Older adults are increasingly affected by rising rates of sexually transmitted infections (STIs), yet they remain underserved in sexual health education efforts. This mixed-methods study evaluated the effectiveness of a tailored sexual health intervention designed to increase STI knowledge and explore attitudes, beliefs, and barriers to preventive behaviors among adults aged 65 and older.

The intervention, delivered in small-group sessions at two community-based sexual health clinics in Southern California, incorporated the CDC’s Safe in the City video and a culturally responsive STI brochure. A total of 77 participants completed pre- and post-intervention surveys using the validated STD-Knowledge Questionnaire, and 15 participants completed semi-structured interviews before the intervention to provide contextual insight into their experiences. Quantitative findings demonstrated a statistically significant improvement in STI knowledge after the intervention (p < .001), with a large effect size (Cohen’s d = 0.83), indicating that brief, targeted education can meaningfully strengthen understanding of STI prevention among older adults.

Qualitative analysis identified recurring themes of perceived exclusion from sexual health messaging, mistrust in healthcare communication, and persistent structural barriers which included stigma, language inaccessibility, limited access to services, and immigration-related concerns, that hinder engagement in preventive behaviors. Together, these results illustrate that while tailored education is effective in improving knowledge, broader systemic and social barriers continue to shape preventive decision-making among aging populations.

This study highlights the importance of culturally responsive, age-appropriate interventions and underscores the need for comprehensive structural strategies to reduce disparities and promote equitable sexual health outcomes for aging populations.