Increase the radar for STDs in seniors
If your practice includes care of those ages 45 and older, be prepared to discuss risk of sexually transmitted disease (STD) infection. British researchers have just published an analysis of sexually transmitted infections among those ages 45 and older attending genitourinary medicine clinics in the West Midlands region of the United Kingdom. Findings indicate rates have doubled in the area analyzed in less than a decade.1
The most commonly diagnosed STD among those older than 45 was genital warts, representing almost half (45%) of the reported infections. Herpes was the next most common STD, accounting for almost one in five (19%) infections.1
STD prevention programs should be tailored toward different age groups and do more to dispel myths and assumptions about the level of sexual activity among older age groups, say the study authors. "Indeed, it may be argued that older people are more susceptible [to sexually transmitted infections] as they are less likely to use condoms than younger people," the scientists report.
Such findings have importance for U.S. clinicians: About 15% of newly diagnosed HIV infections are among Americans older than age 50.2
Older adults are willing to talk with clinicians about issues of sexuality; however, they expect providers to initiate these conversations, says Stacy Tessler Lindau, MD, assistant professor of obstetrics/gynecology and geriatrics at the University of Chicago. "There are a number of reasons why older people don't initiate the conversations, even if they're worried about symptoms related to their sexual function, or maybe even symptoms that they worry are indicative of an underlying infection," says Lindau, who has examined sexuality issues among older Americans. "If the physicians don't ask, patients won't talk about it."
Lindau and research associates recently analyzed results from the National Social Life, Health, and Aging Project, a nationally representative survey of more than 3,000 U.S. adults ages 57-85.3 They found that more than half to three-quarters of those questioned remain sexually active, with a significant proportion engaging in frequent and varied sexual behavior.4
Most older adults have not discussed sex with their doctors, survey results indicate. Just 38% of men and 22% of women said they had discussed sex with a physician since age 50. This finding is troubling in light of the fact that about half of the sexually active adults reported at least one "bothersome" sexual problem. A little more than one-third (37%) of sexually active men said they had erectile difficulties, while women reported low desire (43%), difficulty with vaginal lubrication (39%), and inability to climax (34%).
References
- Bodley-Tickell AT, Olowokure B, Bhaduri S, et al. Trends in sexually transmitted infections (other than HIV) in older persons: Analysis of data from an enhanced surveillance system. Sex Transm Infect 2008; Jun 27. Epub ahead of print.
- Centers for Disease Control and Prevention (CDC). HIV/AIDS Surveillance Report, 2005. Vol. 17. Revised edition. Atlanta: U.S. Dept. of Health and Human Services, CDC; 2007.
- Lindau ST, Schumm LP, Laumann EO, et al. A study of sexuality and health among older adults in the United States. N Engl J Med 2007; 357:762-774.
- Stein R. Elderly staying sexually active. The Washington Post, Aug. 23, 2007:A01.
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