The National Social Life, Health and Aging Project
This project, funded by the National Institutes of Health, aims to decipher the physiological mechanisms through which social factors, including sexual and intimate relationships, influence health at older ages. A national probability sample of 3005 men and women, ages 57-85, were interviewed in their homes during the period July, 2005 through March, 2006. In addition, using innovative methods for collection of biological and anthropometric data in the home setting with older adults, a wide variety of biomarkers and measures were obtained including vaginal self-swab samples, fingerstick bloodspot specimens, salivary specimens, and physical and sensory function testing. These data serve as the basis for novel, clinically-relevant research addressing a vast array of understudied issues pertinent to older women’s health and aging. This project is founded on the Interactive Biopsychosocial Model, a conceptual framework for studying health and sexuality ( Lindau, Laumann et al. 2003) .
HIV-Infected Mothers on the Margin
The Pediatric AIDS Chicago Prevention Initiative funded this work to determine barriers to prevention of vertical HIV transmission among women living in Chicago. Although public health efforts to reduce vertical transmission have been very effective, they have proven insufficient to accomplish eradication of this tragic, and medically preventable, mode of HIV transmission. This study found, in a highly socioeconomically marginalized group of HIV-infected women living in Chicago, that vertical transmission occurred in part because HIV-infected mothers judged the risks associated with disclosure of their HIV status to be greater than the perceived risk of HIV transmission to their newborn ( Lindau, Miller et al. 2004; Lindau, Jerome et al. 2006) . Women identified the environment of care as a major barrier to disclosure of HIV status in pregnancy. These data have helped inform intervention programs to accomplish eradication of vertical transmission in the U.S. and funding has recently been obtained by Jessica Jerome, PhD ( St. John’s College) to conduct a comparative study in Brazil.
Older Women’s Attitudes, Behavior and Communication about Sex and HIV: A Community-Based Study
This project motivates improvements in public health and physician approaches to older women around issues of sexuality and sexually transmitted infection. This study found that older women were sexually active, engaged in potentially risky sexual behavior, and believed that physicians should address issues of sexuality. Older African American women were significantly more likely than white women to report HIV-related changes in their behavior and to discuss sex with a physician. This community-based study corroborates clinical research and suggests both a gap and a disparity in older women’s dialogue with physicians about sexuality. ( Lindau, Leitsch et al. 2006)
Study of Midlife Health Across the United States (MIDUS)
With pilot funding from the MIDUS study, an NIH-funded project, this project examines differences in female sexuality by age and life course health events. It explores the association between sexuality, including sexual partnership, satisfaction with sexual aspects of life, and older women’s health.
Sexuality and Intimacy Among Couples Affected by Lung Cancer
Lung cancer is the leading cause of cancer death in men and women and affects younger and older individuals. This study examines the effects of lung cancer on couples’ intimacy and sexuality and the role of intimacy and sexuality in coping with this life threatening diagnosis. With regard to intimacy and sexuality, the study also seeks to understand attitudes, beliefs and behaviors of physicians, nurses, clergy and other professionals involved in caring for couples affected by lung cancer.
This series of studies examines the correlates and effects of low health literacy on cervical cancer screening knowledge, behavior, and adherence to follow-up after an abnormal screening test. Women with low health literacy exhibit less accurate knowledge about cervical cancer screening and poorer adherence to follow-up. Physicians’ subjective impression of patients’ literacy skills is often inaccurate, but does correlate significantly with the likelihood that a patient will adhere to recommendations for follow-up care. ( Lindau, Tomori et al. 2001; Lindau, Tomori et al. 2002; Lindau, Basu et al. 2006)
Sexuality Among Very Long-Term Survivors of Genital Tract Cancer
Aside from mortality or tumor recurrence data, few studies examine quality of life or health outcomes for very long term survivors of cancer. Using a unique database of survivors of genital tract cancer, we are examining sexual partnership, activity and problems among survivors as compared to population controls. This research also aims to decipher aging effects on sexuality from cancer survivorship-related effects. This work is funded in part by the National Cancer Institute.
Over the last several years, sex education in public schools has been heavily influenced by federal government incentivization of abstinence-only curricula. This research aims to inform physicians and other health care providers about the quality and content of school-based sex education.
This research focuses on bioethical aspects of reproductive and sexual health care delivery including medical student training in these areas.
Population Studies
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