Let’s face it, we’re a little old when it comes to sex. We often assume that young couples have sex, but older couples don’t. This means that when we look at an older couple—whether they’ve been married for decades or just started dating—we assume that sexually transmitted infections (STIs) aren’t a problem. But this is not true. STDs have nothing to do with age, but with sexual behavior. Older people have sex and should think about sexually transmitted infections.
The most recent data from the Centers for Disease Control and Prevention (CDC) found rapidly increasing rates of STDs among adults 55 and older. Between 2010 and 2022 in this age group:
- chlamydia cases increased by 342%
- gonorrhea cases increased by 593%
- Cases of primary and secondary syphilis increased by 760%
People are living longer and staying healthier into older ages, which means they can maintain an active sex life for many more years. The availability of erectile dysfunction drugs also means that many people with penises can have sex later in life. And hormone replacement therapy can help postmenopausal people maintain sex drive.
Older people certainly do. In a recent study, more than half of men aged 65 to 80 and nearly a third of women aged 65 to 80 reported being sexually active. In AARP survey26% of those aged 60-69 and 17% of those over 70 said they had sex once a week.
STD rates increase in the elderly
STDs are increasing in all age groups, and anyone who is sexually active can get an STD regardless of age. There are several reasons, however, that they may be increasing so rapidly in older age groups.
Older people, especially those with sinuses, may be biologically more susceptible to infections. After menopause, the vagina becomes thinner and less acidic, and there is less cervical mucus. All of these can make STD infection more likely.
Today, there are more opportunities—like dating apps—that can help adults of all ages find multiple partners. Because women live longer than men, there are often more single women than single men seeking companionship in any given community. This can encourage men to have more than one partner at the same time, which increases the chance of contracting and spreading STDs. Cases of chlamydia or gonorrhea in nursing and assisted living homes have been traced to this gender imbalance.
Additionally, this generation of people—most of whom came of age before the AIDS epidemic—are often less educated about STIs and safe sex. ONE small study of people aged 65 to 94 found they had many misconceptions about STIs:
- 63% believed that HPV and HIV were caused by the same virus
- 49% believed there was a vaccine for gonorrhea
- 38% believed women could diagnose themselves with chlamydia based solely on vaginal odor
Not surprisingly, condom use among the elderly is low. In one study, only 3% of people aged 60+ used condoms in the last year.
People in this age group are also not routinely screened for STDs. They may not be aware of their continued need for screening tests, and health care providers rarely bring up sexual health with their older patients.
We need to Talk about STDs and sexual health
There are things we can all do to stop the rapid spread of STDs among the elderly.
Health care providers need to start talking about sex with older patients and offer appropriate STD screening tests. They should also encourage communication between partners and encourage condom use for anyone not in a mutually faithful monogamous relationship. These discussions are also great opportunities to talk about other sexual health issues or concerns such as sexual difficulties, vaginal dryness or libido problems.
Older people who have sex should talk to their partners and be honest about things like having multiple partners recently or at the same time. They should also talk to their partners about the importance of condoms in preventing STDs. And they should ask their health care providers about regular STD screening.
Young people, who may have the best understanding of STDs and prevention of sexually transmitted infections, need to talk to the older adults in their lives whether it’s parents, grandparents or aunts. Yes, these conversations can be uncomfortable, but there are important ones.
Everyone deserves a healthy sex life into old age, if that’s what they want. Prevention of sexually transmitted diseases is an essential part of this.
