Older black people spend more of their adult life single and have a greater number of nonmonogamous partnerships than similarly aged whites—potentially increasing their risk of STDs. Nearly one in four sexually active black men and women in a representative sample of Americans aged 57–84 reported having had a nonmonogamous partnership in the past five years, compared with fewer than one in 10 sexually active whites.1 Black men were single for 42% more of their adult life and 88% more of the last five years than were white men; black women, 54% and 56%, respectively, more than their white counterparts. In multivariate analyses, each additional year of the last five years spent single was associated with 68% greater odds of recent nonmonogamous partnership among men and 26% greater odds among women; being black was also positively associated with recent nonmonogamous partnerships (odds ratios, 2.0 for men and 5.6 for women).
The analyses used nationally representative, cross-sectional survey data from 2,825 heterosexual men and women aged 57–84 collected between July 2005 and March 2006 as part of the National Social Life, Health and Aging Project. Survey questions covered respondents’ social and demographic characteristics, self-reported health status, sexual attitudes, and sexual and relationship histories. Researchers classified individuals by whether they had had a nonmonogamous partnership (i.e., had had concurrent partners or a relationship with someone who had other partners) during their lifetime and within the past five years. They also calculated the proportions of time respondents had spent single (i.e., neither married nor living with a romantic partner) since age 18 and in the past five years. Age-adjusted analyses and multivariate analyses were used to examine the likelihood of nonmonogamous partnerships among respondents who had had sex in the past five year. In addition, researchers examined whether respondents had ever been tested for HIV or had received a recommendation for HIV testing from a medical provider.
The median lifetime number of partners was four for black men and three for white and Hispanic men; black and white women had a median of two lifetime partners, and Hispanic women had one. Ten percent of respondents had had at least one new sexual partner in the past five years; blacks were more likely than whites or Hispanics to have had a new partner. Twenty-three percent of blacks reported having had a nonmonogamous partnership in the past five years, compared with 8% of whites and 10% of Hispanics.
Nearly all respondents (94–99%) had ever been married. Only 66% of black men reported being currently married; 81% of white and Hispanic men were currently married. Among women, 40% of blacks, 59% of whites and 52% of Hispanics were currently married. Compared with white men, black and Hispanic men were single for more of their adult life (42% more and 18% more, respectively) and of the last five years (88% more and 14% more); similarly, compared with white women, black and Hispanic women spent more time single during their adult life (54% more and 22% more, respectively) and during the last five years (56% more and 13% more). Blacks were also single for longer than whites following a divorce or a partner’s death.
In age-adjusted analyses, blacks had greater odds than whites of having had a nonmonogamous partnership in the past five years (odds ratios, 3.0 for men and 3.1 for women). The relative odds of a nonmonogamous partnership for black men were lower in multivariate analyses that controlled for social and demographic characteristics, time spent single, health status and sexual attitudes than in the age-adjusted results (2.0); however, for black women, the reverse was the case (5.6). Also, each additional year spent single during the last five years was associated with a 68% increase in the odds of nonmonogamous partnership among men and a 26% increase among women.
Experience with HIV testing was uncommon among the sample of older people. Overall, 16% of respondents reported having ever been tested for HIV; only 3% had received a recommendation from a medical provider for testing. Black men were the most likely to have had an HIV test (26%), and black and Hispanic women the least likely (11–12%). HIV testing was not associated with nonmonogamous partnership among either men or women.
The researchers note that although their study had several limitations, such as its reliance on self-reported measures, it provides rare insight into differences in relationship and sexual behavior patterns among older adults and, therefore, their potential STD risks. They conclude that "training and resources for enhancing the ability of providers to effectively offer HIV testing to older populations should particularly target those serving significant numbers of older black patients."—J. Rosenberg