Advice | 6 Reasons Why STDs Are Skyrocketing Among Older Adults

Advice |  6 Reasons Why STDs Are Skyrocketing Among Older Adults

Sexually transmitted infections have been steadily increasing in the United States in recent years. But one group has been disproportionately affected: the elderly.

Data from the Centers for Disease Control and Prevention shows that among people over 65, the number of chlamydia diagnoses more than tripled between 2010 and 2023. The number of cases of gonorrhea has increased approximately sixfold. And the number of syphilis cases increased almost tenfold.

To address this alarming trend, physicians, health officials and the broader public must understand the underlying factors contributing to it. Here are six:

1. Lack of knowledge about STDs. In a 2020 study, researchers asked 65- to 94-year-olds basic questions about STDs, and many gave incorrect answers. For example, only half knew there was a cure for chlamydia, and almost two-thirds said a woman can tell if she has gonorrhea by looking at her body.

The study’s lead author, Matthew Lee Smith, an associate professor at Texas A&M’s School of Public Health, told me that many older people came of age at a time when there was little or no sexual health education in schools. As a result, they may not be aware of their risk of contracting STDs or the need to prevent them.

2. Low condom use. Smith explained that condom use among this demographic is “really limited.” This may be a result of the misconception that condoms are primarily used to prevent pregnancy. Since this is no longer a problem in this age group, many forego condoms.

A survey by AARP found that only 8 percent of older adults who were sexually active in the past month consistently used condoms. Another study found that only 3 percent of people aged 60 and older used condoms in the past year.

3. Older people are healthier and remain sexually active longer. Thanks to pharmaceutical advances such as erectile dysfunction medications and hormonal therapies to relieve vaginal dryness, today’s older adults can maintain a healthy sex life for longer than in years past.

One study found that more than half of men and 31 percent of women between the ages of 65 and 80 were sexually active. Another study conducted by AARP concluded that 26 percent of people between the ages of 60 and 69 had sex weekly, as did 17 percent of people age 70 and older.

4. More opportunities for new sex partners. Smith pointed to the increase in the number of widows and divorcees choosing congregate living communities. “They live together and want intimacy,” he said. Additionally, many dating apps specifically target older adults, such as OurTime, SeniorMatch, and SilverSingles.

5. An imbalance between the sexes. Women have an average life expectancy that is almost six years longer than men. The disproportionate number of women outliving their partners results in what Smith calls a “partner gap,” where older men have multiple female sex partners. With little or no condom use, such non-monogamous behavior increases the risk of STDs.

This phenomenon is supported by data from the CDC, which shows that there is a huge gender gap in STD rates among people age 65 and older. In this age group, men had almost seven times as much gonorrhea and almost ten times as much syphilis as women. While some of the discrepancy could be because men have sex with each other, it’s likely that some men have unprotected sex with multiple women — and unknowingly spread infections.

6. Discomfort discussing sex. Many older adults are hesitant to communicate with new partners about their sexual preferences and needs, Smith told me. They may not ask about each other’s sexual history or whether they’ve had an STD test recently.

Unfortunately, this discomfort extends to the medical profession. Despite the prevalence of sexual activity among older adults, one study reported that only 17 percent of people between the ages of 65 and 80 talked to their doctor about sexual health in the past two years. Most of these conversations were initiated by the patient, not the doctor.

Doctors may focus on what they believe are more pressing aspects of these patients’ medical histories, such as heart disease, diabetes and other chronic diseases. But ageism undoubtedly plays a role, with healthcare providers pandering to the misconception that older adults are no longer having sex.

Abundant data show the opposite, which should prompt the health care system to change its practices. Doctors routinely ask young people about their sexual history and screen for STDs; they should do the same for older adults. Public health officials target adolescents with educational campaigns about condom use; they should initiate these for seniors and seek the help of congregate living facilities and dating apps.

“Society should not discourage or shame older adults about their needs or desires for intimacy, affection and sex,” Smith said. An active sex life among older adults is indeed a sign of vitality and good physical and mental health. The medical system and wider society should help everyone live their best lives, regardless of age.