Open Access Research article

Motivations for sexual risk behaviors among older men in Shanghai, China: a qualitative study

Yanqiu Zhou12, Yingying Ding2, Kaikan Gu1, Xiaonian Lu3, Meiyang Gao2 and Na He2*

Author Affiliations

1 Jingan District Center for Disease Control and Prevention, Shanghai, China

2 Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China

3 Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China

For all author emails, please log on.

BMC Public Health 2014, 14:802  doi:10.1186/1471-2458-14-802

Published: 7 August 2014



China’s population is quickly aging and this trend is expected to continue. Thus it is important to develop HIV interventions to help protect older Chinese from infection. Limited information exists regarding sexual risk behaviors and associated personal motivations among persons aged 50 and over in China.


In-depth interviews were conducted with 12 HIV-infected and 14 uninfected men aged 50 and over in Shanghai, China.


More than 71% of heterosexual participants had engaged in commercial sex, 37.5% either had engaged in casual sex or had a steady extramarital partner. All gay/bisexual participants had engaged in casual sex with men, and 16.7% had engaged in commercial sex. Personal motivations associated with sexual risk behaviors included sexual desire and interest in sex remaining high at an older age, unfulfilled sexual desires within marriage, homosexual or bisexual orientation, need to socialize with others, peer influence, personal choice of “hobby”, and financial freedom.


This study sheds light on the sexual needs of older people. Our findings underscore the need for both greater education in order to reshape societal perceptions of sexuality among older adults and prevention strategies to help the older male population maintain a healthy sexual life.

HIV/AIDS; Motivation; Sexual risk behaviors; Older men; China