Addressing Older Adults' Sexual Health Needs in Regional Primary Care: A Qualitative Study of Barriers and Enablers

OBJECTIVE: To explore whether sexual health is discussed in regional settings between primary care clinicians (General Practitioners (GPs) and Practice Nurses (PNs)) and older patients (aged 60 and over), and the barriers and enablers of sexual healthcare for older adults in regional areas. SETTING: Participants were based throughout regional Victoria, with all five regions of Victoria represented. PARTICIPANTS: Two participant groups were included: older adults aged 60 and over, and primary care clinicians (GPs and PNs). Nine older adults (5 women, 4 men, ranging in age from 60 to 87 years), and 8 clinicians (4 women, 4 men, 6 GPs and 2 PNs) were interviewed. DESIGN: Data were collected via semi-structured interviews between July and December 2024. Data were analysed using qualitative content analysis. RESULTS: Sexual health conversations were rare and ad-hoc between older adults and primary care clinicians. Key barriers for both groups included stigma around sexual activity and ageing, privacy concerns in small communities, high staff turnover, and structural challenges such as cost and time. Key enablers for both groups included telehealth, systematic inclusion of sexual health in routine care such as the 75+ health check, training for regional clinicians, and health promotion campaigns for older adults living regionally. CONCLUSION: Older adults and primary care clinicians agree that sexual health is important to older adults' quality of life, although such conversations are rarely prioritised. This study offers suggestions for clinicians to broach sexual health so that it stays on the agenda as part of older patients' overall care within regional primary care.