Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 07, 2018
Last Modified Date: Dec 07, 2018
Published Date: Sep 01, 2017
STDs and Older Adults
If you are under the age of 50, it may surprise you to know that today’s senior citizens are almost as sexually active as many of their younger counterparts. Nearly three in four men and about half of women between the ages of 57 – 72 report having sex on average four times a month, according to studies in the Journals of Gerontology (2011).
The New England Journal of Medicine reported that 67 percent of men and 39 percent of women aged 65 to 74 said they had sex within the past year, while 38 percent of men older than 75 said the same. That’s good news, since many healthcare providers and mental health professionals contend that an active sex life is an important component of good health as we age.
The bad news is that seniors 55 and older are also seeing an increase in sexually transmitted diseases (STDs). The Centers for Disease Control and Prevention (CDC) reported a dramatic rise in sexually transmitted infection rates between 2007 and 2011, with rates highest among 45-65 year-olds. Even HIV is becoming a problem for older adults. About 19 percent of the 1.1 million Americans living with an HIV infection are 55 or older and about five percent of the new infections are coming from this age group.
Syphilis, too, has made a comeback, along with gonorrhea and the more common STD, chlamydia. Some statistics show the rates for these infections have doubled for adults in their 50s, 60s and 70s. The reasons vary but as stated in a 2012 medical article published by researchers at Kings College and Saint Thomas Hospital in London, England, safe sex awareness among seniors and the reluctance of healthcare providers to address the issue are a major stumbling block in reversing the trend.
What is a Sexually Transmitted Disease?
Once referred to as “venereal disease,” today’s STD has a much broader definition. The term “VD” was used to describe mostly two sexually transmitted diseases, gonorrhea and syphilis, until about the 1940s. Now there are more than 20 different known STDs, including viral infections that cause HIV that can lead to AIDS.
What’s important to realize first is that STDs are very common, with an estimated half or more of sexually active adults reporting one or more STDs in their lifetime. Though more than half of these occur among teens and young adults, people of any age, socioeconomic background or education can be infected. That we can discuss – and educate – more people today than ever before about STDs may be one of “good” things derived from the sexual revolution.
Still, certain myths remain, including:
- I can’t have an STD since I don’t have symptoms.
- If I use a condom, I can’t get an STD.
- Only promiscuous people get STDs.
- STD testing is scary and invasive.
- People who are in love don’t need to use condoms.
The facts are:
- You can have an STD and have no symptoms. Some STDs can be present for years without symptoms. Don’t assume anything.
- Knowing your partner well, practicing safe sex and getting tested when needed, will minimize your chances of getting an STD.
- People from all walks of life get STDs, not just those who are promiscuous.
- Testing for common STDs is done through a simple blood or urine sample that can be ordered conveniently online.
- Being in love does not provide protection from an STD. Both partners should be tested if any questions arise.
- Same sex couples are at the same risk of an STD as heterosexual couples.
(An excellent source of definitive information on STDs is a 2007 book by Lisa Marr, M.D. titled Sexually Transmitted Diseases: A Physician Tells You What You Need to Know, Johns Hopkins Press Health).
What Is The Most Common Form Of Std Among Older Adults?
Many healthcare professionals say chlamydia rates have doubled for people over 50 in the past decade. Recognized since 1970, this bacterial infection has several variants (it can cause eye infections in newborns, for instance) but in STD form, is considered the most common STD in the industrialized world. Because many people have chlamydia without symptoms, the rates could be even higher since symptom-free patients seldom get tested.
Those who do experience symptoms may report the following:
- In women – genital discharge, burning upon urination, pelvic pain and bleeding between periods or after intercourse.
- In men – penis discharge ranging from clear to yellow, painful urination, irritation in or around the urethra and redness at the tip of the penis.
Treatment involves a course of antibiotics and is highly successful in eliminating the infection. Using condoms during sex helps prevent transmission. Less common yet still preventable STDs are genital warts, yeast infections, herpes and hepatitis A, B, or C, as well as HIV infection and AIDS.
What’s Behind The Rise In Stds Among Seniors?
In 2010, a study of sexual health from Indiana University revealed a surprising result: the lowest rate of condom use was among people ages 45 and older. The study also found that in general, healthcare providers tend to shy away from discussing sexual health and safe sex practices with older patients. Furthermore, health education awareness campaigns are directed toward teens and young adults, minimizing the problem for the older generation.
Little public health research has been conducted on the topic of STDs among seniors, so at this point all that’s known for certain is that infection rates are rising. For example:
- The Centers for Disease Control and Prevention (CDC) reported 885 cases of syphilis in the 45- to-64 age range in 2000. By 2010, the rates had risen to more than 2500. Because the number of older Americans has increased, HIV rates have nearly doubled along with the aging population.
- About three million adults in the U.S. are infected with the hepatitis C virus and most are baby boomers. Once infected with hepatitis C, about eight in 10 people remain infected for life. The virus can cause liver damage over time and even liver cancer. Up to 75 percent of those with the virus don’t know they have it. Therefore, the CDC recommends that anyone born from 1945 – 1965 should have a blood test for hepatitis C.
Besides lack of safe sex practices, little research and less awareness about STDs among the older population than younger age groups, other reasons presented for the rise in STD numbers include:
- A dramatic increase in the use of Erectile Dysfunction (ED) drugs since they were introduced in 1998. A Harvard Medical School study showed about twice the risk of STDs among men who took the drugs as opposed to men who didn’t. (Source: www.webmd.com/healthy-aging).
- People are living longer, divorce rates are high and entering the dating scene is more common today than ever before. Among baby boomers in particular, staying sexually active is paramount to staying “young.”
- Postmenopausal changes in women, including decreased lubrication, can make females more vulnerable to infection.
- In the older population, no one worries about pregnancy, which may account for the lower rates of condom use.
- Subtle symptoms that could be signs of an STD are sometimes mistaken for “normal” aches and pains associated with aging.
- There are still stigmas associated with discussing sex, especially among older generations.
As a result, clinicians are saying it’s now time that seniors took responsibility for safe sex practices and their own sexual health.
So What Is The Best Way To Maintain A Safe, Healthy Sex Life As We Age?
Healthcare professionals advise that any sexually active adult, regardless of age, should consider the following:
- Learn all you can about STDs, either through online research, books, seminars or open discussions with friends and colleagues.
- If you live in a retirement home where sexual activity takes place, suggest having a safe sex counselor visit to provide an educational seminar on safe sex practices and the proper use of condoms. (All condoms should be FDA approved). Find out if condoms are available onsite, as they are on many college campuses. In Baltimore, MD a portion of Department of Aging funds are devoted to health education that promotes safe senior sex and testing at various senior citizen centers.
- A condom should be used for every sexual contact when the STD status of the person is unknown, including oral, anal and genital contact. Don’t use latex condoms with oil-based lubricants due to the chance of breakage. Plastic or polyurethane are fine. Advocate for public health campaigns on safe sex for older populations, especially for those people who live independently and won’t be reached through retirement and assisted living centers.
- Have a frank discussion with friends, both genders, on the topic of sex and its repercussions, especially if you know they are dating or plan to enter a new relationship. Many older adults say it’s difficult to raise the subject of sex with their healthcare providers, who often don’t ask; therefore they don’t volunteer.
- If you are sexually active and have any symptoms that could relate to an STD, see your healthcare provider or get tested right away and be tested so that treatment can begin.
Finally, don’t let the “youngsters” get ahead of you in practicing safe sex. Recent studies show that among college-age Americans, condoms are used in nearly half of all sexual encounters, but only in about six percent of encounters for those 61 and older. As long as an active sex life is important to older adults and will continue, that statistic needs to change.