Urgent Care Needed for STIs in Older Adults

Sexually transmitted infections (STIs) among adults aged 65 and older have more than doubled in the United States over the last decade. This trend is driven by a combination of increased sexual activity in senior-living facilities, low rates of condom use, and a general lack of knowledge regarding STI risks within this demographic.

Data presented by Dr. Sandra Adamson Fryhofer, an AMA trustee and liaison to the Advisory Committee on Immunization Practices (ACIP), highlights a sharp increase in specific infections between 2010, and 2023. For adults 65 and older, chlamydia cases more than tripled, while gonorrhea cases increased sixfold. Syphilis cases in the same age group soared nearly tenfold during that period.

Factors Driving Increased STI Rates

The rise in infections is partly attributed to medical advancements that have extended the sexual lives of older adults. Dr. Fryhofer noted that Hormone-replacement therapy, vaginal lubricants and the approval of sildenafil (Viagra) and its relatives have extended people’s sex lives.

Sexual activity remains common among seniors. According to a 2018 AARP survey, approximately 40% of individuals aged 65 to 80 are sexually active, and nearly two-thirds of older adults express an interest in sex. Further AARP data indicates that 26% of people aged 60 to 69 and 17% of those aged 70 or older engage in sexual activity on a weekly basis.

Public health concerns are further exacerbated by the environment of senior-living facilities and a lack of preventative measures. The increase in rates is linked to low condom use and insufficient education about the possibility of contracting STIs in later life.

Impact of the COVID-19 Pandemic and HPV Risks

The COVID-19 public health emergency also saw a spike in infections among the elderly. A study of health insurance claims found that STIs rose nearly 24% in the 65-or-older group during the emergency. Human papillomavirus (HPV) experienced the largest increase among these infections.

The prevalence of HPV is a significant health concern, as the virus is responsible for 44,000 cancers in the United States every year.

Broad Trends in STI Surveillance

The increase in older adults mirrors broader trends across the United States. According to the Centers for Disease Control and Prevention’s (CDC) STI Surveillance Report, syphilis cases increased nearly 79% between 2018 and 2022, while gonorrhea cases rose by 11.1% in the same timeframe.

In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were diagnosed in the U.S., representing a 2% increase from 2018. Globally, the World Health Organization (WHO) estimates that more than 1 million STIs are acquired every day. In 2020, there were an estimated 374 million new infections of curable STIs—including trichomoniasis, syphilis, gonorrhea, and chlamydia—among people aged 15 to 49.

Clinical Challenges and Treatment Options

Medical professionals emphasize the need for proactive screening in geriatric care. Research published in the Indian Journal of Sexually Transmitted Diseases and AIDS suggests that physicians should inquire about sexual history in older patients who are suspected of having STIs, despite the likelihood of social embarrassment.

Timely intervention is critical to prevent long-term health complications. Delaying care for certain STIs can lead to permanent consequences, including neurological damage, chronic pain, infertility, and impaired sexual health.

For those without a primary care provider or available appointments, urgent care centers offer a viable path to treatment. Vania Landers, DO, an emergency medicine doctor at Mass General Brigham Urgent Care, states that Most urgent care centers have availability for walk-in visits for same-day care.

Dr. Landers added that urgent care providers take the time to listen to a patient’s concern and make sure they know that they are heard and not dismissed.