Free-spirited baby boomers challenged social norms and launched the sexual revolution of the 1960s and ’70s. Now that lifestyle is playing a part in the rise of sexually transmitted diseases (STDs) among older people that challenges traditional perceptions of seniors’ sexual health.
While STDs are commonly associated with younger individuals, recent data shows a significant increase in infection rates among those aged 55 or older.
“The rates of STDs for people in their 60s is still just a fraction of those for people in their 20s who are at the peak of their sexual activity, but they are rising faster percentage-wise,” said Dr. Gerald Pierone, a board-certified infectious disease doctor who practices at Whole Family Health in Vero Beach and Fort Pierce.
Historically, older people have been considered at low risk for STDs because they weren’t very sexually active, but with the advent of drugs like Viagra and other social factors, this assumption falters.
According to the Centers for Disease Control and Prevention (CDC), cases of gonorrhea have grown roughly sevenfold since 2010 among American adults older than 55. Data also shows that cases of chlamydia have more than quadrupled since 2010 and cases of syphilis were nearly eight times higher among the same age group.
“One reason is that people are entering into new relationships later in life due to divorce or death of their spouse,” Dr. Pierone said. “They may have been in a relationship for 20 or 30 years and they aren’t necessarily thinking about condoms or about the risk of sexually transmitted diseases. It’s not uncommon for someone who enters into a relationship later in life and becomes intimate to find out that they have HPV or the herpes simplex virus.
“We call it the condom gap because younger people who are sexually active are more likely to use condoms. Older people didn’t grow up in an era of wearing a condom because they didn’t grow up with HIV.”
Another contributing factor is the lack of awareness and education regarding STDs among older adults. Many seniors grew up in a time when discussing sexual health was taboo, and as a result, they may not be well informed about the risks of STDs or the importance of using protection. Older adults may also mistakenly believe that they are not at risk for STDs, especially if they are past childbearing age.
“Sexual activity has definitely been extended because people are living better,” Dr. Pierone continued. “There are a lot of robust, very active people in their 60s, 70s and 80s. And there are also medications like sildenafil (Viagra) for men that are able to preserve sexual function.”
The stigma associated with sexual activity in older age also plays a role. It can prevent older adults from seeking information, testing or treatment for STDs because they feel it is somehow inappropriate for them to have sexual partners. Additionally, healthcare providers may not prioritize sexual health discussions with their older patients, further exacerbating the issue.
Diagnosing STDs in older adults presents unique challenges because symptoms of STDs can often mimic other age-related health issues, such as urinary tract infections or skin conditions. This can lead to delays in diagnosis and treatment, increasing the risk of complications. Untreated syphilis, for example, can lead to serious long-term health problems including cardiovascular and neurological damage.
“The good news is that most of these sexually transmitted infections are pretty easy to treat,” Dr. Pierone assured. “Gonorrhea is an easy injection and often a pill that goes with it, as are so many others. Syphilis is an injection. Those are curable with a very short treatment. Now hepatitis C, HIV and even HPV are different. They tend to become chronic infections and may require longer term, more complicated treatment plans.”
Treatment of STDs in older adults also requires special consideration as they may have comorbid conditions or may be taking multiple medications that can complicate treatment regiments. Additionally, the social and psychological impact of an STD diagnosis can be significant in older adults, leading to feelings of shame, guilt or depression.
Fortunately, while this trend is taking hold nationwide, Vero Beach has not been heavily affected to date.
“We really don’t see that many STD cases among the elderly here in Indian River County,” said Dr. Pierone. “We’ve only seen two or three cases in the last year of people over the age of 55 compared to 30 to 50 cases of younger people. National and state numbers are often disproportionate for some areas versus others. It has a lot to do with culture. We don’t live in an area where we are out partying a lot, and our community is a more conservative community than you might find in a larger city or more metropolitan area.”
Addressing the rise in STD rates among the elderly requires a multifaceted approach. First is increasing awareness and education for that population through public health campaigns with messages about the importance of STD prevention, testing and treatment.
Healthcare providers should be more proactive in discussing sexual health with older patients and encouraging them to routinely screen for STDs. And efforts should be made to reduce the stigma associated with sexual activity in older age. This could be achieved through community-based programs that promote healthy aging and normalize discussions about sexual health at all stages of life.
Anyone entering into a new relationship should talk to their partner about STDs prior to having sex so they can take any needed precautionary measures. It’s possible to reverse this troubling trend so that adults can enjoy healthy, satisfying sex lives without the risk of infection.
Dr. Gerald Pierone received his medical degree from the University of Florida and completed his internal medicine residency training at the University of Medicine and Dentistry in New Jersey. He trained in infectious diseases at the Mount Sinai School of Medicine in New York.
He is board certified in Internal Medicine and Infectious Diseases and a member of the Infectious Diseases Society of America. He can be reached at Whole Family Health in Vero Beach at 772-257-5785 or in Fort Pierce at 772-468-9900.