There’s no such thing as being too old to get a sexually transmitted infection (STI). Despite that, there’s “a misconception” that older adults are “immune to STIs simply because they’re over the age of 55 and that’s not going to happen to them anymore,” Dr. Ina Park, associate professor of family community medicine at the University of California, San Francisco and author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STIs, tells Yahoo Life.
Park wants older adults to know that you can get an STI “regardless of your age.” Quoting HIV research scientist Dr. Stephen Karpiak, Park says, “Age is not a condom.”
In fact, according to Park, “you might be surprised to know that STIs are going up for everybody, including for people over the age of 55.”
STIs on the rise
The Centers for Disease Control and Prevention tracks STIs, including chlamydia, gonorrhea and syphilis. Although infections like chlamydia, for example, are highest among adolescents and young adults, a new research review presented at the European Congress of Clinical Microbiology and Infectious Diseases points out that STIs — specifically, chlamydia, gonorrhea and syphilis — in Americans ages 55 to 64 have more than doubled over the past decade. Given that 1 in 6 people globally will be 60 and older by 2030, the review calls on health professionals to take the initiative by bringing up sexual health as a routine part of health care for older adults.
This isn’t the first study to point out the rise in STIs in this age group. A 2020 study found that STIs in general among older adults have “dramatically increased in recent years, especially among those who are widowed and divorced.”
Although new HIV diagnoses are dropping among people 50 and older, about 1 in 6 HIV diagnoses in 2018 were in this older age group, according to the CDC. In addition, Park points out that herpes, which is highly contagious, is “an infection that stays with you forever once you become infected” and that the percentage of people with herpes “goes up with age.”
By the time people are over the age of 50, Park says “about 1 in 5 of us has herpes type 2,” which causes genital herpes. “And then when we talk about herpes type 1, which causes oral herpes or cold sores, it’s over 60 percent of the U.S. population over the age of 50 that has herpes type 1.”
STIs — including the most common sexually transmitted infection, HPV (or human papillomavirus), which can cause health problems such as genital warts and certain cancers in women and men, according to Cleveland Clinic — can also spread in retirement communities where the ratio of men to women is “really skewed,” says Park.
That’s because men typically don’t live as long as women, notes Park, so there tends to be fewer men in those communities. “The ones that are around are getting lots of action, so they’re having multiple partners,” she says. “And if you have multiple concurrent partners, that is the easiest way to spread an STI in a community.”
Why are older adults at risk of STIs?
There are several reasons STIs continue to infect older adults. Park, who also serves as a medical consultant to the CDC Division of STD Prevention, says that some have had “absolutely zero education” when it comes to sexually transmitted infections and how to prevent them, while others were either only taught about unplanned pregnancy or experienced “fear-based education” that focused solely on the “worst-case scenario” pictures of STIs.
For still others, it may have been years since STIs were even on their radar. Park acknowledges that one of the “biggest adjustments” that some newly single older adults face is dating after being in a long-term, stable partnership and “not having had to think about sexual health for decades,” she says, adding: “It’s definitely a brand-new world out there.”
Dr. Justyna Kowalska, author of the new study and professor of medicine at the Medical University of Warsaw in Poland, stated in a press release: “Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over 50s.”
However, she added that these numbers likely underestimate how many older adults are impacted by STIs, given that “stigma and embarrassment both on the part of older people and health care professionals … is leading to this age group not seeking help for STIs.”
‘We make assumptions that older people are not sexual beings’
Another contributing factor: Some doctors either assume that older adults aren’t having sex, aren’t comfortable bringing up the topic or run out of time to cover it during a checkup.
“I think we, as a society, really stop discussing sexuality or thinking about sexuality past a certain age, because I think we make assumptions that older people are not sexual beings,” says Park. “And I’m here to tell you that’s absolutely not the case. I think we’re really doing a disservice to folks.”
If physicians don’t ask their older patients whether they’re sexually active, then they’re “missing out on that opportunity to have that conversation,” not only to “see if they’re actually having pleasure in their sex life” but also to “troubleshoot any issues that might be going on and then give them the opportunity to test for STIs.”
Park says that the reason physicians may not bring up the topic is that “some of us feel uncomfortable with the idea that someone that’s the age of our parents, for example, is still having sex,” she says, “but it’s certainly still happening — not for everybody, but it’s important as providers and clinicians to ask and see what’s going on in people’s sex lives, because it’s something that for some people goes on lifelong.”
There is also the issue of shame when it comes to sex and STIs, making it harder for older adults (and younger people) to bring it up with their doctor. “Shame and stigma are such a huge factor in STIs and why people avoid going in to get tested because they are afraid to know the answer to the test results,” Park says.
But Park wants people of all ages to know that “most STIs can be cured,” and the ones that can’t be cured can “certainly be controlled.”
She says we need to think about sexual health as an important part of our overall health and not something that only younger people need to be conscious of. Along with using condoms, which reduce the risk of STIs when used consistently and correctly, Park recommends that those who are sexually active and aren’t in monogamous relationships get tested for STIs between different sexual partners or at least once a year.
“Just because you happen to be above a certain age, you are not immune to getting an STI if you are still sexually active,” Park says. “So don’t have that illusion that your age is going to protect you. Go out and use protection yourself and get tested.”
Video produced by Jacquie Cosgrove.
This article was originally published on Feb. 24, 2022 and has been updated.
