Age Doesn’t Protect: The Rise of STIs in Older Adults

Rates of sexually transmitted infections (STIs) have doubled in older adults. The increase is part of a decade-long trend of rising STI rates in America. Yet older adults remain largely excluded from public health discussions and interventions, which continue to focus predominately on younger populations.

Seventy-five percent of adults aged 57-65 years and half of adults over 65 are sexually active. Due to divorce, widowhood, or choice, many (36%) are single, and this percentage is growing, with 14% of single adults over 57 in a “dating relationship.” For those who are newly single, this period may mark a reawakening of sexual desire with new partners. Many older adults are now using dating apps to meet potential partners, allowing them to explore their sexuality in ways that have been previously inaccessible. However, no matter how old you are, STIs can be an invisible risk; older adults may not be thinking about this. But they should.

A review article examining the rise in STIs among older adults revealed a prevalent belief that those past reproductive age are no longer at risk for infections. Researchers suggest that this misconception stems from a lack of age-appropriate sexual education and the fact that many older adults are sexually active for the first time in years. Additionally, health care providers often overlook sexual health during visits with older patients.

Ethan Morgan and colleagues surveyed 794 older adults in Columbus, Ohio, to assess factors influencing STI prevention and infection. They used data from the Columbus Healthy Aging Project and defined older adults as being 50 years old or above, with an average participant age of 58.5 years. Notably, 40.6% of the participants were living with a spouse or partner, which is lower than the national percentage.

Results showed that 46.4% of participants had undergone an STI test. Among those tested, 15.6% had positive results, which aligns with national trends for this demographic. Cisgender women, bisexual persons, and Black individuals were most likely to report a positive STI test.

Condoms emerged as the most common form of STI protection, with 51.8% of respondents reporting their use. However, 27.8% of participants indicated they used no prevention methods. Cisgender men were more likely to use condoms compared to cis- and transgender women and intersex individuals, who were least likely to use any form of protection. The data also revealed a decline in the use of condoms or other infection prevention methods as individuals age.

Morgan and colleagues emphasize that older adults are not a homogenous group, urging the development of educational curricula tailored to diverse needs based on age, gender identity, and sexual orientation. They particularly advocate for targeted education for historically low-risk populations, such as heterosexual individuals, who were found to be least likely to use any prevention methods. Researchers from both studies advise medical professionals to spend more time discussing sexual health with their older patients during appointments.