STIs in Older Adults are Rising-Up to Seven Times Higher Than 2012

Sexually transmitted infections (STIs) among adults aged 55 and older have risen sharply over the last decade, with syphilis cases increasing sevenfold between 2012 and 2022, according to data from the American Sexual Health Association. This trend reflects a combination of increased sexual activity in older populations and a lack of targeted public health screening for seniors.

The rise in infections is closely tied to shifting demographics and behaviors. A 2022 national survey by the AARP found that 52% of adults 50 and older had sex in the week prior to the survey. This included 17% of respondents aged 70 or older. Another 2022 survey from the University of Michigan reported that 53% of women ages 50–64 and 30% of women ages 65–80 engaged in sexual activity, including intercourse, masturbation, or foreplay.

STI Infection Rates for Adults 55 and Older

While younger demographics still represent the majority of annual STI cases, the growth rate among older adults is significant. Between 2012 and 2022, syphilis cases in those 55 and older increased seven times, while gonorrhea cases rose five times and chlamydia cases more than tripled, according to the American Sexual Health Association.

Specific 2023 data highlights the volume of these infections across different age brackets:

• Chlamydia: Over 17,000 cases among people ages 55–64 and over 3,700 cases in those 65 and older.
• Gonorrhea: Over 15,600 cases among people ages 55–64 and approximately 3,600 cases in those 65 and older.
• Syphilis: About 3,800 cases reported among people ages 55–64 and just over 1,000 in those 65 and older.

Factors Driving the Increase in Senior STIs

Experts attribute the rise to several intersecting social and medical factors. Improved overall health and the availability of medications for erectile dysfunction allow men to maintain sexual activity later in life. Additionally, many older adults enter the dating pool again after becoming widowed or divorced following long-term monogamous relationships.

The American Sexual Health Association notes that retirement communities and nursing homes can function as sexual networks. Because women generally live longer than men, these environments often have more men than women. If men within these networks have multiple partners, infections can spread rapidly regardless of individual behavior.

Perception remains a primary barrier to prevention. Older adults often do not view themselves as being at risk, and society frequently overlooks the sexual health of seniors. This leads to a decrease in the use of condoms and a lower frequency of STI testing. Consequently, health care providers and public health campaigns rarely focus their outreach on this age group.

Biological Risks for Menopausal Women

Biological changes following menopause can make older women more susceptible to certain infections. Lower estrogen levels cause the thinning and drying of vaginal tissues, which increases the likelihood of tiny tears during sexual activity. These tears, combined with a weakening immune system, can facilitate the contraction of STIs, according to the American Sexual Health Association.

Diagnosis is often delayed because symptoms of STIs frequently overlap with common menopausal changes. Vaginal dryness, irritation, and discomfort during sex are common after menopause, leading many women to assume these symptoms are age-related rather than signs of an infection.

Prevention and Clinical Guidance

Prevention strategies for older adults are identical to those recommended for younger populations. The American Sexual Health Association advises open communication with partners, consistent condom use, regular testing, and prompt medical treatment upon the onset of symptoms.

Public health experts emphasize that sexual health does not have an age limit and urge health care providers to incorporate STI screening and prevention discussions into the care of older patients.