An integrated model to understand sexuality in older adults in urban China: The mediating role of sexual interest

Background: The subject of sexuality in older adults has remained grossly understudied in China, despite the country having the largest older population in the world. Objective: Guided by the Sexual Script Theory and the Theory of Planned Behavior (TPB), this study used path analysis to test an integrated path model for sexual activity with sexual interest as a mediator. Methods: Survey data was collected from a representative sample of 688 community-dwelling older Chinese adults aged 60 or above residing in Tianjin, China. Results: The final integrated model yielded a satisfactory model fit. Sexual knowledge, sexual attitude and perceived sexual control have direct positive effects on sexual interest in sample older Chinese. Furthermore, sexual interest mediated the effect of sexual knowledge, sexual attitude, perceived sexual control, available sexual partner, male gender and education level on sexual activities. Age was found negatively associated with sexual activities, while a non-significant relationship for sexual interest was observed. Male gender positively associated with sexual activities and sexual interest. In addition, education level has a positive effect on sexual interest. Conclusion: The integrated model highlighted the mediating role of sexual interest on sexual activities, thereby contributes to advancements of understanding of sexuality in older Chinese population. The current study also provides empirical evidence to the development of intervention and education programmes on sexuality among older Chinese adults. These programmes should pay attention to address the issues of sexual interest and partnership in older adults. Frontline health professionals should be sensitive to the needs of sex education in older population.