Older people, especially gay men, are getting more STIs than ever. What’s going on?

An older gay couple — Posed by models (Photo: Shutterstock)

Infectious disease experts say more needs to be done to address rising STI rates in older people. The call to action will be presented next month at the European Congress of Clinical Microbiology and Infectious Disease in Barcelona, Spain.

In a press statement in advance of the conference, they explained what was happening… and suggested some reasons.

For example, STIs in Americans aged 55 to 64 years have more than doubled over the past decade. It’s even worse for gonorrhea, rising from 15 cases per 100,000 people in 2015 to 57 per 100,000 in 2019.

In England, the number of over 45s diagnosed with gonorrhea and syphilis doubled between 2015 and 2019. The majority of that rise has been in gay men.

Professor Justyna Kowalska from the Medical University of Warsaw, who leads the research offers some reasons. These include the rise of dating apps, and erectile dysfunction medication such as Viagra. An increasing number of people are having sex at a later stage in life.

“Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over 50s”, says Professor Kowalska.

It’s known that some men are foregoing condoms due to advances in HIV treatment and prevention.

“These data likely underestimate the true extent of the problem as limited access to sexual health services for the over 50s, and trying to avoid the stigma and embarrassment both on the part of older people and healthcare professionals, is leading to this age group not seeking help for STIs,” continued Kowalska.

“People do not become asexual with age”

She says assumptions that people stop having sex as they age need to be challenged. For many people, sex remains an important part of their life into old age.

In a study in England, 50% of men aged 70 and over reported being sexually active. In a Swedish study, 10% of those aged 90 and over said they still had sex.

“People do not become asexual with age,” says Kowalska. “In fact, with preventive medicine and improved lifestyles people are enjoying a healthy life and sex life for longer.”

“Older people often find greater satisfaction in their sex lives due to experience and known expectations. We need more role models like Samantha Jones in the TV show Sex and the City to challenge stereotypes around older sexuality.”

Kowalska says health professionals need to talk more to older people about sexual health.

“Sexual health campaigns are focused on young people and overlook the needs and experiences of those aged 50 and older,” she says.

“Health promotion messages give the impression that condoms and concerns about STIs only apply to young people. But the dangers of undiagnosed and untreated STIs such as HPV-related cancers and onwards transmission are very real, particularly in this age group who are more likely to have underlying conditions such as heart disease and stroke.”

Although the rates of STIs in older people are lower than those in younger age groups, health awareness material aimed at elders remains rare.

Amsterdam

Queerty recently reported on how Amsterdam in the Netherlands had dramatically reduced its HIV transmission rates. It recorded just nine new cases in 2022. Part of the approach was a multi-pronged awareness campaign that included older people. The film below is about a man who grew up during the AIDS epidemic having a hook-up with a younger guy. They discuss safer sex methods.

In 2021, the British counseling service, Relate, produced an advertising campaign exploring intimacy between elder couples. It included a pair of older gay men within the campaign.

In a campaign video, the couple talk about their shared moments of intimacy. This included their feet touching while they read in bed together to feeling like teenagers again if they have sex for the first time in a while.

“It might go infrequent but I think the older you get the better you get at it,” says Mark, one of the men. “It’s quite normal now on television, on TV programmes to see older couples sort of showing intimacy. But it’s very rarely shown if the older couple is a gay couple.