Community-engaged strategies to improve sexual health services for adults aged 45 and above in the United Kingdom: a qualitative data analysis

Background Sexual health is an essential component of health and well-being across the life course. However, sexual health research often focuses on young adults and excludes those aged 45years and older. We organized a national crowdsourcing open call and co-creation events to identify recommendations to improve sexual health service provision for middle-aged and older adults in the United Kingdom (UK). Methods We conducted a crowdsourcing open call and seven co-creation events consisting of workshop-style meetings and one-to-one in-depth interviews. Open call submissions and qualitative data from the co-creation events were analyzed using a thematic approach. A social-ecological framework was used to code deductively, but new codes were allowed to emerge. Thematic categories were organized to describe factors influencing the accessibility and inclusivity of sexual health services for middle-aged and older adults. Results We received 22 submissions in total; of those, 35% of participants reported a disability, 40% of individuals were aged 45-65years, and 6% of submissions came from individuals that identified as gay/lesbian. Five key themes highlighted that improving sexual health services for adults aged 45years and over requires a multi-leveled approach: increase sexual health education, enhance patient and provider relationships, utilize community-led sexual health promotion efforts and delivery of reliable sexual health information, improve inclusive sexual health services, and break down sexual health taboos against adults aged 45+ years. Conclusions Our data suggest that middle-aged and older adults can co-create compelling strategies to enhance sexual health services for middle-aged and older adults in the UK. Further implementation research is needed to pilot these strategies.