Risk of sexually transmitted infections high but underdiagnosed among adults above 45

Sex is a natural part of life but, unfortunately, it comes with the risk of contracting sexually transmitted infections (STIs). The World Health Organisation reveals that more than one million STIs are contracted by people every day worldwide, and each year there are 376 million new infections. The WHO says that herpes, chlamydia, gonorrhoea, syphilis, trichomoniasis and the human papillomavirus (HPV) are some of the most common STIs people may contract.STIs can have a huge impact on your life, no matter what your age. Recent studies show that STIs are on the rise among people of all ages across the world. But what many may not know is that this also includes people above 45 years of age -- an age group in which STIs are prevalent but getting proper treatment may not be, as per the suggestions of some studies.Why older adults have higher risks of STIsAccording to a study published in the International Journal of Environmental Research and Public Health in April 2020, STIs have increased dramatically among older adults, especially those who are single, in recent years. Although sexual activity levels are believed to decrease after a certain age — especially during perimenopause and postmenopause among women — many older adults still desire sexual contact and do engage in sexual activity. However, the study points out, sexuality in later life is often associated with stigma, misconceptions and therefore a reduced emphasis on safe sex practices.This inevitably leads to a higher risk of STIs among adults above the age of 45 years, even more so in those in their 50s and 60s. An article published in 2018 in Harvard Health Publishing suggests that the following could be the possible reasons for the rise in STIs among older adults:

• Lower immune responses and underlying comorbidities increase with age and this can decrease an older adult’s ability to fight off the STI.
• Since pregnancy risks are at a minimum or nil at this age, the need to use protection in any form may not be felt. This and a lack of awareness about STIs can increase transmission risks.
• Loss of long-term partners due to mortality or divorce may spur an older adult into unhealthy sexual behaviour, thereby increasing the risks of STIs.
• Compared to previous generations, older adults now find it easier to have sex due to the easy availability of medications like Viagra. This, in tandem with all the above factors, can increase their risk of contracting STIs.
• Older adults don’t often get screened for STIs as they may not consider themselves at risk and their healthcare providers may not bring up the topic due to stigma or social awkwardness. This can not only delay detection but also cost lives.

Are STIs in older adults ignored?The stigma attached to sexual activity in later life coupled with lack of awareness leads to many misconceptions about safe sex and STIs. A new study currently underway as part of the Sexual Health In the over ForTy-fives (SHIFT) project in the UK and Europe suggests that this stigma and society’s inability to talk about STIs among older adults is increasing the dangers of these infections among this age group. The tendency to ignore the sexual health of those above 45 years is not only leading to an increase in STI transmission rates but also depriving this group of the easily accessible treatment courses for these diseases.This, the study’s initial reports suggest, is leading to more severe disease and higher disability among an age group that is already prone to many other health issues. The problem is particularly acute for those who come from socially or economically disadvantaged backgrounds and don’t have easy access to healthcare services. The researchers’ initial findings highlight four critical areas that need immediate attention to address this increased risk of STIs among older adults:

• Better information on the risks of STIs, their symptoms, treatment and prevention should be made available to those aged 45 and above. Social media is considered to be the most effective tool for this by the study.
• More than adequate sexual health awareness is necessary so that people in this age group get regular screenings for STIs. Knowledge dissemination is also urgently required for healthcare professionals, nurses and trainees so they can support patients better.
• Overcoming the barriers of shame and stigma through mass and public awareness campaigns, specifically targeted for this age group, is essential. 
• All credible and verified information about STIs, preventives and protection as well as nearby sexual health centres should be made accessible to all. Rural outreach for this information sharing is vital.

For more information, read our article on Sexually transmitted diseases.Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.