From Our 2012 Archives
Sex and the Elderly: STD Risk Often Ignored
STD Rates Rising, but Reasons Aren't Clear
By Salynn Boyles
Reviewed by Laura J. Martin, MD
Feb. 2, 2012 -- The rate of sexually transmitted diseases (STDs) has more than doubled among middle-aged adults and the elderly over the last decade, but the reasons for this are unclear.
One cause may be the increased popularity of erectile dysfunction drugs that have made sex possible for millions of aging men.
Or it could be the determination of baby boomers, who ushered in the sexual revolution, to stay sexually active as they age.
Or it might be the low rate of condom use among older couples, who no longer worry about pregnancy and may not think they are at risk for STDs.
The contribution of any or all of these factors to the rising STD rate in this age group is not clear, experts say, because very few researchers have studied the issue.
"If you want to know about sexually transmitted infections in teens and younger adults, there are plenty of studies to look at, but there is almost nothing to tell us why rates are increasing among older adults," says Rachel von Simson of King's College London, who co-wrote an editorial published in the journal Student BMJ.
STD Risk Rising Among Seniors
According the CDC, close to 2,550 cases of syphilis were reported among adults between the ages of 45 and 65 in 2010 -- up from around 900 cases in 2000.
And the number of reported chlamydia cases in the age group almost tripled, from around 6,700 in 2000 to 19,600 a decade later.
In its 2010 report "Sex, Romance, and Relationships," the AARP surveyed a nationally representative sample of middle-aged and older people about their sex lives.
Among the major findings:
Erection Drugs and STDs
In a 2010 study, Anupam B. Jena, MD, PhD, and colleagues from Massachusetts General Hospital and Harvard Medical School examined the impact of erectile dysfunction (ED) drugs on the rising STD rate in the elderly.
The dramatic increase in the use of ED drugs since their introduction in 1998 has coincided with the rise in STDs among the elderly.
Men in the study who took Cialis, Levitra, or Viagra had about twice the risk for being diagnosed with an STD as men who didn't take the drugs.
But their risk was also higher in the year before they filled their first prescription for an erectile dysfunction drug.
"We showed that men who used erectile dysfunction drugs had higher rates of STDs before they purchased the drugs," Jena says, adding that physicians should discuss STD risk when prescribing the drugs.
Von Simson, who is in her last year of medical school, says sexually active older patients may be reluctant to discuss their sex lives with their physicians, and their physicians may be reluctant to bring the subject up.
"But it is a conversation they need to have," she says. "Just like younger people, older people who are sexually active are at risk for STDs."
SOURCES: Von Simson, R. Student BMJ, published online Feb. 2, 2012.Jena, A.B. Annals of Internal Medicine, July 5, 2010.Rachel von Simson, final year medical student, King's College London, London, U.K.AARP: "Sex, Romance, and Relationships Survey," 2010.CDC: "Sexually Transmitted Diseases, 1996-2009."
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