Rates of chlamydia, gonorrhea and syphilis in people ages 55 and older more than doubled in the U.S. during the 10-year period from 2012 to 2022, according to data from the Centers for Disease Control and Prevention. .
Bsip | Universal Image Group | fake images
Sexually transmitted infections are increasingly common in older adults.
Rates of chlamydia, gonorrhea and syphilis in people ages 55 and older more than doubled in the U.S. during the 10-year period from 2012 to 2022, according to data from the Centers for Disease Control and Prevention. .
The number of syphilis cases among people ages 55 and older increased sevenfold during those 10 years, while gonorrhea cases increased nearly fivefold and chlamydia cases tripled during that time.
A presentation on Thursday (part of an event ahead of the European Congress of Clinical Microbiology and Infectious Diseases next month) warns that both doctors and older adults are overlooking the risks of STIs in this age group.
“We talk about smoking, we talk about diet, exercise, a lot of things, and no sex,” said Justyna Kowalska, author of the presentation and professor of medicine at the Medical University of Warsaw.
The problem is not limited to the U.S. In England, surveillance data released in 2022 suggested that STI diagnoses increased by 22% between 2014 and 2019 among people ages 45 and older. Chlamydia was the most common, followed by gonorrhea.
Kowalska pointed out some factors that could be increasing STI rates among older adults.
For one thing, people are living longer compared to past generations and enjoying more active lifestyles in their 60s, 70s, and 80s. For many, that includes sex. A 2018 survey from AARP and the University of Michigan estimated that 40% of people ages 65 to 80 are sexually active and nearly two-thirds are interested in sex.
Hormone replacement therapy, which can treat menopausal symptoms, can prolong sexual desire in older women, while erectile dysfunction medications like Viagra can help older men remain sexually active.
But older adults may not have received the kind of sex education that teenagers receive today, according to Matthew Lee Smith, an associate professor at the Texas A&M School of Public Health.
“In the '30s, '40s and '50s, traditional school didn't really teach sex education in a very formal way,” said Smith, who studies behavioral health risks in older adults.
Smith's research has shown that older adults lack some knowledge about STI transmission, symptoms and prevention.
He said doctors may be embarrassed to ask older patients about their sexual activity, and that older people are often unwilling to talk about their sex lives with their peers or family.
“No one wants to think about Grandma doing this,” Smith said. “You're certainly not going to ask grandma if she used condoms, and that's part of the problem, because everyone, regardless of their age, has the right to privacy.”
Some older men may have difficulty using condoms, Smith said, due to lack of skill or erectile dysfunction.
What's more, he added, many older adults married at a younger age than is typical now and only had one sexual partner until they were divorced or widowed. Therefore, some people may not think about using a condom, Smith said, especially since pregnancy is not a concern.
Nursing homes also create opportunities for new sexual partners. Results from a US survey of nursing home directors, published in 2016, found that sexual activity was common in these settings, which often have more female than male residents.
“In the heterosexual older adult community, there is a couple gap: women live longer than men and there is a higher proportion of women than men,” Smith said. “What this can lead to a lot of times is multiple partners and sharing partners.”
Although STIs pose health risks in all age groups, older people may have a harder time clearing infections or be more susceptible to contracting them, medical experts said.
“The immune system is weaker, so it's easier to get an infection, but there are other physical things related to just sexual intimacy that make you more susceptible,” said Ethan Morgan, assistant professor of epidemiology in the College of Ohio State University Nursing. Among postmenopausal women, for example, the vaginal lining is more prone to tearing, making it easier for an infection to develop.
Experts stressed that doctors need to do a better job of discussing safe sex with older patients.
“We want them to have the best life,” Smith said, “but we want them to have it safely.”
