Determinants affecting the quality of sexual life among older adults in Africa: a scoping review

Abstract

BACKGROUND: Older adults (people aged >60 years) are often stereotyped as being asexual, reflecting a broader lack of research into the sexual lives of this age group. Few studies have examined sexual well-being among older adults in low- and middle-income countries, especially in Africa. This scoping review aims to identify and synthesize the factors that affect sexual functioning and quality of sexual life among older adults in Africa. METHODS: Following the approach of Arksey and O'Malley, a scoping review was conducted on determinants affecting the quality of sexual life among older adults in Africa. Seven databases were searched: PubMed, Google Scholar, CINAHL, Scopus, Web of Science, ProQuest and AJOL. Full texts were reviewed to determine the final set of papers for inclusion. Included papers were published, with publication dates between January 2010 and January 2025. Data were extracted on the study population, study design, mean age of the study participants, aims of the study and the determinants affecting the quality of sexual life, and summarized using narrative synthesis. RESULTS: A total of 14,398 citations were identified in the database search, and seven studies were included in the review. The age of study participants averaged approximately 70 years. The research consisted of three qualitative and four quantitative articles. Four studies were conducted in Nigeria, and one each from South Africa, Morocco and Tanzania. Our review identified four categories of determinants influencing the quality of sexual life among older adults in Africa: psychological, sociocultural, physiological and health. Psychological determinants, including past trauma, performance anxiety and societal expectations, were identified across five studies. Sociocultural determinants, including sexual attitudes and culturally embedded behaviors, were examined in six studies, and found to shape the sexual functioning and behaviors of older adults. Physiological determinants, such as menopause and erectile dysfunction, were reported in four studies and associated with reduced sexual activity. Health determinants, including chronic conditions and pharmacological factors (medications), were identified in five studies as influencing older adults' sexual function and intimacy. CONCLUSION: Multiple, complex determinants affect the quality of sexual life among older adults in Africa. Our study findings have implications for designing sexual health services among older adults in Africa.