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Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk

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Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk UNLV Theses, Dissertations, Professional Papers, and Capstones 8-1-2020 Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk Alexus Miranda Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Geriatrics Commons, Public Health Commons, and the Virus Diseases Commons Repository Citation Miranda, Alexus, "Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk" (2020). UNLV Theses, Dissertations, Professional Papers, and Capstones. 4012. http://dx.doi.org/10.34917/22110077 This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. SEXUALLY TRANSMITTED INFECTIONS AND THE 65 AND OLDER POPULATION: KNOWLEDGE AND PERCEIVED RISK By Alexus Maurine Miranda Bachelor of Science – Biological Sciences Chapman University 2014 A thesis submitted in partial fulfillment of the requirements for the Master of Public HealtH Department of Environmental and Occupational HealtH School of Public HealtH The Graduate College University of Nevada, Las Vegas August 2020 Copyright 2020 by Alexus Maurine Miranda All Rights Reserved Thesis Approval The Graduate College The University of Nevada, Las Vegas August 11, 2020 This thesis prepared by Alexus Maurine Miranda entitled Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk is approved in partial fulfillment of the requirements for the degree of Master of Public Health Department of Environmental and Occupational Health Melva Thompson-Robinson, DrPH. Kathryn Hausbeck Korgan, Ph.D. Examination Committee Chair Graduate College Dean Courtney Coughenour, Ph.D. Examination Committee Member Amanda Morgan, DHS Examination Committee Member Susan Van Beuge, DNP Graduate College Faculty Representative ii Abstract Sexually transmitted infections (STI) can impact all persons. Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office treatments of STIs between 2014 and 2017 (Howley, 2018). The purpose of this study was to use the Sexual Health Model to examine the relationship between various predictors and these persons’ perceived risk of STIs, tHeir STI knowledge, and other barriers that impact the sexual health of persons 65 years of age and older. This study used a 30-item survey to assess these predictors. The data collected was analyzed via IBM SPSS version 25 using descriptive statistics, chi- square/correlation, and multiple linear regression. The findings of this study indicated a few predictors that impact sexual health of those 65 years of age and older, including gender, Medicare enrollment, and STI knowledge. Although this study had its limitations, it is one of the few examining sexual health within the 65 and older population. Even though some predictors were identified, this study highlights the need for sexual health education within the 65 and older population, especially between health care providers and patients of this age group. iii Acknowledgments I want to thank Dr. Melva Thompson-Robinson for her constant support, patience, and advisement throughout my thesis. I am extremely grateful for her help with this project. I also wanted to thank Dr. Courtney Coughenour, Dr. Amanda Morgan, and Dr. Susan VanBeuge for giving their time to serve on my committee. I am incredibly grateful. I would like to give a special thank you to Nevada Heart and Vascular for the availability and use of their office to obtain data. Additionally, a special thanks to their office staff and medical assistants for helping with the data collection. Lastly, I would like to thank my family and friends for their constant support and encouragement. A special thank you to my grandmother for being the inspiration behind this project. These past few years have been some of the most challenging; however, thank you for helping me through my thesis journey. Your love and support mean the world to me. iv Table of Contents Abstract ....................................................................................................................................... iii Acknowledgments ........................................................................................................................ iv List of Tables ............................................................................................................................... vi Chapter 1: Introduction ................................................................................................................ 1 Chapter 2: Literature Review ....................................................................................................... 3 Chapter 3: Methods ..................................................................................................................... 16 Chapter 4: Results ....................................................................................................................... 25 Chapter 5: Discussion ................................................................................................................. 36 Chapter 6: Conclusion ................................................................................................................. 42 Appendix ..................................................................................................................................... 44 References ................................................................................................................................... 57 Curriculum Vitae ........................................................................................................................ 65 v List of Tables Table 1: Independent and Dependent Variables and Relation to their Research Question ........ 16 Table 2: Survey Questions, their Constructs, and Relation to the Research Question ............... 21 Table 3: Each Research Question and the Statistical Technique that was used Answered it ..... 24 Table 4: Demographic Data from Participants Who Completed the Survey ............................. 26 Table 5: Percentage of Correct Responses to STI Knowledge Questions .................................. 27 Table 6: Percentage of Responses to Perceived Risk Questions ................................................ 29 Table 7: Multiple-Linear Regression Model Examining the Predictors of Perceived Risk of Contracting an STI in Persons 65 and Older in Clark County? .................................................. 31 Table 8: Percentage of Responses to Comfort and Frequency of Talking to Physicians About Sexual HealtH .............................................................................................................................. 32 Table 9: Multiple-Linear Regression Model for Comfort of Talking with Physician About Sexual Health .......................................................................................................................................... 34 Table 10: Multiple-Linear Regression Model for Frequency of Talking with Physician About Sexual HealtH .............................................................................................................................. 35 vi Chapter 1: Introduction Sexually transmitted diseases (STDs), sometimes called sexually transmitted infections (STIs), are very common and can be passed from one person to another via vaginal, oral, or anal sex (CDC, 2018b). Diseases that are spread through sexual contact are usually referred to as STDs; however, a new term is emerging, STI (ASHA, n.d.). The change from “disease” to “infection,” is because disease suggests a clear medical problem with obvious signs and/or symptoms and most STDs do not have any signs and/or symptoms (ASHA, n.d.). If signs and/or symptoms are present, they are most often mild and then can be referred to as an infection, which may or may not lead to a disease (ASHA, n.d.). This term has not been accepted by everyone in the medical and public health fields (ASHA, n.d.), but for the purpose of this paper, STI will be used. People aged 65 and older are not the first group that comes to mind when discussing STIs. The assumption is that persons 65 and older are less sexually active than their younger counterparts, whicH is not always the case (Purpora, 2012). STDs/STIs do not discriminate against age, gender, or sexualities; they affect persons from all types of backgrounds (ASHA, n.d.). Due to medical advancements, including medications, people are able to live longer, despite health issues, including sexual health issues (Howley, 2018). Since 2000, the number of STIs has steadily increased among persons aged 50 years and older in the United States (Purpora, 2012). Persons over the age of 60 accounted for the biggest increase of in-office
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