Patients over age 60 comprise the largest increase of in-office treatments for sexually transmitted diseases, according to an analysis of patients on athenahealth's network.
Diagnosis rates for herpes simplex, gonorrhea, syphilis, chlamydia, hepatitis B and trichomoniasis rose 23 percent in patients over age 60 between 2014 and 2017, according to athenahealth data from 110,000-plus providers. By contrast, the entire population over age 13 reported only an 11 percent increase in STD diagnosis rates during the same period.
A few factors might contribute to the rise in STD rates, including public perception of healthcare discoveries made during the 1960s — a decade when many baby boomers came of age. Oral contraceptives — which protect against pregnancy, but not STDs — were gaining traction as a common birth control method, and advances in modern medicine made STDs seem treatable, rather than life-threatening, according to an athenaInsight blog post.
"We went through a relatively brief period of time in the antibiotic era, before the advent of AIDS, where [a sexually transmitted infection] generally meant a trip to the doctor for a one-time shot or a pill you took for a few days," said Janet Pregler, MD, director of the Iris Cantor-UCLA Women's Health Center in Los Angeles.
Today's seniors, who may find themselves recently widowed or divorced, have missed recent public education campaigns about the necessity of barrier contraceptives, such as condoms. People over the age of 60 report the lowest condom usage of any population, according to a study by Indiana University in Bloomington.
Education campaigns related to STDs typically focus on younger people in high-risk communities, and include initiatives such as distributing condoms in college dorms or posting fliers in nightclub bathrooms. A similar approach to sexual health in retirement homes and senior centers might improve safe behaviors among seniors, according to athenaInsight. However, the burden is currently left on providers to educate their older patients about sexual health.
Dr. Pregler suggested providers ask seniors if they're sexually active, and recommend appropriate screening and education resources for those who are.
"It's not just young people who look like TV or movie actors who are having sex," she told athenaInsight. "We need to think more broadly about how we approach [all] groups."