STI Testing and Older Adults

Discussing sexual health, pleasure and STI testing for older adults can seem taboo, even in social circles or health care settings. While sex can be a great source of fun, connection and excitement, the unsexy reality of sexually transmitted infections (STIs) exists, even as we age.

One study examined the sexual health and lives of older adults, noting that over 50% report engaging in sexual activity. While older adults have sex, there are several misconceptions about preventing STIs, such as the lack of condom use, sexual health education for older adults and the lack of discussions around sexual health.

More people find sexual partners via dating apps and social networks, leading to increased sexual encounters without adequate education on STI prevention. In addition, STI rates have steadily increased nationwide and are expected to continue to increase, causing a demand for understanding STI testing for older adults and STI prevention awareness.

STI testing is something that anyone, regardless of age, can feel shy, embarrassed or hesitant to talk about. Testing can be done in many health care settings and doesn't have to be done precisely at a women's, men's or sexual health clinic. 

If you have a primary care provider (PCP), your PCP can order STI testing. It is important to note that many health care providers do not receive formal training on discussing sexual health, let alone discussing sexual health and STI testing for older adults. 

You can take your time and search locally to see who can be a good fit for you to discuss your sexual health needs. You can also educate yourself on STIs and testing options. You can even order an at-home STI testing kit for you and your partner(s).

If you engage in sexual activity, such as oral sex, anal sex or vaginal sex, you are at risk of contracting an STI. Talking with your partners and educating yourself are significant steps to ensuring you are in control of your sexual health. It's time to be prepared so that you can have the best sex life possible.

• Chlamydia is a bacterial infection and among the most common STIs. It can be tested via a urine sample or localized swab, such as a vaginal swab. 
• Gonorrhea is a bacterial infection that has earned public attention for newer antibiotic-resistant strains. It can be tested via a urine sample or localized swab, such as a throat swab. 
• Syphilis is another bacterial infection and has earned much public attention for making a nationwide resurgence after almost being undetected in America for years. It can be tested for via a blood sample.

• Human Papilloma Virus or HPV: HPV is the most common STI in the United States and can lead to certain cancers if left untreated, such as cervical or oral cancer or genital warts. Many times, HPV can remain dormant in someone's body for years without any signs of infection. Testing is done via a Pap smear for women, but currently, there is no approved HPV test for men. 
• Herpes Simplex Virus (HSV): HSV is a viral STI that can be transmitted via skin-to-skin contact. Like HPV, HSV can remain dormant in someone's body for years without any signs of infection. HSV testing is done via blood sample. 
• Human Immunodeficiency Virus (HIV): HIV is a viral STI that can progress to acquired immunodeficiency syndrome (AIDS) if left untreated. HIV can be transmitted via breast milk, blood, semen and vaginal fluids. It can be tested for via saliva or blood sample.

• Trichomoniasis is a parasite that can be transmitted via sexual contact. It can be tested via a urine sample or localized swab, such as a penile swab. 
• Hepatitis A is a type of liver infection that can be transmitted via the oral-fecal route, such as when someone is engaging in oral sex on the anus or eating contaminated food. Hepatitis A can be tested via blood samples and prevented with the Hepatitis A vaccine.
• Hepatitis B is another type of liver infection that can be transmitted sexually and via blood. Like Hepatitis A, it can be tested for via blood sample and prevented with the Hepatitis B vaccine.

When looking for STI testing, whether using an at-home kit or in your doctor's office, ask or look to see which infections will be tested for. Remember, you can ask your doctor about particular sexual health concerns, and the doctor will review them with you.

Unfortunately, an exact cost is hard to provide, given the nature of insurance coverage and the types of tests you get. Contact your insurance company or seek STI testing at your local public health departments if concerned about cost.

STI tests are often available within a few weeks, like other medical testing. Most health care practices have online patient portals in which you can see your results when they are posted. If you test positive for an STI, most clinics will notify you and discuss your STI management options.

That is a personal choice, as that frequently depends on how much sex you are having. If you are having sex with the same person and that person is having sex with only you in a monogamous relationship, then your risk for STIs is not as high as someone who engages in casual sex with various partners.

Generally, STI testing is often recommended annually. However, your lifestyle, health history and other factors can affect how often you can be tested for STIs.

Morevoer, the most common STI symptom is no symptoms. Many people have perceptions of STIs only affecting certain people, such as people who "look dirty" or "look like they have a lot of sex." Untreated STIs can lead to chronic pelvic pain, pelvic inflammatory disease and possibly more health complications. 

Many older people are having sex, are contracting STIs, and are not being offered STI testing because of ageism, negative bias and shame around sexual health.

Talking to your doctor about your sexual health questions and asking about STI testing can be nerve-wracking at times, yet it is critical to your health. Sexual health is health care and an essential part of your well-being.

Sadia Arshad, MPH, MSN, WHNP-BC, is a freelance health and wellness writer. She earned her nursing degree from Emory University. Her work has appeared in Nursing CE Central, the Reproductive Health Access Project, and elsewhere. Read More