This is why STIs are spreading rapidly among older adults
The rates of STIs among seniors over the age of 65 is skyrocketing.
unbranded – Lifestyle
In 2010, Lisa Copeland found herself single, again.
After two marriages – one lasting 24 years and the other lasting two – the Cleveland-area resident in her early fifties didn’t know where to start her search for companionship.
Copeland tried enlisting the help of a dating coach but realized there weren’t any under 50 years old who would understand the dating scene for adults her age. Instead of crying to her sister on the phone, which she had tried already, she decided to change her outlook.
“Dating in your 20s was about getting married, having kids, cats, dogs – building your world,” Copeland said, now 68. “Today, it’s about fun and play.”
But the dangers single people over 50 face differ from those they encountered as singles decades earlier. Learning that lesson has become essential for Copeland and others as research shows that sexually transmitted infections, or STIs, are skyrocketing among older adults at a faster rate than among other age groups.
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The rising STI rates for older adults can be explained, in part, by the comforts of 21st-century life. Older adults are living and staying sexually active longer thanks to medical advances, health experts say. They’re more likely to live in senior communities and have multiple partners, but are less aware than their younger counterparts about how to use prevention tools, such as condoms and regular STI screenings.
Part of the problem is people in this population lack education, experts say. The larger issue is that people of all ages are uncomfortable talking about sex – especially among older Americans – which makes it difficult to spread awareness about sexual health.
“There’s a lot of factors going into this,” said Janie Steckenrider, who researches political gerontology, aging and sexuality as an associate professor at Loyola Marymount University. “We need to start normalizing that older adults are sexually active and interest in sex doesn’t stop at a certain age.”
STIs skyrocket among boomers
Younger people have a greater number of STI cases, however, experts say what’s alarming is the rate at which STIs are increasing among adults 55 and older.
From 2012 to 2022, chlamydia cases in this population more than tripled, increasing from 6,084 cases to 19,776 cases, according to the Centers for Disease Control and Prevention. During the same time, the agency’s researchers also found gonorrhea cases more than quadrupled and syphilis cases increased sevenfold.
Steckenrider said the increase since 2012 has been “extremely dramatic.”
These diseases can be easily cured with the right cocktail of antibiotics, but they cause complications if left untreated. This is especially true for older adults, who often have other medical conditions that could worsen with an infection, said Dr. Angelina Gangestad, division chief of obstetrics and gynecology at University Hospitals in Cleveland, Ohio.
Untreated chlamydia and gonorrhea in women can lead to pelvic inflammatory disease which may lead to chronic pelvic pain, according to the World Health Organization. Men with untreated chlamydia can also experience painful infections and swollen joints.
Syphilis can attack any organ system and can cause long-term damage to the heart, brain, nerves and eyes, according to the Cleveland Clinic.
Dating trends that increase STI risk
Sexually transmitted infections are increasing at an alarming rate among older adults partly because they’re living longer, healthier lives, experts said.
They’re also more likely to remain sexually active for longer thanks to the help of erectile dysfunction drugs and hormone therapy to treat menopausal symptoms. Two-thirds of older adults say they’re interested in sex, according to AARP.
“When you have an elderly population who are just physically healthier, they’re going to be more sexually active and are better able to perform in those ways,” Gangestad, from University Hospitals in Ohio, said.
More adults are also choosing to live in senior living communities than staying at home or with a family member, Steckenrider said, which leads to more socialization and sexual encounters.
More than 800,000 people live in assisted living communities in the U.S. and approximately 1.5 million live in nursing homes, according to the American Health Care Association/National Center for Assisted Living.
The dating prospects are often narrower for older adults than singles in their twenties.
About 30% of U.S. adults over the age of 50 are single as the result of death or divorce, according to 2022 data from the Pew Research Center, compared to 47% of adults under 30.
Women live six years longer than men on average, according to the National Center for Health Statistics. While research shows men of all ages tend to have more partners than women, experts say this trend may be more pronounced among older men because there are fewer men in the dating pool.
Older adults are also more likely to meet online through dating apps, where partners are unaware of each other’s sexual history and the plethora of options lends itself to more casual dating with multiple partners.
“This is a generation that came of age in the 1960s and 70s during the sexual revolution,” which challenged monogamy and traditional sex roles, Steckenrider said. They carry this perspective of sex and free love into their later years but fail to incorporate the safe sex component that was taught to younger generations.
Sex education and stigma
Having multiple partners or anonymous sex is less of an issue if older adults use prevention tools to protect themselves against STIs, experts said. The problem is they aren’t.
This population may have grown up in the generation of “free love,” but education about sexually transmitted infections didn’t enter the comprehensive curriculum until the 1980s, according to Planned Parenthood.
Gangestad, from University Hospitals in Ohio, said teens during that era learned pregnancy prevention but teachers didn’t focus on STIs. “You have an age group where you’re no longer concerned about pregnancy and so… they’re not thinking about using condoms in the same way.”
Many older adults were in monogamous relationships and had families by the time HIV became a public health crisis in the 1980s, Steckenrider said. Sexually transmitted infections weren’t a concern for them then, and aren’t a concern now.
“For many seniors, there’s a disconnect. They don’t think of themselves as being at risk,” said Fred Wyand, sexual health expert and communications director at the American Sexual Health Association (ASHA).
Experts say people can prevent STI transmission by getting screened and tested, however, health care providers are less likely to offer testing to older adults than younger patients, experts say.
Patients may not show signs they have a sexually transmitted infection or their symptoms may mimic those associated with certain medications or other health conditions, so providers may not think to ask about testing for STIs.
Doctors “tend to assume that older adults are not sexually active, so they don’t routinely ask about their sexual health,” Steckenrider said. “Unless the older adult brings it up with their medical provider, it’s not being talked about.”
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How to reverse the trend
The key to reversing the skyrocketing STI rate among older adults is better awareness and education, experts say.
Doctors must be unafraid to broach the topics of sex and STIs with their older patients and older patients must know what to ask.
“There’s discomfort for both patients and professionals,” Wyand said. It’s difficult for older patients to discuss these topics with a primary care provider who is much younger than them.
To help start these conversations, the organization offers ten questions to ask healthcare providers during a wellness visit, including, “Where can I go for testing?” and “How often should I get tested?”
Sex health experts also suggest that educators bring materials about sex and STIs to senior living communities, senior centers, libraries, hospitals and other places where older adults are likely to see them.
It’s also important to promote testing information, experts say. ASHA and Everly Health, a virtual care provider, partnered for a National Get Tested Day on Sept. 30, to spread awareness. They’re offering 250 free at-home kits, which typically cost $69 each, to test for chlamydia and gonorrhea.
“The whole issue of stigma is really a barrier, not just for older people, but anything to do with S-E-X can be hard to talk about,” Wyand said.
But dating after 50 doesn’t have to be uncomfortable. Copeland, who got back out there in 2010, said recalling her own experience. In fact, it should be fun.
After she found joy in her romantic life, she created the website FindAQualityMan.com in 2012 to help other women over 50 navigate the seemingly daunting world of dating. She always advises her clients to have conversations about safe sex with prospective partners and use condoms and lubricants.
“I don’t want people to feel guilty, but be safe about it,” Copeland said.“It’s okay to fulfill your hormones.”
Adrianna Rodriguez can be reached at [email protected].