Older Adults Paying the Price For ‘Free Love’

Seniors experiencing increase in health threat usually associated with younger people.

Seniors experiencing increase in health threat usually associated with younger people.

The generation that advocated “free love” is now finding out that having sex as an older adult, has its costs. Among Americans 65 and over, between 2007 and 2011, chlamydia infections increased by 31 percent and syphilis by 52 percent. In 2013, people over 50 accounted for 27 percent of the HIV diagnoses in the United States. It’s an alarming enough statistic that Medicare started providing free tests for sexually transmitted diseases (STDs) in 2011.

Complications from STDs can be worse for seniors than for younger people because our immune systems weaken as we get older, leaving us more vulnerable to infections. Also, we tend to have more health-related issues, such as diabetes, that can complicate and worsen STDs. Because STDs can exist in our bodies for long periods of time before exhibiting symptoms, we can pass HIV or syphilis to our partners without knowing it. And healthcare practitioners might not see the early signs of STDs because symptoms can mimic age-related conditions.

Reasons for STD Increase

There are many reasons for the surge in STDs in the older population:

• The availability of drugs such as Viagra and testosterone hormone therapy for men and hormonal replacement therapy for women are allowing older adults to enjoy sex at a later age.
• Past the age of menopause, women are not afraid of getting pregnant and feel freer to enjoy unprotected sex.
• As a general population, we are getting older and staying healthy and strong longer, and thus have more interest (and ability) in sex. Several nationwide surveys report that more than half those over 65 say they are sexually active.
• Many seniors were already married or came of age before schools emphasized sex education and safe sex, so they aren’t as aware as younger generations of the risks. Older baby boomers relied on birth control pills rather than condoms for pregnancy prevention, but with pregnancy risk off the table, seniors may not think to use condoms for STD prevention. According to an AARP survey, fewer than 10 percent of men and women 45 and over use any protection from STDs. Sexually active older adults have the lowest rate of condom use compared to all other age groups, according to the 2010 National Survey of Sexual Health and Behavior.
• Seniors aren’t talking to their doctors about their sex lives, and doctors aren’t broaching the subject with their older patients. It could be embarrassment on the seniors’ part, while the health practitioner doesn’t think to order an STD test as part of the standard physical exam.
• Senior living communities make it easier to meet and hook up with available older adults. Nationwide, the largest increases in STDs were found in Pima and Maripoca counties in Arizona, which are heavily populated with large retirement communities. Among those 55 and older, cases of reported syphilis and chlamydia rose 87 percent from 2005 to 2009 in those counties. In the same time frame, central Florida, another place popular with retirees, saw a 71 percent rise, and South Florida experienced a 60 percent increase. Because of this, many of the more progressive communities around the country are developing policy/procedures to confront this problem.

Steps You Can Take

Although sex can be an uncomfortable topic, experts say it’s better to become aware of the dangers beforehand.

How to Prevent STDs

Berkeley Wellness advises those who are not in monogamous relationships to take steps to protect themselves.

• Use latex condoms. When used correctly and consistently, latex condoms provide highly effective (though not infallible) protection against STD infection. Use a new condom for each sex act.
• Consider a female condom if a male condom can’t be used. It might substantially reduce the risk of some STDs, according to a few clinical studies.
• Do not rely on other forms of birth control. Nonbarrier methods of birth control, such as birth control pills and intrauterine devices (IUDs), offer no protection against STDs.
• Be observant. Don’t have sexual contact with anyone who has genital or anal sores, a visible rash, a discharge or any other sign of an STD.
• Be informed. Recognize the symptoms of STDs and seek medical treatment at once if you notice them in yourself. A lesion, blister, sore, discharge or rash in the genital or anal area are all signs, as are persistent unexplained flu-like symptoms and abdominal pain.

• Educate yourself on the risks of unprotected sex: What are the warning signs of STDs? What are the safest methods to counteract STDs? What are the short- and long-term effects? If you’re not comfortable talking to your healthcare practitioner, Planned Parenthood offers counseling, even to those beyond the “parenting” age.
• Don’t be afraid to talk to your partner about STDs. Cover all those uncomfortable topics such as previous partners, when or if your partner has been tested and if they have ever used IV drugs.
• As a general population, we are getting older and staying healthy and strong longer, and thus have more interest (and ability) in sex. Several nationwide surveys report that more than half those over 65 say they are sexually active.
• Ensure you’re using a condom correctly to get the best protection. Check the expiration date and use lubricant, which lowers the risk of the condom breaking and spreading infection (see sidebar).

Besides the personal actions you can take, experts say institutions and the government need to be more proactive. Senior living communities should distribute condoms, and Medicare needs to better publicize its free STD screenings. Public health departments should start including older adults in their sex education campaigns. For example, one nationwide study of health agencies’ sexual health pamphlets found only two that focused on aging adults.