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Yes, It's Still Important to Protect Yourself From STIs

Here's what you need to know to avoid sexually transmitted infections

By Erin Yelland

News flash: Just because you (or your partner) cannot get pregnant does not mean you get a free pass to not practice safe sex. Unfortunately, this is a fact that many older Americans are realizing the hard way. Data from the Centers for Disease Control and Prevention continues to show rising rates of sexually transmitted infections (STIs) among adults 65 and older.

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In the 65-plus population, from 2013 to 2017, chlamydia infections rose 58 percent, syphilis increased 115 percent and gonorrhea led the charge with a 150 percent increase. So, why is this happening? And more importantly, what can you do to protect youself?

STIs or STDs?

Incidentally, you are probably more familiar with the term sexually transmitted disease (STD) than STI, since that's how it was referred to for many years. The term sexually transmitted infection is now more common, because it is more accurate. Disease means symptoms are present, but a person can have a sexually transmitted infection, such as herpes, syphilis and gonorrhea, without having symptoms. Also, you don’t have to be symptomatic to infect another person.

People over 65 are having more sex than ever before, and this is happening for a multitude of reasons. Because we are living longer, we simply have more opportunity to engage in sexual activity in our later years than previous generations. And thanks to modern medicine, we generally do not let physical limitations get in our way — hello, Viagra and lubricants!

Not only are we more physically able to engage in sexual activity later in life, we are also doing it with more partners than in the past. Factors like choosing to be single, greater incidences of later-life divorce, communal senior living sites catering to the independent living crowd and longer lifespans all contribute to a greater likelihood of engaging in sexual relationships with numerous partners across your lifetime.

Although this degree of sexual freedom and opportunity can be intoxicating, the reality is that the more sexual partners you have in your lifetime, the greater sexual health risk you face.

Thank goodness we all know how to practice safe sex, right? Not so fast.

Not Everybody Knows about Safe Sex

Many members of the current generation of older adults never received sex ed, and if they did, it was often focused solely on the avoidance of unwanted pregnancy and riddled with incorrect information on other topics. Current efforts to promote safe sexual practices are almost exclusively targeted toward young adults.

And evidence has shown time and again that doctors typically are not talking to their older patients about safe sexual practices. They often report not knowing how to raise the topic with their patients and generally express feeling uncomfortable and embarrassed when doing so.


But it is not only a physician’s feelings that can get in the way of discussing sexual health. “Doctors lack fundamental knowledge about sex and older people and therefore do not view their older patients as sexual beings. If we do not acknowledge them as sexual beings, then STIs will never raise a blip on our diagnostic radar,” says Dr. Michael Bauer, a research fellow at the Australian Centre for Evidence Based Aged Care at Latrobe University in Melbourne.

Protecting Yourself and Others

As someone who studies sex and older adults professionally, I would be remiss if I did not take a moment to acknowledge the incredible contribution having a safe and mutually satisfying sexual relationship can have on overall quality of life and physical and emotional health. So, you won’t see me jumping on the abstinence train here.

Although abstinence is the only 100% effective way to avoid acquiring an STI, that is simply not the reality for most of us. So, if you are going to have sex, here’s what you need to know to do it safely:

  • Use a condom. Condoms are highly effective in reducing the transmission of STIs. Always use a condom during sexual activity that includes vaginal or anal penetration. Women: Not sure if your partner will come prepared? Purchase condoms yourself. Safe sex is everyone’s responsibility.
  • Talk about your sexual history and current partnering plans with your partner. Always disclose any pre-existing STIs you may have and talk about your plans regarding sexual monogamy.
  • Talk with your doctor about any potential age- or health-related sexual risks. “As we age, a combination of physiological changes increases our risk of infection due to immune system weakening and lack of elasticity of tissues increasing the risk of micro trauma,” said Dr. Shannon Dowler, a family practice physician in Asheville, N.C. It is important to be aware of these changes and how to protect yourself from potential vulnerabilities and injury.
  • Get tested. STI testing can be done by your primary care physician and is quick, easy and often covered by most insurance. Many STIs are curable and all are treatable. Starting treatment immediately is most effective and can reduce the risk of future negative health outcomes.

Sexual health is important for everyone, regardless of your age.

“A week doesn't go by when I do not diagnose an otherwise healthy senior with an unexpected sexually transmitted infection — HIV, syphilis, HPV, herpes, you name it.” Dowler says.

Luckily, there are relatively simple precautions we can take to decrease these rates.

Erin Yelland Erin Yelland is an assistant professor at Kansas State University where she studies sexuality among older adults and works to protect their rights to safe, consensual relationships in the context of long-term care. She has a doctorate in family science and a graduate certificate in gerontology from the University of Kentucky. Read More
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