Older people mostly in low income countries suffer from ‘misperception’ of sexual and reproductive health and rights (SRHR), experts at an international conference said.
“There is a common misperception that older people are not sexually active, and so they do not need sexual health services and counseling,” Sono Aibe, a US based independent consultant who works with philanthropic and non-profit organizations, said.
She was chairing the seventh episode of the 10th Asia Pacific Conference on Reproductive and Sexual Health and Rights (APCRSHR10) held virtually for Covid-19 pandemic on Monday.
The APCRSHR10 secretariat in Cambodia - Reproductive Health Association of Cambodia (RHAC) and the CNS are co-hosting all the virtual sessions.
Sexuality of older people is almost a taboo subject. Most of the discussions are focussed on sexual dysfunctions and sexual matters are barely discussed even in the context of regular healthcare among health professionals. Target 3.7 of the SDG-3 talks of ‘universal access’ to sexual and reproductive health services.
Sono Aibe said getting old is the fact of life. “We are all ageing day by day and we have to own that fact as living beings.”
“But we see a lot of negative images of the elderly people and we all fear losing youthfulness. Ageism is discrimination that is based on assumptions about what happens to us when we all age,” she said.
“In the low income countries, where healthcare resources are already very stretched, women who are not reached by reproductive and maternal health programs, might be missing age appropriate preventive health education or regular check-ups; and needless tests from preventable reproductive cancer could occur and people are often left to deal with sometimes debilitating symptoms and also psychological impacts brought about by hormonal changes al on their own.”
“So our commitment to SRHR needs means that we have to work to make the SRH needs of all people throughout their life cycle,” she said.
“This is what we had pledged at the 1994 international conference on population and development. Yet 26 years later we are still barely keeping up with meeting the needs of an increasing number of married women in reproductive age of 15-49 years.”
Sai Jyothirmal Racheria, Programme Director at Asia Pacific Resource Centre for Women (ARROW), said Asia and the Pacific region faces a rapidly ageing demographic.
As per 2019 estimates, 548 million (60%) of the world’s older population reside in the Asia-Pacific region. This number is expected to increase to nearly 1.3 billion by 2050. Women comprise 52.9% of the older population in this region.
“The pace of ageing in this region is also rapid. Countries like China, Thailand and Vietnam will take only 25 years, 22 years and 19 years for moving from ageing to aged societies, countries such as France have taken 115 years,” she said.
She recommended a “concerted research” effort for pinpointing essential indicators to provide a basis for developing and strengthening implementation of comprehensive and integrated policy frameworks that address and mainstream population ageing into national development strategies and plans.
“Align disease prevention and health systems and advance universal health coverage, so that all older persons have access to quality health services without out of pocket expenses.
“Develop health and social long-term care systems, including palliative care, to deliver high-quality integrated care. Health services for older persons need to ensure mental as well as physical health, address violence, neglect and abuse of older persons, promote positive images of ageing, prevent ageism and age-related discrimination at the workplace,” she recommended.
Caitlin Littleton, Regional Programme Adviser at HelpAge International, Asia Pacific Region, highlighted four key false beliefs about sexuality among older adults.
“First, older people are not able to have sex- In reality inability to have sexual intercourse is linked with health issues rather than age.
“Second, older people do not want to have sex - In reality many older people continue to desire sex for the same reasons younger age groups do that for pleasure, relationships, reducing stress and increased wellbeing.
“Third, older people should not have sex- This is a largely an external viewpoint- strongly reinforced by media and societal norms and some older people internalise this message. In reality every adult should be able to safely and fully express their sexuality with respect to the rights of others.
“Fourth, older people do not have sex- In reality cultural beliefs and norms, marital status, gender/sex, sexual orientation, physical and mental health- all influence sexual practice (a 2009 global survey of sexual behaviour in 26 countries corroborates this). Just as with any age, there is a large variety in sexual frequency, activities, satisfaction, etc.”
Dr Tey Nai Peng, Associate Professor at the Department of Applied Statistics, University of Malaya, said there is a misconception that individuals become asexual as they get older.
One study shows that about half of older Malaysians still have a sexual desire. Most of the older people still maintained an intimate relationship with their spouses, he said.
“About 80% were sharing a bed and holding hands, and nearly 66% still hugged and kissed the spouse. Overall, 57% of older men and 47% of older women had sex with their spouse.
“The percentage of men still having sex with wife decreased from 73% among those aged 60-64 to 30% among those aged 75+, while the corresponding figures for females were 58% and 17% respectively,” he said.