To address this alarming trend, clinicians, health officials and the broader public need to understand the underlying factors contributing to it. Here are six:
1. Lack of knowledge about STIs. In one 2020 study, researchers asked 65-to-94-year-olds basic questions about STIs, and many gave incorrect answers. For instance, only half knew there was a cure for chlamydia, and nearly two-thirds said a woman can tell if she has gonorrhea by looking at her body.
The lead author of the study, Matthew Lee Smith, an associate professor at Texas A&M’s School of Public Health, told me that many older individuals came of age at a time when there was limited, if any, education in schools about sexual health. As a result, they might not be aware of their risk of contracting STIs or the need to prevent them.
2. Low condom use. Smith explained that condom use among this demographic is “really limited.” This might be a result of the misconception that condoms are primarily used to prevent pregnancy. Since this is no longer a concern in this age group, many forgo condoms.
In one study by AARP, only 8 percent of older individuals who were sexually active in the past month reported using condoms all the time. In another study, just 3 percent of people 60 and older used condoms in the past year.
3. Older people are healthier and staying sexually active for longer. Thanks to pharmaceutical advancements, such as medications for erectile dysfunction and hormonal therapies to alleviate vaginal dryness, today’s older adults can sustain a healthy sex life for longer than in years past.
One survey found that more than half of men and 31 percent of women between the ages of 65 and 80 reported being sexually active. Another, by AARP, concluded that 26 percent of those 60 to 69 had sex weekly, as did 17 percent of those 70 and older.
4. More opportunities for new sex partners. Smith pointed out the rise in widowed and divorced people choosing congregate living communities. “They are residing together and want intimacy,” he said. In addition, many dating apps specifically target older adults, such as OurTime, SeniorMatch and SilverSingles.
5. A gender imbalance. Women have an average life expectancy that is nearly six years longer than that of men. The disproportionate number of women who outlive their partners results in what Smith calls a “partner gap,” with older men having multiple female sex partners. With low or absent condom use, such non-monogamous behavior increases the risk of STIs.
This phenomenon is supported by CDC data, which shows a huge gender gap in STI rates among those 65 and older. In this age group, men had nearly seven times the rate of gonorrhea and nearly 10 times the rate of syphilis compared with women. Though some of the discrepancy could be from men having sex with each other, it’s likely that some men are having unprotected sex with multiple women — and unknowingly spreading infections.
6. Discomfort in discussing sex. Many older adults are hesitant to communicate with new partners about their sexual preferences and needs, Smith told me. They might not be asking about each other’s sexual history and whether they recently had an STI test.
Unfortunately, this discomfort extends to the medical profession. Despite the prevalence of sexual activity among older individuals, one study reported that only 17 percent of people ages 65 to 80 spoke to their physician about sexual health in the past two years. Most of these conversations were initiated by the patient, not the doctor.
It’s possible that clinicians are focused on what they think are more pressing aspects of these patients’ medical history, such as heart disease, diabetes and other chronic illnesses. But ageism no doubt plays a role, with health-care providers giving in to the misconception that older adults no longer have sex.
Abundant data shows otherwise, which should prompt the health-care system to change its practices. Physicians routinely ask young people about their sexual history and screen for STIs; they should do the same for older adults. Public health officials target adolescents with educational campaigns on condom use; they should initiate these for seniors and enlist the help of congregate living facilities and dating apps.
“Society should not deter or shame older adults about their needs or desires for intimacy, affection and sex,” Smith said. Indeed, active sex lives among older adults are a sign of vitality and good physical and mental health. The medical system and the broader society should help everyone live their best lives, no matter their age.
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