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The Effectiveness of Safe Sex

Education on Promoting Healthy

Sexual Behavior, Self-Efficacy and
Knowledge in Older Adults
Natalie Beal, ELM Student, Elise Martinez, ELM Student
Sarah Roberts, ELM Student and Charity Smith, ELM Student


Theoretical Framework

Improvements in healthcare and the availability of

various medications, are allowing the older
population to live longer and remain sexually
active. However, with sexual activity comes the
potential for acquiring and spreading sexually
transmitted infections (STIs). Of the people with
HIV/AIDS in the US, nearly a quarter are age 55
and older (CDC, 2013). While HIV is the most
reported and studied, it is not the only STI causing
morbidity in older adults (WHO, 2013). The
literature reveals that safe sex education is
predominantly directed at young adults and
remains a rarely discussed topic in the older

This theory-driven study will utilize the Health

Promotion Model (Pender, 2001) to potentially
increase the health-promoting behaviors in older

To improve self-efficacy, STI knowledge and
healthy behaviors of older adults, aged 55 and over,
through a theory-based intervention promoting
healthy sexual behaviors by providing STI
information and safe sex practice education.

We hypothesize that there will be a significant
improvement in self-efficacy and safe sex practices
following a safe sex education program verses a
comparison group receiving only an informational

Proposed Methodology
A prospective quasi-experimental pre-test/post-test
design with a convenience sample of 110
participants, aged 55+, in a senior living
community, randomly assigned to either the
intervention group or comparison group. The
Canadian Sexual Health Indicators Survey
(Smylie et al., 2013) will be used to measure the
effects of a safe sex education program
(independent variable) on self-efficacy, STI
(dependent variables) in older adults.

Figure 1: Penders Health Promotion Model, with the

proposed intervention point and specified variables.

Nursing Implications
Nurses play an integral role in bridging the
generational gap that often fails to address the
sexual health needs of the older adult. This nursing
intervention of safe-sex education presents the
opportunity to neutralize the sense of taboo
associated with the older adult's sexual activities
through the promotion of self-efficacy and healthy
behaviors, and may lead to a healthy behavior
change that will support older adults during this
life transition.

1. Center for Disease Control and Prevention (2013). HIV Among Older
Americans. Retrieved from:
2. Pender, Nola, J. (2011). Health Promotion Model Manual. Deep Blue.
University of Michigan. Retrieved from:
3. Smylie, L., Clarke, B., Doherty, M., Gahagan, J., Numer, M., Otis, J., & ...
Soon, C. (2013). The development and validation of sexual health
indicators of canadians aged 16-24 years. Public Health Reports,
128(Supp 1), 53-61.
4. World Health Organization (2013). Sexually transmitted infections (STIs)
Factsheet. Retrieved from

Acknowledgements: Najood Azar, RN, PhD