The Ultimate Guide to Sex after Fifty

I’ve been on a safer sex soapbox for years, and now that I’m dating again, I’m even more adamant about using barrier protection. I don’t find that it lessens the erotic quality of a sexual interaction at all. In fact, I find the sound of the condom packet ripping open to be as erotic as a kiss. It means that sex will happen—not just in my fantasies, but here and now in this bed, with this partner.

When I hear a statement like the above—which is often—I sometimes ask how she chooses partners “carefully.” Too often, I hear something like, “He says he’s safe,” or “I can just tell.”

Right, how could someone who looks like a kindly grandparent possibly have a STD? Thanks to the misconception that safer sex is unnecessary if we’re no longer fertile and someone looks safe and says he or she has no STDs, sexually transmitted diseases are soaring among our age group.

Hearing “I got tested and I’m STD-free” is useless information if he or she is having unprotected sex with other people! If you and your partner are not sexually exclusive, test results from last month or even this morning won’t give you any valuable information.

Being willing to go to bed with you without protection indicates that this new partner did that with other partners, and they did it with their other partners, and so on. Do you really want to have sex with all the people this person has had sex with? Imagine them all in bed with you, and just say no to unsafe sex and yes to barrier protection. It’s the smart, safe, and sane thing to do.

Use barrier protection every time unless and until you’re in an ongoing, sexually exclusive relationship, and you were both tested for STDs, and retested three to six months* after your last unprotected sex with anyone else.

*Some sexually transmitted diseases are detectable much sooner, but HIV is not conclusive until after three months for most, and in rare cases, up to six months, using the common tests available, according to the Centers for Disease Control and Prevention.¹⁰⁰

I think that eroticizing safer sex is an important step toward using it regularly. Buy a selection of condoms, gloves, dental dams—whatever you might need—and display them with the lubricants in a basket. Now the choice is not whether or not to use them—it’s which one(s) to use.

I’ll be frank with you. I have dozens of scary statistics that should convince you that safer sex barriers are imperative for those of us in our age group who are sexually active outside a committed, exclusive relationship.

If I give you too few of these, you’ll think that safer sex isn’t really important. If I give you too many, your eyes will glaze over and you’ll skip the whole chapter. But what if I omit just the statistic that would change your mind? It’s a dilemma.

• Cases of sexually transmitted diseases among fifty- to ninety-year-olds more than doubled between 2002 and 2012.¹⁰¹

• Fifty percent of males and 29 percent of females rarely or never use condoms and only 12 percent of men and 32 percent of women use protection regularly, according to a 2009 AARP survey of single, sexually active midlife and older people.¹⁰²

• A 2010 study found that 91 percent of men over fifty did not use a condom when they had sex with a date or casual acquaintance, and 70 percent didn’t use a condom with someone they just met.¹⁰³

• In a survey of single women ages fifty-eight to ninety-three, nearly 60 percent said they didn’t use a condom the last time they had sex.¹⁰⁴

• Cases of syphilis and chlamydia in adults aged forty-five to sixty-four nearly tripled between 2000 and 2010.¹⁰⁵

• Among people over fifty who are HIV-infected, about 27 percent of heterosexual men, 37 percent of gay/bisexual men, and 35 percent of heterosexual women sometimes have anal or vaginal intercourse without using condoms.¹⁰⁶

• An estimated 20 to 25 percent of HIV-positive individuals are not aware they are infected.¹⁰⁷

• Older women are particularly at risk for blood-borne diseases like HIV or chlamydia because their thinning vaginal lining and lack of lubrication may lead to tearing during intercourse, permitting easy access to the bloodstream.¹⁰⁸

If my partner is not monogamous with me, we don’t do penetration. Instead of using barriers, we go to nonpenetrative sex, which is delightful in its own right. I have orgasms through finger play rather than penetration anyway. And, as for my partner—I give great hand jobs!

You tell me that you meant to use barrier protection, but in the heat of the moment, you didn’t. The best intentions can fall by the wayside unless you (a) prepare; (b) practice; and (c) plan ahead.

Practice: Try out what you want to say in front of the mirror. Look and sound assertive, not apologetic or giggly. Eliminate embarrassment. Have a couple of choice statements ready to plug into the conversation. For example,

Plan: Talk to your partner (or potential partner) before you get excited. Don’t wait until the heat of passion to bring up the subject, because that’s a recipe for disaster. Instead, have the safer sex discussion long before getting naked.

SIZE YOUR CONDOM

Did you know that condoms come in three different sizes? You want the size that feels snug but not constricting. Too loose, and it can slip off. Too tight, and wearing it is painful. Here’s how to figure out your size, according to Lucky Bloke (www.thecondomreview.com), a website that reviews and sells condoms:

• Have an empty toilet paper roll ready.

• Give yourself an erection.

• Put your erection into the toilet paper roll.

• If there’s extra room, choose a smaller, snugger, more tailored fit condom, best for 35 percent of men. If there’s just enough room, use a medium, standard condom, best for 50 percent of men. If it’s too tight, choose a larger, generous fit condom, best for 15 percent of men.

• Since few condoms are actually labeled by size, see www.thecondomreview.com/pages/ find-your-condom-size for links to appropriate brands and styles for each size.

We are the ones responsible for our own health. If you can’t talk about safer sex with someone, do you really want to invite that person inside your body?

The new version of the female condom, called the FC2 (female condom, 2^nd generation), is a vast improvement over the first product, which was like having sex in a shower curtain. The material is completely different now. It is soft and pliable, made of nitrile, like today’s medical exam gloves.

The FC2 is a loose sheath with a large ring at one end, which stays outside the body, and a small ring at the other end, which helps with insertion and holds it in place. When using it vaginally, push the inner ring past the pubic bone, much like the diaphragm of decades past. The outer ring is large enough to cover much of the vulva and provide a barrier with the base of the penis, so there’s no exchange of body fluids. It provides a protected tunnel with freedom of movement.

One big advantage for a woman is that she alone determines to use the female condom and can insert it at any time before sex—no need to wait for the heat of the moment or for a partner’s erection or even agreement. This actually can make sex more spontaneous—no need to stop the action to fumble with a condom.

The female condom is a boon to safer sex with undependable erections, because the penis does not have to be hard. Since the woman inserts it on her own, it doesn’t affect or require the man’s erection. Men have said that the sensation is better than with a male condom. One partner should hold it in place by the outer ring especially during vigorous thrusting.

Although called a “female” condom, this can also be used for anal sex for any gender body. Sometimes called a “bottom condom,” “internal condom,” or “receptive condom,” it’s getting popular in the gay male community. I heard one man say that using the FC2 was a way “to feel bareback sensations while staying protected.”

Before using it anally, you may want to remove the inner ring—or you may want to keep it for ease of insertion. Practice before you need it, so you know which you prefer. Push it in past the sphincter muscle. You can also use your partner’s penis to push it in. About an inch of the condom should stay outside the body. Be careful during use to hold onto the outside ring to keep it from being pulled into the body by the sphincter muscles and to prevent the penis from entering to the side of the condom instead of inside it.

Yes, the FC2 does look funny emerging from the body, but give it a few tries to discover how comfortable and empowering it is. Use plenty of lubricant inside and outside the condom.

• It’s very comfortable for both partners, and not constricting.

• It warms to the temperature of the vagina.

• It can be inserted long before needed.

• It can be left in after ejaculation, with no need to pull out immediately—more cuddling!

• It can be used with any kind of lubricant.

• Insertion is easy.

• Nitrile is very thin, conducting sensation better than latex.

• It’s latex-free and can be used by those with latex sensitivity.

• Some women find that the outer ring stimulates the clitoris.

• Some men find that the inner ring stimulates the penis.

• It is under control of the wearer.

To remove the FC2, twist the outer ring three times so the contents can’t spill, then pull it out, and dispose of it in the trash, not in the toilet.

Never use a male condom and a female condom at the same time. It’s unnecessary, because either condom provides complete protection, plus the friction between the two condoms can lead to one or both of them tearing.

I am HIV+, healthy and undetectable. I will never get over the impact HIV has had on my sex life. My partner of more than twenty-one years is negative, so we have a “mixed marriage,” and it has definitely impacted our ability to be intimate over the years.

The problem with being poz [HIV-positive] is that it always impacts sex with other partners, especially if the partner is negative. All the poz guys I know tend to serosort, meaning we play with other poz guys if we’re poz and neg guys with neg guys. “Safer sex” often is tossed out the window if playing with other poz guys.

If it’s a mixed pairing, though, negotiations are always complex. Mostly because every neg guy out there has a different definition of safer sex! What is off the table for one is fine with the next. Some guys want to wear a rubber suit if playing with a poz guy; others are fine with everything but receptive anal sex. Sometimes it’s simply too much trouble to want to bother with. Then there’s always the “mid-scene” act that’s off the table but wasn’t discussed until it comes up, so it can be very awkward, not to mention a buzz-kill, to hit that in the middle of things. I prefer to play with other poz guys because all that nonsense is gone with them.

LIVING WITH HIV AND ENJOYING SAFE, SEXY SEX

By Terri Clark

Many seniors who are living with HIV are concerned about how sexy they are to other people and how to protect themselves and their partner(s) while enjoying intimacy and sex. Here are some tips:

1. Talk about your status. For most HIV-positive folks, disclosing their status is one of the biggest challenges. HIV-positive seniors can enjoy satisfying relationships (with sex or not), and the key is to communicate open and honestly with partners. Plan ahead for the best time, the best place, and what you will say.

2. Green Light, Yellow Light, Red Light. Think about safer sex in terms of “Green Light”: No-risk behaviors, such as masturbation, sexual fantasies, massage, holding hands, showering together, using sex toys (using and changing condoms on sex toys if sharing them), hugging, and kissing. “Yellow Light”: Low risk behaviors, like oral sex, vaginal and/or anal sex with condoms. “Red Light”: High risk behaviors, such as vaginal and/or anal sex without a condom, withdrawal (pulling out). Reduce your risk by using condoms consistently and correctly.

3. Lower your viral load. HIV treatment works by reducing the level of HIV in the body (the viral load) to such an extent that a person’s infectiousness is almost zero—sometimes called an undetectable viral load. This means that people living with HIV who are on treatment and taking meds as prescribed become less likely to transmit the virus. A lower viral load is important for your overall health and wellbeing, not just your sex life.

4. Your most important sex organ is your brain. It’s not just what is below your waist and between your legs that counts. Remember that intimacy comes from communication, sharing and letting our partner(s) know we care. Sometimes the best turn on is a great conversation!

5. You are not alone. Approximately one quarter of the people living with HIV in 2005 were fifty or older, and studies project that by 2015 more than half of all people living with HIV in the US will be over fifty. There are terrific resources available for support and information, such as POZ (www.POZ.com) and The Body (www.thebody.com).

—Terri Clark, MPH, CHES is Prevention Coordinator at ActionAIDS in Philadelphia and Co-Chair for the Lesbian, Gay, Bisexual and Transgender Elder Initiative (www.lgbtei.org), whose mission is to advocate for services that are inclusive and responsive to the needs of LGBT seniors.

The risk of HIV transmission from an infected partner through oral sex is much less than the risk of HIV transmission from anal or vaginal sex. Measuring the exact risk of HIV transmission as a result of oral sex is very difficult…. [S]everal co-factors may increase the risk of HIV transmission through oral sex, including: oral ulcers, bleeding gums, genital sores, and the presence of other STDs. What is known is that HIV has been transmitted through fellatio, cunnilingus, and anilingus. In addition to HIV, other STDs can be transmitted through oral sex with an infected partner. Examples of these STDs include herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites (amebiasis), and hepatitis A.

Protecting yourself during oral sex with condoms and dental dams is the smart thing to do. Dental dams are squares of latex that are used to cover the vulva or anus during oral sex. Although they may seem weird and not very sexy at first use, you’ll find that they transmit sensation and body heat well, and provide proven protection.

In cunnilingus, it may feel a little tricky at first for the giver to figure out exactly how to position the tongue with a dental dam hiding visual cues. In many women, the clitoris has a delightful habit of growing bigger and perkier when stimulated, making herself known by feel—but that’s not true for all.

You can get dental dams or the Sheer Glyde dams made especially for oral sex from a woman-friendly sexuality shop, or order online.

If you don’t have dams, you can use Saran Wrap (avoid microwavable plastic wrap which does not offer enough protection). You can also create a dam from a condom:

For fellatio, use a nonlubricated condom—flavored or unflavored, your preference. If the man has trouble getting or maintaining an erection, a dental dam over a penis will work for fellatio on a soft penis.

For the pleasure of the person receiving oral sex, apply silicone, water-based, or hybrid lubricant on the vulva, penis, or anus first whether using dams, condoms, or Saran Wrap. Oil-based lube can degrade the latex.

SAFE TOY TIP

If you share insertible vaginal or anal sex toys with a new or nonexclusive partner, wrap the toy in a condom, and use a new condom when you swap. Whether you’re using toys solo or with a partner, if you like to insert a toy both anally and vagi-nally, replacing the condom when changing body parts will prevent bacteria from the anus (even if well-scrubbed) from getting into the vagina and causing an infection. This is also true when a penis is going from anus to vagina—use a fresh condom before switching.

I’m a sixty-five-year-old female. After being celibate for twenty years (!), I met a lovely man online. Anticipating intimacy, I wanted to be able to demonstrate that I was STI free. I asked for blood tests for STI, HIV, HSV, HPV, and hepatitis. My doctor said that I didn’t need a HSV (herpes) test unless I had an outbreak. I insisted on the test anyway.

I was stunned to discover that I have antibodies for both herpes simplex 1 and 2, even though I have never had a cold sore or genital herpes outbreak. Obviously, I have been carrying the virus for over twenty years.

I had “The Talk” with my friend. He took the news very well and did not panic. We discussed what it meant for our growing relationship, for sexual activity, and for his risk. He agreed to get blood tests, although he had no partners other than his ex-wife for over twenty-five years.

It turned out that he also tested positive for herpes and never knew. What are the odds? Probably higher than we thought: we both had been sexually active in the seventies and eighties when easy and unprotected sex was the norm. We were young, horny, and stupid. We probably contracted herpes that far back. The bad news is that he has to tell his ex-wife.

Requiring barrier protection sends the message that I don’t trust a new partner.

Actually, not requiring barrier protection sends the message that you’re reckless and you don’t care about your own or your partner’s health.

If I keep a collection of condoms, a new partner will think I’m promiscuous.

That’s an old idea from our sex-negative upbringing that we can let go of now. We’re sexually active (or hoping to be), and we’re responsible enough to be prepared in case sex happens. Don’t leave it to chance that your partner might bring the condoms—take care of it yourself. If a partner thinks that naiveté trumps sexual responsibility, educate or dump that partner.

I try to use barrier protection, but I back down if my partner insists on not using it.

If you don’t protect your sexual health, who will? Besides, this new person is unlikely to be your final sex partner. If this one doesn’t work out, and you’re facing the Conversation with the next one, which one of these would you prefer to say?

My policy with new lovers is open communication about any limitations and sexual expectations. We answer these questions early on: “What are you into? What do you especially enjoy? What really turns you on? What do you need emotionally from this relationship? Where would you like things to go?” It’s a continual process of discovery and growth.

Second is an offer to get tested as a sign of good faith. Third is the use of condoms for at least three months after test results if the decision of exclusivity is made. If there is an agreement of nonexclusivity, then condoms are always used and incorporated as an unashamed part of sex play.

The reason is multiple—for trust, for fun, for honesty, for safety, but primarily for caring. All of this must be clearly voiced as soon as the possibility of intimacy is considered.

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