Sexual risk behaviors and HIV risk among Americans aged 50 years or older: a review.

Although HIV-related sexual risk behaviors have been studied extensively in adolescents and young adults, there is limited information about these behaviors among older Americans, which make up a growing segment of the US population and an understudied population. This review of the literature dealing with sexual behaviors that increase the risk of becoming HIV-infected found a low prevalence of condom use among older adults, even when not in a long-term relationship with a single partner. A seminal study by Schick et al published in 2010 reported that the prevalence of condom use at last intercourse was highest among those aged 50-59 years (24.3%; 95% confidence interval, 15.6-35.8) and declined with age, with a 17.1% prevalence among those aged 60-69 years (17.1%; 95% confidence interval, 7.3-34.2). Studies have shown that older Americans may underestimate their risk of becoming HIV-infected. Substance use also increases the risk for sexual risk behaviors, and studies have indicated that the prevalence of substance use among older adults has increased in the past decade. As is the case with younger adults, the prevalence of HIV infections is elevated among ethnic minorities, drug users (eg, injection drug users), and men who have sex with men. When infected, older adults are likely to be diagnosed with HIV-related medical disorders later in the course of illness compared with their younger counterparts. Physicians are less likely to discuss sexual risk behaviors with older adults and to test them for HIV compared with younger adults. Thus, it is important to educate clinicians about sexual risk behaviors in the older age group and to design preventive interventions specifically designed for older adults.

DEMOCRACY ISN'T THAT SMART (BUT WE CAN MAKE IT SMARTER): ON LANDEMORE'S DEMOCRATIC REASON

Copyright © Cambridge University Press 2016In her recent book, Democratic Reason, Hélène Landemore argues that, when evaluated epistemically, “a democratic decision procedure is likely to be a better decision procedure than any non-democratic decision procedures, such as a council of experts or a benevolent dictator” (p. 3). Landemore's argument rests heavily on studies of collective intelligence done by Lu Hong and Scott Page. These studies purport to show that cognitive diversity – differences in how people solve problems – is actually more important to overall group performance than average individual ability – how smart the individual members are. Landemore's argument aims to extrapolate from these results to the conclusion that democracy is epistemically better than any non-democratic rival. I argue here that Hong and Page's results actually undermine, rather than support, this conclusion. More specifically, I argue that the results do not show that democracy is better than any non-democratic alternative, and that in fact, they suggest the opposite – that at least some non-democratic alternatives are likely to epistemically outperform democracy.