Sexual health among older adults in China and the United Kingdom: A multi-disciplinary study

在19世纪中期，活到50岁以上的人并不多见。医学的显著进步已经造成了巨大的人口变化，导致更多的老年人，在本申请中定义为50岁及以上。世界人口的老龄化对性健康有重要影响。越来越多的老年人长期维持充满活力的性生活和亲密关系，需要支持和医疗建议来优化他们的性健康。与此同时，一系列相关的虚弱和残疾以及权力不平衡可能增加一些老年人无保护性行为和艾滋病毒/性传播感染的风险。性健康是世界各地老年人越来越重要的话题，但我们传统的学科方法回避这个话题。许多性健康研究都集中在年轻人身上，忽视了正在发生的巨大人口变化，并错误地认为“年龄是安全套。“我们的中英联合团队在行为科学、社会学、人类学、医学和公共卫生领域拥有丰富的经验。英国和中国人口老龄化的普遍性要求创新的解决方案，以确定与性健康相关的需求和障碍以及性健康服务的差距，并确保它们是包容性的，赋权的和可靠的。利用我们的多学科团队，我们提出了以下具体目标：目标1：使用流行病学研究来了解中国老年人的性健康和幸福，并与英国全国性态度和生活方式调查（NATSAL 3）的现有数据进行比较。目的2：确定不同的老年人之间的性健康服务的偏好，使用离散选择实验（DCEs）。目标3：通过两个平行的众包竞赛，识别高质量的信息，以促进中国和英国老年人对包容性健康服务的接受。目标4：就如何使性健康服务更适应老年人在不同环境中的需求和偏好提出政策建议。DCE是一种基于调查的方法，可以量化参与者对医疗服务的偏好，通过观察参与者如何在各种属性之间进行权衡来评估哪些属性对参与者最重要。众包竞赛允许一组人解决一个问题，然后与更广泛的公众分享解决方案。众包干预措施成功地使边缘化群体参与艾滋病毒检测方案的制定，改善了艾滋病毒检测和避孕套的使用。

People who lived beyond the age of fifty years were uncommon in the mid-1800s. Remarkable advances in medicine have created substantial demographic changes, resulting in larger numbers of older adults, defined in this application as 50 years and older. This greying of the world's population has important implications for sexual health. An increasing number of older population sustain vibrant sexual lives and intimate relationships for a long period, needing support and medical advice on optimizing their sexual health. At the same time, a range of related frailties and disabilities alongside power imbalances may increase the risk of unprotected sex and HIV/sexually transmitted infections among some older adults. Sexual health is an increasingly important topic among elderly individuals across the world, but our conventional disciplinary approaches shy away from the topic. Much of the sexual health research has focused on youth, ignoring the tremendous demographic changes underway and incorrectly assuming that "age is a condom." Our UK-China joint team has a rich experience in behavioural science, sociology, anthropology, medicine, and public health. The common greying of the population in the UK and China demands innovative solutions to identify needs and barriers relevant to sexual health and gaps in sexual health services and ensure that they are inclusive, empowering, and reliable. Leveraging our multi-disciplinary team, we propose the following specific aims:Aim 1: Using an epidemiological study to understand sexual health and wellbeing among older adults in China, in comparison to existing data from National Survey of Sexual Attitudes and Lifestyles (NATSAL 3) in the UK. Aim 2: Determine preferences for sexual health services among diverse older adults, using discrete choice experiments (DCEs). Aim 3: Identify high-quality messages to promote uptake of inclusive sexual health services among older adults in China and the UK through two parallel crowdsourcing contests.Aim 4: Create policy recommendations about how to make sexual health services more adaptive to older adults' needs and preferences in diverse settings.DCEs are a survey-based method that quantifies participants' preferences for health care delivery, evaluating which attributes are most important to participants by observing how participants trade-off between various attributes. A crowdsourcing contest allows a group to solve a problem and then shares solutions with the wider public. Crowdsourcing interventions have successfully engaged marginalized groups in HIV testing program development, improved HIV test and condom use.