Opinion | 6 reasons why sexually transmitted diseases are increasing rapidly among older people

To counteract this worrying trend, doctors, health officials and the general public need to understand the underlying factors that contribute to it. Here are six of them:

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

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

2. Low condom use. Smith explained that condom use is “really limited” in this population. This may be due to the misconception that condoms are primarily used to prevent pregnancy. Since this is no longer an issue in this age group, many forego condoms.

According to an AARP study, only 8 percent of older adults who were sexually active in the past month reported using condoms consistently. Another study found that only 3 percent of people over 60 used condoms in the past year.

3. Older people are healthier and remain sexually active longer. Thanks to pharmaceutical advances, such as drugs for erectile dysfunction and hormone therapies to relieve vaginal dryness, older people can now maintain healthy sex lives longer than before.

According to one survey, more than half of men and 31 percent of women between the ages of 65 and 80 reported being sexually active. Another survey conducted by AARP found that 26 percent of those ages 60 to 69 had sex weekly, as did 17 percent of those over 70.

4. More opportunities for new sexual partners. Smith pointed to the rise in the number of widowed and divorced people choosing to share homes. “They live together and want intimacy,” he said. In addition, many dating apps are specifically geared toward older adults, such as OurTime, SeniorMatch and SilverSingles.

5. A gender imbalance. Women have an average life expectancy that is almost six years longer than men. The disproportionately high number of women who outlive their partners leads to what Smith calls a “partner gap”: older men have multiple female sexual partners. With little or no condom use, such non-monogamous behavior increases the risk of sexually transmitted diseases.

This phenomenon is supported by data from the CDC, which shows a large gender gap in STI rates among those over 65. In this age group, men are nearly seven times more likely to get gonorrhea and nearly 10 times more likely to get syphilis than women. Although some of the discrepancy may be due to men having sex with each other, it is likely that some men are having unprotected sex with multiple women – and unknowingly spreading infections.

6. Discomfort talking about sex. Many older adults are hesitant to talk to new partners about their sexual preferences and needs, Smith told me. They may not ask about each other’s sexual history and whether they have recently been tested for sexually transmitted diseases.

Unfortunately, this discomfort extends to the medical profession. Although older people are sexually active, one study reported that only 17 percent of 65- to 80-year-olds had discussed their sexual health with their doctor in the past two years. Most of these conversations were initiated by the patient, not the doctor.

Doctors may focus on aspects of their patients’ medical history that they consider more pressing, such as heart disease, diabetes, or other chronic illnesses. But ageism undoubtedly plays a role, as health care providers indulge the misconception that older adults no longer have sex.

A large body of data shows the opposite and should prompt the health care system to change its approach. Doctors routinely ask young people about their sexual history and test them for sexually transmitted diseases; they should do the same for older adults. Public health officials are targeting adolescents with condom education campaigns; they should also introduce such campaigns for seniors and enlist the help of shared housing and dating apps.

“Society should not discourage or shame older adults from their needs or desires for intimacy, affection and sex,” Smith said. In fact, an active sex life in older adults is a sign of vitality and good physical and mental health. The medical system and society in general should help everyone live their best life, regardless of age.