Older adults

By Elizabeth Boskey, PhD September 20, 2021 https://www.verywellhealth.com/stds-the-elderly-3133189

STDs in Older Adults

There is a significant risk in this group

Sexually transmitted diseases aren’t just a problem of the young. Older people can suffer from them, too. In fact, there are several reasons why older adults may actually be in more danger from STDs than their younger counterparts, including:

  • Lack of regular screening for sexual problems can increase the risk of a disease going unnoticed for years, leading to serious complications.
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  • After menopause, women’s vaginal tissues thin and natural lubrication decreases.1 This can increase the risk of micro-tears and of sexual transmission of certain diseases such as ​HIV/AIDS.
  •  
  • Older people are less likely to use condoms, both because they don’t consider themselves to be at risk of STDs and because they were never educated that condoms should be part of their sex lives.
  • The immune system naturally becomes less effective as people age, which can also increase the risk of sexually transmitted infections.

The Size of the Problem

More than 60% of individuals over 60 have sex at least once a month,3 and yet they are rarely considered to be at risk of an STD. Furthermore, even those older adults who are no longer sexually active may still have a sexually transmitted infection for which they were never treated or screened, and the long-term neurological side effects of diseases such as HIV and syphilis may be easily mistaken for other diseases of aging.

It is, therefore, essential that not only older adults, but the individuals who care for them, be educated about STD risk. Additionally, older individuals and their caregivers need to be taught about safer sex, so that they know how to reduce their risk if, and when, they choose to engage in sexual activity. Sex can be an important part of a person’s life, no matter what their age. It’s important that everyone learns how to engage in it safely so that it enhances their health rather than damages it.

HIV Is a New Problem for Older Adults

Statistics published in 2018 by the Centers for Disease Control and Prevention (CDC) have shown that the number of new HIV infections is actually growing faster in individuals over 50 than in people 40 years and under, and HIV may just be the tip of the iceberg.

Numerous factors have contributed to the increase in sexually transmitted diseases in older persons, and many of them stem from a single problem. Namely, clinicians and scientists don’t spend enough time thinking or talking about older individuals having sex. Not only are older adults usually overlooked in many STD studies, but they are frequently less likely to get screened for STDs than their younger counterparts.

 

Part of the problem, at least, is addressed by the CDC screening guidelines which, among other things, recommend that healthcare providers screen all patients between the ages of 13 and 64 for HIV as part of their regular visits. In this age, when divorce rates are up and Viagra and other erectile dysfunction medications are available online, sex among older persons may be at an all-time high.

Cervical Cancer

Every year, thousands of women in the United States die from cervical cancer.6 But cervical cancer is largely a preventable disease.7

Caused by human papillomavirus (HPV), an STD, regular cervical screening via Pap smear is an effective way to catch early cancerous changes before they can start to cause problems.

One of the many reasons why the incidence of cervical cancer rises so quickly in older women is that many women stop going to their gynecologist once they stop using birth control pills.

 

Although Pap smears can be done by any clinician, many older women are reluctant to seek out the discomfort of a sexual health exam, particularly if they are unmarried, not sexually active, post-menopausal, under-insured, or have a limited income. Older women may also be reluctant to be screened for something that, in its early stages, has no symptoms and for which they perceive themselves to be at little risk.

Screening, however, is essential. It can take a decade or more for an HPV infection to develop into the early stages of cervical cancer. Although screening guidelines vary by organization, in general even older women who are not sexually active should still be considered to be at risk.

If you are a woman age 55 or older, it is important to talk to your doctor about how often you need to be screened for cervical cancer. Most women will need to be tested every couple of years, but certain women who are considered to be at very low risk may be able to stop screening after a certain number of negative tests.

If you have a woman in your family of that age, such as a mother or a grandmother, make certain she knows she needs to be regularly tested. It could save her life.

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