American Sexual
Health Association

STIs Are Not Just for the Young

An older couple kissing

Let’s face it, we’re a little ageist when it comes to sex. We often assume young couples are having sex, but older ones are not. That means that when we look at an older couple—whether they’ve been married for decades or just started dating—we assume sexually transmitted infections (STIs) aren’t an issue. But that’s not true. STIs aren’t about age, they’re about sexual behavior. Older people are having sex, and they need to be thinking about sexually transmitted infections.

The most recent data from the Centers for Disease Control and Prevention (CDC) found rapidly increasing rates of STIs among adults 55 and over. Between 2010 and 2022 in this age group:

  • cases of chlamydia rose 342%
  • cases of gonorrhea rose 593%
  • cases of primary and secondary syphilis rose a whopping 760%

People are living longer and staying healthier until older ages which means that they can maintain an active sex life for many more years. The availability of erectile dysfunction medication also means that many people with penises are able to have intercourse later in life. And hormone replacement therapy can help post-menopausal people maintain sexual desire.

Older people are definitely doing it. In one recent study, over half of men ages and almost a third of women ages 65 to 80 reported being sexually active. In an AARP survey, 26% of people ages 60-69 and 17% of those over 70 said they had sex once a week.

STI Rates Are Rising in Older Adults

STIs are on the rise among all age groups, and anyone who is sexually active can get an STI regardless of their age. There are a number of reasons, however, that they may be rising so fast in older age groups.

Older adults, especially those with vaginas, may be biologically more prone to infection. After menopause, the vagina becomes thinner and less acidic, and there is less cervical mucous. All of this can make contracting an STI more likely.

Today, there are more opportunities—like dating apps—that can help adults of all ages find multiple partners. Because women live longer than men, there are often more single women than single men looking for companionship in any given community. This may encourage men to have more than one partners at once which raises the likelihood of contracting and spreading STIs. Outbreaks of chlamydia or gonorrhea in nursing homes and assisted living facilities have been traced back to this gender imbalance.

In addition, this generation of people—most of whom came of age before the AIDS epidemic—are often less educated about STIs and safer sex. A small study of people ages 65 to 94 found they had many misconceptions about STIs:

  • 63% thought HPV and HIV were caused by the same virus
  • 49% thought there was a vaccine for gonorrhea
  • 38% thought women could diagnose themselves with chlamydia based solely on vaginal odor

Not surprisingly, condom use among older adults is low. In one study, only 3% of people aged 60+ used condoms in the last year.

People in this age group are also not getting screened for STIs regularly. They may not be aware of their continued need for screening test, and health care providers rarely bring up sexual health with their older patients.

We Need to Be Talking about STIs and Sexual Health

There are things we can all do to help stop the rapid spread of STIs among older adults.

Health care providers need to start talking about sex with older patients and offering the appropriate STI screening tests. They should also encourage communication between partners and urge condom use for anyone who is not in a mutually faithful monogamous relationship. These conversations are also great opportunities to talk about other sexual health issues or concerns like sexual difficulties, vaginal dryness, or issues with libido.

Older adults who are having sex should talk to their partners and be honest about things like having multiple partners recently or at the same time. They should also talk to their partners about the importance of condoms to prevent STIs. And they should ask their health care providers about regular STI screening.

Young people, who may better understand STIs and STI prevention, need to talk to the older adults in their lives whether it’s their parents, grandparents, or great aunts. Yes, these conversations may be awkward, but there are important.

Everyone deserves a healthy sex life well into old age if that’s what they want. Preventing STIs is an essential part of this.

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