Table 2

Extracts illustrating themes within participants’ accounts

Factors relating to/about individuals Self-identity regarding orientation to relationships.
“I’ve always been in long term relationships…it’s not been an issue, if you know what I mean? Like I’ve got mates that go out and sleep with everyone. Now, obviously they do use precautions, that lot, so they say. But it’s never been an issue. See, I’ve had the snip as well, so….” (Man, 45)
“When you sort of come out of your [marriage], your sort of sexual identity is from the 80s and you’ve been with one person for all that time you don’t think down that route at all […] you go through a sort of a 20 year period where AIDS and sexual health becomes something that people can talk about and you just think to yourself, oh my God, I’m glad I’m not in that category, y’know, I’m glad I know who I’m with and what’s he done and […] Y’know we’re both loyal to each other, we’ve been together for 20 years so if either of us had got AIDS we would have both had it by now, that sort of thing […] And you don’t worry about it because you don’t see yourself ever being with anybody else and then suddenly your marriage breaks up and you’re both with new people. But again, you’re not in relationships – or you don’t think you’re in relationships with people that have been around because it’s somebody else that’s been in a long-term marriage and you think ‘right, okay we’re sort of kindred spirits here, we’re in the same boat, there isn’t an issue.’” (Woman, 44)
Factors relating to/about sexual partners Legacy of mistrust and ambivalence within former long-term relationships.
  • Immediate testing in the context of suspected non-monogamy.

“…as soon as I kind of finished with what’s-his-name I did actually go to the clinic, I had my smear test done and tested everything else [i.e. STIs], just wanted to make sure everything was clear because sometimes your mind can be thinking it overtime and thinking ‘oh he’s been sleeping with somebody else or whatever’ so you know, it is important to be careful.” (Woman, 43)“
…when I split up with [ex-partner]– I think she’d slept with somebody else before we split up anyway – I went up to the hospital and had a [STI] test, like full MOT.” (Man, 44)
  • Delayed testing and ambivalence in the context of suspected non-monogamy.“

I did end up having tests and stuff but it wasn’t really because of that, I don’t think he [ex-husband] would be the type that would sleep around with lots of people, I didn’t think that because he’d done it with her [i.e. during their marriage] he must have slept with loads of different women because he wasn’t like that and I don’t think he intentionally went out to do it […] I didn’t think that I could catch something.” (Woman, 46)
Gender-age dynamics in negotiation of safer sex with new partners.
  • Negotiating condom use.

“[describing recent experience using condoms for first time in twenty years]…it was like being a kid again, yeah, because although you know what to do, that doesn’t help the situation, it is a passion killer and you fumble about. Don’t know, not a good experience, I don’t enjoy that.” (Man, 48)
“He [new sexual partner] didn’t worry about using a condom, y’know, he sort of come in with that mindset. It was just a case of ‘oh well I’ve had a vasectomy so you won’t have any children.’” (Woman, 44)
“Y’know, it is strange how you find how many men, especially my age group, don’t use condoms and you have to question them, y’know, are they going to use anything? You have to sort of initiate the conversation where it should be automatic, I think. But I got to the stage where I carried them because, yeah, well they didn’t have them and you don’t know, especially with online dating, how many of them do that […] I think it could be quite risky if I didn’t insist that we use condoms but I find that some men just don’t think they’re necessary […] They’d say, well you’re on the pill aren’t you? Well no, I’m not actually. (Laughs) […] And I don’t know if they seem to think getting a sexual disease is a young person’s problem. They seem to think because they sleep with older people a lot that it doesn’t matter and it does matter!” (Woman, 47)
  • Negotiating mutual STI testing.

“My last girlfriend […] she was concerned about it [STIs), because after I’d broken up with my previous girlfriend, I had slept with a couple of women, so she actually wanted me to get a test and, in fact, I went and got a test. And I never said anything, but I was annoyed about it. She wanted me to do it because, perhaps she wanted to be sure, so I did it and showed her the clean bill of health, and off we went […] I think she could have taken my word for it, because I know the women I’d been with were very– not promiscuous at all, so I was kind of annoyed about it, really.” (Man, 57)
Factors relating to/about peers and communities Peer and community influences on understandings of sexual risk and safety.
  • Learning from similarly aged peers.

“Well it’s interesting because the biggest rise in STDs is in the sort of 50, 45–50 plus age group, isn’t it? […].”
“So does that cross your mind about being a new risk group?”
“Yeah it does, it does. I mean, my friend and I, we’ve kind of had this conversation. We went on holiday and she did meet this guy, and we just got talking and she said she’d said to him ‘No condom, no sex, until you bring me that piece of paper telling me that everything’s alright’, and he did, he went and got the piece of paper for her, yeah […].”
“What did you think about that strategy?”
“Well it’s very sensible, very sensible […] you would be silly not to, wouldn’t you? It wouldn’t be very sensible not to, y’know, you just don’t know, you just don’t know.” (Woman, 58)
  • Learning from younger relatives.

“I have conversations with my nephew…they all go to the GUM clinic regularly, and they go en masse…when I was first sort of yes I’m in another relationship and he was saying ‘now if you’re worried about getting condoms or anything or you want to go to the GUM clinic, come with me and I’ll get them for you’…I mean it’s nice to think that kids these days can be like that and it makes you sort of think oh it’s no biggie, y’know, you sort of get down with the kids, do what they do really, y’know?” (Woman, 43)
“I noticed a little sample bottle thing on the side and I said to him [son], ‘what’s that for?’ He goes, ‘oh I’m just going to be tested’ because he’d been seeing his girlfriend about six months and I go ‘why?’ and he goes, ‘well me and her have decided that as she’s on the pill that we won’t use condoms anymore so we’re just being tested first to make sure we’re both alright and then we’re not going to have condoms anymore’ and I just thought that was quite a responsible thing to do, of a boy of twenty he was at the time. So I suppose because he told me that I was sort of thinking well really, it’s a good way to think. It’s not just about getting someone pregnant, it’s about being safe.” (Woman, 47)
Change in networks of support and care after relationship transition.
  • Postrelationship changes in social network, greater social integration.

“I’ve got a very good and strong network of friends and family around me […] four of my very close friends, we’re all in the same situation, we’re all single so a lot of my friends around me, one by one they’re all kind of separating […] and I don’t like it but unfortunately my friendship group and my ability to go out and enjoy myself has become more and more possible because more and more people are splitting up […].” (Woman, 48)
  • Reduced capacity to prioritise sexual health in the context of midlife stressors.

“[reflecting on sexual safety following discovery of ex-husband’s non-monogamy]I didn’t think about it [own sexual safety] […] I was working and also having the kids and at first I didn’t think about it until the kids got a bit older and you have some more time for yourself and then you start thinking of things, yeah, then you start worrying.”
“What did you worry about?”
Getting something, ‘cos he [ex-husband] got crabs and then when I found out he was sleeping with men as well that was it…” (Woman, 46)
Factors relating to/about broader structures and society
  • Media landscape shapes understandings of dating, sex and sexual health at midlife.

“I don’t want no sexual diseases or nothing like that.”
“And would you see that as a risk now for you?”
“Yeah, there’s a lot more of it about lately, y’know, or so you read in the papers and that. Everybody’s at it and a lot of sexual diseases about, so there’s more chance of getting one now than there was when me and my (ex)wife was younger.” (Man, 58)
“I’ve probably only slept with about 25 women in my life, which I think is actually quite low compared to young people, I’m guessing, what do I do know? But you think they’re at it all the time and with each other and everywhere, from what you read in the paper…” (Man, 57)
“…in your 40s you stereotype things on what you learn, and if you look at programmes that you’ve watched on telly in the 70s and the 80s, you take a lot of that on board and then you sort of, as I say, you think about the classified ads and the internet dating and you see all these things on the TV and as somebody older you think ‘oh no, I couldn’t possibly do that!’ But then loads of people do, so you think ‘oh fair play, if that’s the way it is.’” (Woman, 44)
  • Age-related barriers to accessing sexual health services.

“I thought it [GUM clinic] was for dirty people, and when you went there you feel at ease actually ‘cos they don’t make you feel like you’re disgusting sort of thing, you know, the nurses and that, they don’t make you feel like you’re a tramp, I don’t know if that’s the right word but that’s how I, you do, you feel like it’s for young people who sleep around and stuff, but sometimes it’s really not, it could be just someone coming from one relationship to another and have caught something can’t it? And then I, they’re quite old they were, you know, well older than me some of them!” (Woman, 48)
  • Age-related barriers to accessing condoms in commercial venues.

“You throw caution to the wind, y’know, I suppose with the no pregnancy risk. So yeah, you have to be mindful of that, so that means thinking about being prepared […] I mean you’ve got to be prepared, but I’m in my 50s, so what, I go into a shop and they’d be like ‘what are you doing buying condoms?’” (Woman, 58)
  • GUM, genitourinary medicine; MOT, Ministry of Transport.