Sexually Transmitted Diseases (STDs) in Older Adults
Age offers no protection against STDs. You only have to look to a recent survey from Britain that shows that the numbers of STDs in people over 50 has doubled in the past decade. In the study, nearly half of the STD cases were genital warts,which is caused by certain forms of human papilloma virus (HPV). The rates of herpes, Chlamydia, gonorrhea and syphilis also increased.
The rate of STDs were highest in men and in those aged 55 to 59.
Other studies have found that the rates of HIV have also increased in this age group. A 2005 study found that 15% of all new HIV diagnoses were among men and women over the age of 50. And, thanks to newer therapies that have turned HIV into a chronic disease, many people who contracted the disease 10, 15 or 20 years ago are living well into mid and later life with the disease.
So, what's causing the skyrocketing rates of STDs? Some say it's the popularity of ED drugs Cialis, Levitra and Viagra or perhaps it's the increased numbers of divorces leading to more singles over 50 or is it simple ignorance?
Most older adults don't know what the younger set does about safe sex. While we've been drilled for years about the need for condoms to prevent STDs, ,any older people think that condoms are not needed after menopause or with partners they know.
In a survey conducted by the University of Chicago, nearly 60% of single women ages 58-93 didn't use condoms the last time they had sex. That's a much lower rate than in younger women.
... AND they mistakenly think STDs only occur in younger people.
I myself have diagnosed STDs in several older patients who are navigating new relationships after divorce or widowhood. And I have to admit, the diagnosis is often tough to make.
The symptoms are usually more subtle and we don't often think "STD" when evaluating a complaint in a older patient. For example, HIV can present with memory loss and fatigue.
Older women who are having unprotected sex may be at higher risk of getting an STD because the thinning of vaginal tissues that occurs after menopause make transmission of STDs much easier.
And once the diagnosis is made, Needless to say, the reaction is uniformly shock.
Much of the stigma that exists amongst younger people with STDs is MAGNIFIED in older patients who carry around outdated ideas about STDs.
Getting these patients to discuss their STD with their partner is, needless to say, tedious. Most feel tremendous shame. Some never discuss it.
Since this study, I've made a concerted effort to include safe sex as a topic for my older patients. It feels awkward, but I think it's necessary