A recent story detailing an outbreak of sexually-transmitted diseases has gotten a good deal of attention from news outlets and blogs. The reason it's newsworthy is because the individuals affected aren't teenagers or single twenty-somethings; they're senior citizens. So, let me point out the obvious: even "old people" have sex.
This sometimes uncomfortable fact of life was driven home to me when I was just a teenager myself, when my grandma was discussing the difficulty she had showering (she'd just had surgery). Someone had asked whether grandpa was much help, and she mentioned that if she ever suggested he jump in the shower with her, he'd "be there with bells on." At the time, she was around 70 (and grandpa's 3 years older)--so, yeah: major yuck factor to the grandkids, but they're far from the only septuagenarians and octogenarians who are still getting' busy.
Indeed, levels of sexual activity in older adults remain much higher than the stereotype of the asexual senior citizen. In one report, authors found that over 80% of adults over the age of 50 were involved in one (or more!) sexual relationships (Gott, 2001). Another publication (Dunn and Cutler) found that approximately half of adults over age 60 engaged in sexual activity at least once a month, and that 71% of men and 51% of women in their sixties (and approximately 25% in their eighties) were still sexually active. The percentage of sexually active adults in the oldest age groups has increased over the past decade, attributed largely to Viagra and other erectile dysfunction medications. This drug has caused levels of sexual activity to increase in these older age groups, and has been implicated as one factor in the increased levels of STDs in this population.
Older women, in particular, are at increased risk for STDs. Estrogen loss causes reduced vaginal lubrication and thinning of the vaginal walls, resulting in an increased possibility of abrasions during intercourse. Additionally, impaired immune function in older adults makes them more susceptible to a host of infectious diseases.
While sexually active seniors are at risk for many types of STDs, HIV gets the most attention. More than 10% of HIV infection is found in adults age 50 and older (Tordoff)--a percentage that has been slowly, but steadily, rising, and approximately 65,000 Americans over the age of 50 are living with HIV. These are likely underestimates, as many at-risk individuals in this group fail to get tested, and there is still significant social stigma attached to a positive HIV test. Additionally, there are two main reasons why this percentage is rising: 1) increasing incidence of disease in older adults, and 2) increased longevity in HIV-positive middle-aged adults.
Additionally, there is some evidence that seniors are increasingly using the internet to meet partners, both for long-term relationships and for sex. Though this alone may not be a risk factor for disease, the internet enables match-making (and there are a number of senior-specific dating sites) but does not offer much in the way of sex and STD education, and there is a dearth of research on the topic of high-risk sexual behavior and internet use in older adults.
Seniors,in general, aren't a group that has been targeted for STD prevention efforts. Few individuals over 60 who are active with new partners use condoms. There are a number of explanations for this: lack of realization that they are at risk for STDs; association of condoms with pregnancy prevention; and a disinclination of medical providers to ask about sexual history (and subsequently, educate about the importance of safe sex measures). Seniors may engage in high-risk behaviors as well. For example, the outbreak linked above describes STDs in a retirement community. Particularly in areas with large populations of seniors (such as Florida), there is the potential for increased disease transmission. In some adult communities, the ratio of single women to men is as high as 7:1, leading to the emergence of so-called "condo Casanovas" who have relationships with multiple women. As noted in the link: "With that level of competition for a man's affection, typically after decades of marriage and a healthy sex life, many women are reluctant to demand that their partner use a condom." This puts the woman--and her future sex partners--at risk for a range of STDs.
Even if one wants to start a STD prevention effort in seniors, dealing with STDs in older populations isn't the same as dealing with them in the younger generations. For one, I'm sure many of you have noticed that, in many of the studies I reference, everyone over the age of 50 are grouped together as "seniors." However, it won't come as a newsflash to many that those in their 80s often have very different beliefs and experiences than those in their 50s. A "one size fits all" approach to prevention simply doesn't work, but because this is a group that has largely been overlooked as far as STD prevention campaigns, we're not sure what does work. Additionally, physicians may be reluctant to 1) ask about the sexual history of older patients, and 2) discuss STD prevention issues. Finally, as I mentioned above, there is significant social stigma attached to a diagnosis of not only HIV, but any STD. These problems make it difficult to address the problem of STDs in older age groups head-on, but at least it's a problem that is gaining more recognition and attention.
References
Dunn ME, Cutler N. 2000. Sexual issues in older adults. AIDS Patient Care STDS. 14:67-9.
Gott CM. 2001. Sexual activity and risk-taking in later life. Health Soc Care Community. 9:72-8.
Inelmen et al. 2005. HIV/AIDS in older adults: a case report and literature review. Geriatrics. 60(9):26-30.
Strombeck R. 2003. Finding sex partners on-line: a new high-risk practice among older adults? JAIDS. 33:S226-8.
Tordoff C. 1996. The prevalence of HIV and AIDS in older people. Prof Nurse. 12:193-5.
Wilson MG. 2003. Sexually transmitted diseases. Clin Geriatr Med. 19:637-55.
Image from http://www.chrisruzin.net/images/uploads/t.Old_Man_&_Woman.jpg
- Log in to post comments
So I guess dinner and a movie still works! However, I am guessing that my partner down the road will unfortunately, NOT look like the "dame" in the picture...
Indeed--though it may now be dinner, movie, and a little blue pill.
I guess this isn't all that surprising. When my parent's moved my Grandfather into his retirement home the women were all over him. He had more girlfriends than we could keep track of. I definitly saw the 7:1 ratio there. However I never considered STD's being an issue but I guess its possible because we don't know what they did behind closed doors. At one point he dated a much younger woman she was 68 and he was at least 85 with dementia to boot. I don't want to think what they might have been up to especially after we got a warning call from the home that one of his girlfriends fell after trying to climb into his lap which caused real concern of breaking hips.
I must say it would be difficult to educate individuals like my Grandpa on safe sex because his memory was shot but he did seem to have a way with the ladies I really don't get it.
Laura, you're looking at it from the wrong angle. He was still physically active, a good listener (he'd not complain he's heard your story before), and after having had a fling he would never brag or tell on you, since he didn't remember it happening.
I'm sure they don't see it this way, and perhaps when I'm old, I won't either, but for now, all I can say is: GROSS!
I don't know how easily available it is, but maybe 2 years ago there a was documentary put out called _Still Doin' It_ about sex and the older woman. The squick factor that senior sex seems to induce is fairly ageist. I mean really, these people have been having sex for years and they are just supposed to stop b/c society no longer deems them attractive? On the other hand, there is bizarre and disgusting elder-fetish which you can find out about by web surfing - prepare to be seriously disturbed. Anyway, it's a fabulous documentary, but now that I think about it, STD's were not mentioned.
Frumious B -
Which web-sites were those again? :)
I don't suppose it's good to be catching STDs, but I suspect the elderly have little to fear in terms of pregnancy, and that with age, we finally grow up and get over hangups(?).
I had a similar experience with my grandparents, and after my grandmother passed, my grandfather quickly got another girlfriend (they were both in their 90s). Hey, I hope I'm still enjoying all life has to offer at that age myself!
Indeed--and the association of condoms with pregnancy prevention (and seniors generally having no need to do so) can also lead to an increased risk of STDs.
50 is the start of old?? Bloody hell. That means I've only got 10 years of action left before I have to give it up.
Hey, thought this story would interest the folks here about a new angle on defeating HIV and its drug resistance:
http://www.newscientist.com/article/mg19025554.400-trials-for-drug-that…