under the age of 25. The present qualitative study investigates risk behaviours and the practice of safer sex in older populations. Group discussions comprising women over the age of 30 (n = 23) targeted two issues: the gendered power dimension of heterosexuality and safer sex in long term relationships. Cohort issues were also discussed. The discussion groups revealed that the imbalance of power between men and women which has been shown by previous research to constrain younger women's choices with regard to safer sex, continues to affect older women's decisions. Many of the group participants still found it difficult to assert themselves in sexual relationships and even those who were able to challenge overt pressures to engage in unsafe sex were still susceptible to internalized social pressures. In addition, it seems that risks for older age groups are increased by difficulties in continuing to use condoms in long term relationships where monogamy cannot be taken for granted. It was also apparent that there are difficulties in changing sexual behaviours which were established before HIV became an issue.The present study investigated risk behaviors and the practice of safer sex in older age groups focusing on heterosexual women's attitudes and behaviors. Group discussions with women over the age of 30 (n = 23) targeted the gendered power dimension of heterosexuality and safer sex in long term relationships. All were resident in the UK and lived in London. Ages ranged from 30 to 51 years, and the average age was 38 years. 22 of the participants described themselves as heterosexual; one described herself as bisexual. The 23 women were divided into three groups of six and one group of five. Virtually all the participants disliked condoms. Nonpenetrative sex was spontaneously mentioned as a method of safer sex in two of the four groups. However, only one person had actually chosen it as a method of safer sex. It was noticeable that whilst some participants reported a certain amount of empowerment in short term or casual relationships, the power differential seemed to be even greater in long term relationships. It is possible that women in long term relationships may indeed practice unsafe sexual behaviors through a need for trust. Many of the group participants still found it difficult to assert themselves in sexual relationships and even those who were able to challenge overt pressures to engage in unsafe sex were still susceptible to internalized social pressures. Change may be even more problematic because of social norms and gender-power imbalance. Cohort issues were also discussed. Women and men over 30 may be even more vulnerable to the difficulties inherent in changing behavior because they established their sexual behaviors at a time when the condom as a method of contraception had been superseded by the pill. The vast majority of participants had taken the pill and had not readily established a pattern of condom use.

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