Everybody knows about it, still nobody talks about it. This is the reality about intimate physical relationships among older adults. The consequences of this silence are obvious- increasing number of Canadian seniors are getting diagnosed with sexually transmitted infections (STI), which is quite concerning.
According to the Public Health agency of Canada, the reported rates of sexually transmitted infections among those who are 60 years and above have been steadily increasing since 1990s. Though the national rates of STI for people 60 and older are relatively low, since the early 2000s, the number of Syphilis, Chlamydia and Gonorrhea cases has increased significantly among seniors.
In 2005, 359 cases of Syphilis, 148 cases of Chlamydia and 102 cases of Gonorrhea were reported among seniors. By 2015, those numbers increased to 526, 507, and 267 respectively – which translate into 5% increase in syphilis, 142% increase in Chlamydia, and 87% increase in gonorrhea infections.
In addition, between 2005 and 2015, men aged 60 and over consistently had significantly higher rates of STIs compared to women of the same age group, Health Canada reports. The risk of HIV in this age group has also increased gradually over the years. In 2015, 501 new cases were diagnosed in people over the age of 50, and 158 new cases in those over 60.
If you are wondering what could be causing this increase in STI among seniors, Barbara Clement, manager of sexual and blood borne infections at York Region Public Health in GTA has an answer- engaging in unprotected sex.
Compared to 1990s, older adults are generally living longer and staying healthier in 2015, and therefore, engaging in intimate sexual relationships. Pharmacological advances such as Viagra, Cialis, and estrogen and progesterone products are facilitating increased sexual activity among seniors.
There is a higher risk of STIs in older adults, because of decrease in immunity with age. Moreover, many STI s may remain asymptomatic in early stages, which causes delay in diagnosis and treatment, leading to spread of disease in the interim.
Many seniors are actively dating after losing a spouse, or after a divorce. If they had not been using condoms in their past relationship, they may not see a need to use them.
Some seniors might think that there is no need to use condoms as there is no possibility of getting pregnant at their age. All these factors together lead to low rate of use of condom use among seniors.
Though intimacy, sexual expression and activity are integral parts of healthy living, there is an overall lack of health education programs for seniors. This is partly due to incorrect assumptions about older adults’ sexuality and sexual health. Physicians in general avoid discussing sexual health and risk of STIs with their older patients.
There are several things we can do as a community to lower the risk of STIs in older adults. Since mandatory screening for STIs in all older adults tends to be very expensive, promoting screening in those in the high-risk group, or those who self- identify as having a higher risk could be beneficial. Screening could be included as part of the admission process in retirement homes and long-term care facilities.
In response to the increasing incidence of STIs in older adults, the Public Health Agency of Canada released a resource titled, ‘Questions and Answers: Prevention of Sexually Transmitted and Blood-Borne Infections Among Older Adults’ in 2015, which attempts to address the most commonly asked questions about the prevention of STIs and blood-borne infections among older adults.
Conversation about safe sex needs to happen at home. However, family members often feel uncomfortable discussing these sensitive topics with their aging parents. So family physicians and other health professionals become reliable source of information for seniors and therefore, they have a major role to play in educating their sexually active older patients about the risk of STIs and the need for engaging in safe sex.
Finally, the onus of our health is on us. Seniors need to bring up the topic of safe sex and use of condoms with a new partner or spouse. This is ultimately the most effective way to lower our risk of HIV and other STIs as we age. Be aware of risks and be safe.
Padmaja Genesh, who holds a bachelor degree in medicine and surgery as well as a bachelor degree in Gerontology, has spent several years teaching and working with health care agencies. A past resident of Red Deer, and a past board member of Red Deer Golden Circle, she is now a Learning Specialist at the Alzheimer Society of Calgary. Please send your comments to padmajaganeshy@yahoo.ca