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Sexually transmitted infections such as syphilis and gonorrhea are rising more rapidly among older people than any other age group in America, according to new data.
Figures from the health research non-profit FAIR Health showed that STI diagnoses rose by 23.8 per cent among over-65s and 16.2 per cent among those aged 55 to 64 between 2020 and 2023, even as the they declined among under-25s.
That echoes previous data from the Centers for Disease Control and Prevention (CDC) and around the world, indicating a long-term trend not solely explained changes in testing rates or the end of Covid lockdowns.
Experts believe that the rise is due to older people being more sexually active than ever before, while being less likely to be screened against STIs or take precautions.
“Many healthcare providers, and society, incorrectly assume that older adults do not have sex, do not want to have sex, and cannot have sex,” Matthew Lee Smith, a 45-year-old professor of public health at Texas A&M University who studies sexual behaviour among older adults, told The Independent.
Smith’s research has found that older Americans have a lower level of knowledge and education on average about STIs and their risks, likely in part because there was less formal sex education when they were growing up.
"Good girls didn't and bad girls did – that's how we were taught about sex half a century ago," said Joan Price, an 80-year-old sex educator in California and the author of Naked at Our Age: Talking Out Loud about Senior Sex.
"Seniors are having more sex; they are more sexually lively. They have found ways to cope with the challenges, and they also feel seen and heard in a way that they didn't used to in our society.
"However, that also works against them. Their doctors don't even think to ask if they should be tested when they go in for their routine appointments,” Price said.
"Many of them are returning to dating after a divorce or the death of a spouse, and they have not dated for 40, 50 years. They thought pregnancy was all they had to worry about."
In March, CDC data showed that chlamydia, gonorrhea, and syphilis diagnoses in people over 55 had more than doubled between 2012 and 2022, with syphilis in particular increasing sevenfold.
Similar trends have been reported in China, Korea, Kenya, and Botswana, and the UK, where STIs in over-45s rose by 22 per cent between 2014 and 2019.
One key reason is that people are remaining healthy and energetic for longer than ever before, Price said, making it easier to maintain – or begin – an active sex life.
But she also argued that the growing culture of senior sex education, and the rise of the internet and online dating, has given older folk a new sense of confidence and possibility despite lingering prejudice from younger cohorts.
Smith also cited the increased availability of medical treatments that enhance sexual function – such as Viagra for erectile troubles or hormone therapy for menopause – as well as the large number of older people living together in retirement homes and villages.
However, senior citizens exploring this new frontier are often doing so with beliefs, instincts, and knowledge that they absorbed many decades ago, especially if they have recently come out of a long-lasting monogamous marriage.
That, says Price, can mean an increased sense of shame in talking openly about STIs and a lack of confidence negotiating boundaries such as always wearing a condom.
"At the end of [my dating workshop] I talk about safer sex, and the audiences are always so with me up until that point," Price said. "Then they go 'oh nooo, no no no! Don't tell us! They really would rather not face it."
Some older men, she adds, are resistant to wearing condoms because they already struggle with erectile dysfunction and are reluctant to do anything that could decrease their level of sensation.
According to Smith, older people may also feel ashamed to buy condoms or bring up STIs to their doctors due to societal prejudice and stigma.
Moreover, because women live longer than men on average, there is often a heavy gender imbalance on the elder dating market, at least among straight people. That, Smith said, can lead to a high degree of partner sharing – and thus speed the spread of infections.
To combat the rise, Smith argues that society must become more accepting of senior sexuality and make it easier for older people to speak freely about their sex lives.
He recommends that doctors routinely ask older patients whether they are sexually active, and screen them for STIs if approiate.
Price also advises older people to always carry condoms in any situation where sex involving a penis might be on the cards, and to insist on using protection unless they are in a committed monogamous relationship.
"We need to help people understand that condoms are not going to be a huge blow to your sex life. It will actually make more things possible, because you will feel safe doing things you would not feel safe doing without it," she said.
