Sex and older generations: it's not a topic that gets discussed much, not even in the doctor's office. But some physicians say that needs to change, because older patients are leading active sex lives - and their rates of sexually transmitted diseases (STDs) may be on the rise.
Whatever the cause - Viagra, midlife divorce, online dating or simple ignorance - studies suggest that STDs are no longer just an affliction of the young. A study published online last week by the journal Sexually Transmitted Infections adds to that growing body of evidence. Researchers at England's West Midlands Health Protection Agency found that in less than a decade, STD rates had more than doubled among people ages 45 and older. And Dr. Babatunde Olowokure, an author of the study, thinks that figure may be low. "These observations are based on a small proportion of people who actually attend clinics," he says. While that proportion of the population has increased overall over the past decade, Olowokure points out that middle-aged and older people tend to delay visiting a doctor for treatment of an STD, or they avoid it altogether, in large part due to the stigma associated with sexually transmitted infections.
In their study, Olowokure and his team counted 4,445 infections (excluding HIV) reported to 19 clinics in the region. From 1996 to 2003, total cases of chlamydia, genital herpes, gonorrhea, syphilis and genital warts among people over 45 increased 127%, from 344 cases in 1996 to 780 in 2003. Rates of STDs increased in patients under age 45 as well, by 97%, during the same time period. In the U.S. the most recent Centers for Disease Control and Prevention figures - which include prevalence of syphilis, chlamydia and gonorrhea - reflect relatively stable rates of infection in people ages 55 and older, but that data relies on self-reporting, and in many parts of the country it is out of step with what physicians are seeing. "Our rates of syphilis and chlamydia are up across all ages," says Dr. Sharon Lee, a Kansas City, Mo., family physician and medical director of HIV Wisdom for Older Women. According to a 2000 study of Washington State residents, one of the only comprehensive analyses of STD infection among the middle-aged and older, cases of gonorrhea increased 18.2% between 1997 and 1998 among people ages 45 and older; in younger people, that increase was 17.3%.