A team of British researchers has found that among the over-45 age group, there has been a doubling of sexually transmitted infections (STI) rates in less than 10 years. The findings are published in the BMJ journal Sexually Transmitted Infections.

Studying sexual health among older age groups, as the authors point out, is a rare practice in a world where research on sexual health, as well as national surveys of sexual behavior, has almost exclusively focused on young people. To break this trend, the researchers analyzed an eight year span (1996 to 2003) of data from 19 sexual health clinics. The numbers of diagnosed STIs were reported to the Health Protection Agency’s Regional Surveillance Unit in the West Midlands.

During the time period, there were 4,445 STI episodes among people who were 45 years old or more – the majority among heterosexual men and women. About 45% of the episodes were diagnosed as genital warts, the most commonly diagnosed infection; the second most common STI was herpes, affecting about 19% of the total. The groups most likely to have an STI were men and those between the ages of 55 and 59. Women aged 45 to 54 and men aged 55 to 60 plus had the highest rates of STI for their sex group, respectively.

A main purpose of the study was to compare how STI rates have changed over time. The researchers found that cases of Chlamydia, herpes, warts, gonorrhea, and syphilis all increased quite dramatically. In 1996, the cumulative rate of infections was 16.7 per 100,000 of the population, and in 2003 it was 36.3 per 100,000 – a more than twofold increase from 1996 to 2003. Clinic visits increased for older persons as well – from comprising 3.9% of visits in 1996 to 4.5% of visits in 2003.

Notably, the number of infections among people aged 45 and over rose 127% during the eight years of study compared to a 97% increase in infections in younger age groups. The researchers suggest that programs aimed at preventing STIs should not only be specifically tailored towards these different age groups, but they should also work to address the common fallacies that older people may believe about sexual activity. The authors write that, “Indeed, it may be argued that older people are more susceptible [to STIs] as they are less likely to use condoms than younger people.”

“The results of this study, together with evidence from a number of other studies, would indicate that sexual risk-taking behaviour is not confined to young people but also occurs among older people…There is therefore a need to support a programme of good quality (both qualitative and quantitative) research that can contribute to effective planning and implementation of intervention strategies that, while aiming to reduce STI transmission among all age groups and high risk sub-groups, include interventions aimed specifically at older people. These programmes should include strategies that encourage early diagnosis and treatment, provide age-appropriate educational materials and address societal attitudes and myths, as well as healthcare provider assumptions, regarding sexual activity among older people,” conclude the authors.

Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system
A T Bodley-Tickell, B Olowokure, S Bhaduri, D J White, D Ward, J D C Ross, G Smith, H V Duggal, P Goold, on behalf of the West Midlands STI Surveillance Project
Sexually Transmitted Infections (2008).
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Written by: Peter M Crosta