A new research review presented at a pre-congress day of this year’s European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024, Barcelona, April 27-30) will examine how to manage the rise in sexually transmitted infections (STIs). ) in the elderly. people, such as gonorrhea, syphilis and genital warts. The focus will be on the importance of sex, intimacy and sexual health for the baby boomer generation, especially as one in six people worldwide will be aged 60 or over in ‘by 2030. The presentation will be given by Professor Justyna Kowalska from the Medical University. of Warsaw, Hospital for Infectious Diseases in Warsaw, Poland-; which will highlight the need to normalize conversations around older people and sexual health.
Data from the U.S. Centers for Disease Control and Prevention (CDC) indicates that rates of chlamydia, gonorrhea and syphilis among U.S. adults aged 55 and older have more than doubled over the past 10 years. For example, gonorrhea rates among people aged 55 to 64 years increased from approximately 15 cases per 100,000 people in 2015 to 57 cases per 100,000 in 2019 (1). In England, 31,902 new STIs were recorded among over-45s in 2015, compared to 37,692 in 2019, an increase of 18%, with the majority of new diagnoses affecting men who have sex with men (2) . High prevalence estimates of STIs have also been reported more widely among older adults around the world, including in China, Korea, Kenya and Botswana.
Rising divorce rates, forgoing condoms because there is no risk of pregnancy, availability of medications for sexual dysfunction, large numbers of older people living together in retirement communities, and increased use of dating apps have likely contributed to this increasing incidence. STIs in people over 50. This data likely underestimates the true scale of the problem, due to limited access to sexual health services for over-50s and the attempt to avoid stigma and embarrassment from older people and professionals health conditions lead this age group not to seek help. for STIs.”
Professor Justyna Kowalska from the Medical University of Warsaw
The problem is compounded by the many misconceptions regarding sexuality and sexual activity among older adults, as well as the importance of sex and intimacy to older adults’ happiness and well-being. As Professor Kowalska explains: “People don’t become asexual with age. In fact, through preventative medicine and lifestyle improvements, people are enjoying healthy, sexual lives longer. We need more role models like Samantha Jones on the TV series. Sex and the city to challenge stereotypes around the sexuality of older people.
Although the frequency of sexual activity tends to decrease with age, older people continue to have a lot of sex. In a study in England, half of men and almost a third of women aged 70 and over reported being sexually active. Similarly, in a Swedish study, 46% of people aged 60 and over reported being sexually active, as did 10% of people aged 90 and over.
Studies show higher levels of sexual desire, greater sexual frequency, and a greater number of sexual partners in older men than in women. A retrospective study in the United States of 420,790 couples aged 67 to 99 found that widowhood was associated with an increased risk of STIs in older men, but not in women. And the effects in men were greater after sildenafil (Viagra), the first phosphodiesterase type 5 inhibitor (PDE5 inhibitor), came on the market. Professor Kowalska said: “These results indicate that sexual risk-taking is common among older people, particularly men. Given that the number of people aged 60 and older is expected to double worldwide by 2050 and medications to enhance sexual activity are widely available, healthcare professionals must be proactive in discussing sexual concerns and making sexual health a routine part of general health care for older people.
Although the incidence of STIs among the over-50s is low compared to younger age groups, it is increasing, and Professor Kowalska will call for awareness of sexual health among older people, explaining that they are came of age at a time when sex education in schools did not exist. “Sexual health campaigns focus on young people and neglect the needs and experiences of people aged 50 and over,” she says. “Health promotion messages make it seem like condoms and concerns about STIs only apply to young people. But the dangers of undiagnosed and untreated STIs, such as HPV-related cancers, and their onward transmission are very real, especially in this age group who are more likely to be infected. have underlying conditions such as heart disease and stroke.
Professor Kowalska will also highlight the lack of evidence on using communication to promote positive behaviors to reduce the spread of STIs among older adults, particularly outside the United States and for infections other than HIV. “Increasing older people’s knowledge about the risk of STIs and how to practice safer sex is crucial to combating record levels of STIs,” says Professor Kowalska. “Tailoring educational programs for the over-50s, including peer support and ensuring they are located within existing community settings is essential to their success.” Ultimately, she says, “Older people have a right to good sexual health, so let’s normalize conversations around sex and older people, and change the conversation about aging.” »