While sexually transmitted infections (STIs) are on the rise among older adults, medical providers may associate this problem with younger populations, missing prevention and treatment opportunities.
Possible Reasons for the increase of STIs in older adults1:
- Lack of STI screening and treatment
- Physiologic changes (e.g., weakened immune system, thinning mucosal tissue)
- Changing relationships (e.g., widow/widowerhood, divorce)
- Increased availability of medication for intercourse (e.g. sildenafil)
- Misinformation/misunderstanding (e.g., risks of unprotected sex, need for condom use even for postmenopausal women, STI transmission routes)
- Inaccessibility to STI protection in community living environments
Conversations about “safer sex” may be difficult and uncomfortable for providers and patients but are vital to maintain patients’ health. Having open, nonjudgmental discussions about individual risk factors may lead to safer sexual practices.
Sexually active older adults seen in an outpatient practice setting.
Use the communication skills and question suggestions to better assess risk of STI infection in older adult patients.
The CDC recommends STI/ HIV prevention counseling to all sexually active adults who:
- Currently have an STI
- Have had an STI within the past year
- Have multiple sexual partners
Effective STI prevention counseling is characterized by:
- Empathetic and nonjudgmental tone
- Dynamic conversations that engage the patient’s point of view
- Discussion of available prevention resources
- Patient-centered counseling targeting the adult’s personal risk, situation and goals
- Identify possible reasons underlying the increased incidence of STIs in older adults
- Identify individuals who may benefit from prevention counseling
- List counseling skills to aid in taking a sexual history with older adults
- Identify direct, targeted questions to understand patient STI risk
- Harvard Health Publishing. (2018, February). Sexually transmitted disease? At my age? Retrieved from https://www.health.harvard.edu/diseases-and-conditions/sexually-transmitted-disease-at-my-age
- Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. (2017, October 10). 2015 Sexually Transmitted Diseases Treatment Guidelines. Retrieved from https://www.cdc.gov/std/tg2015/clinical.htm#risk
- Patients over 60? Screen for STIs. Athenahealth, 16 May 2018, www.athenahealth.com/insight/over-60-stis-may-not-be-done-you.