FACTORS INVOLVED IN HIV PREVENTION IN OLDER ONLINE DATERS: A FEASIBILITY STUDY

Restricted (Penn State Only)
Author:
Wion, Rachel Kathryn
Graduate Program:
Nursing
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
February 28, 2018
Committee Members:
  • Susan Jayne Loeb, Dissertation Advisor
  • Susan Jayne Loeb, Committee Chair
  • Donna Marie Fick, Committee Member
  • Jacqueline Ann Mogle, Committee Member
  • Patricia Koch, Outside Member
Keywords:
  • older adults
  • online dating
  • HIV prevention
  • risk behavior
  • confirmatory factor analysis
  • risk perception
  • self-efficacy
Abstract:
Background: By 2020, 70% of all people living with human immunodeficiency virus (HIV) in the United States will be age 50 and older. Part of this growing proportion is attributed to contracting the disease later in life. Older adults continue to date and have sex well into their 80s. Online dating has gained popularity with adults age 50 and older as a means for finding potential romantic partners. There is a gap in the science related to what older adults who date online know about HIV prevention as well as the factors that might put them at risk for contracting the disease. Purpose: This study explored the feasibility of conducting online research regarding HIV prevention factors (i.e., risk perception, sexual risk behaviors, and self-efficacy to take action to prevent HIV) in older adult online daters. Also, this research sought to modify and test instruments related to HIV prevention factors in an older adult population. Methods: A cross-sectional, descriptive correlational design was employed. Adults age 50 and older who had used online dating sites within the past year were recruited online to complete a survey. The study instrument included HIV prevention scale items that had undergone two rounds of expert panel review. Based on the expert panel review, the HIV prevention scale items overall were comprised of (a) original items, (b) modified items, and (c) new items from both the Condom Use Self-Efficacy Scale and Sexual Risks Scale. The data were analyzed using descriptive and correlational statistics. The 31 items from the HIV prevention scale underwent exploratory factor analysis and confirmatory factor analysis (CFA) to determine factor structure and model fit. Results: A total of N = 280 older adults participated in the study. SurveyMonkey Audience and Facebook were the best recruitment sites in terms of numbers of participants recruited. Participants were not able to be recruited from online dating sites. Most of the participants (72.8%) desired a relationship that included sex and 64.6% (n = 181) had at least one sexual relationship in the past year. Of the sexually active participants, only 29% used a condom with every sexual encounter, 45% never used a condom, and 26% had inconsistent condom use. Participants’ risky sexual behavior and low perceived susceptibility to HIV were incongruous with their agreement that they would take precautions to reduce their risk of contracting HIV. Higher self-efficacy had moderate to strong associations with the intention to take action to reduce the risk of HIV. In CFA, the HIV prevention items loaded on eight different factors in three different models. The factors for Model 1 (Mechanics, Advocacy, Intoxicants), Model 2 (Attitudes, Normative Beliefs, Perceived Susceptibility), and Model 3 (Intention, Expectations) had adequate to excellent model fit. Conclusions: This study was the first to examine HIV prevention factors in older online daters as well as attempt to adapt instruments that measure HIV prevention factors in older adults. Older adults are dating online and have risky behaviors related to sex. Conducting an online survey examining HIV prevention factors in older online daters was both feasible and acceptable. The finding of participants with high levels of sexual risk behavior but low levels of condom use and low HIV risk perception suggests the critical need to target older online daters for HIV prevention interventions. The HIV prevention items were found to be appropriate for an older adult population.