What single midlife women think about and do to protect their sexual health

Sexually transmitted infections (STI) are a significant public health problem among U.S. women. Single midlife women aged 40-59 are at particular risk for STI. Little is known about the factors that contribute to low sexual health protection and condom non-use in this population. The majority of research on STI prevention has focused on populations of younger women. This cross sectional study, guided by the theory of planned behavior examined relationships between STI perceived risk, attitudes, subjective norms, perceived behavioral control, condom use intention and sexual health behaviors. Data were collected with a convenience sample of single midlife women at risk for STI who participated via a web-based survey. Of the 611 women who entered the survey website, eligible participants (n=285) were predominantly 40-49 years of age (65.6%), Caucasian (94.7%), college graduates, (62.1%) and employed (85.3%). Approximately one-third (31.6%, n=90) indicated a previous STI diagnosis. Half (49.5%) of the women reported they had used a condom use with the last new sexual partner. For the entire sample, attitudes, subjective norms, and perceived behavioral control each significantly correlated with intention to use condoms with a new sexual partner. Logistic regression analysis showed that using a condom with a new sexual partner significantly increased as attitude (p=.002) and intention (p=.001) increased. Higher level of education correlated with decreased subject norms and intention towards condom use. There was a significant decrease in condom use of women with a college degree. A positive correlation was found between STI and number of new sexual partners. However, having more new sexual partners was significantly correlated with decreased condom use. Findings indicated this sample of single midlife women had positive attitudes, subjective norms, perceived behavioral control and intention toward condom use. Yet, a condom was used only half of the time with new sexual partners. Findings from this study can inform interventions and programs that aim to enhance sexual health outcomes and reduce STI acquisition among midlife women.