Older adults are having sex, and they’re getting STIs, too

“Any falls in the past 90 days? Are you sleeping okay, getting enough exercise, eating well? What medications are you taking?” My primary care doctor asked the questions you’d expect at the annual physical of someone who had just turned 60.

There was one topic she didn’t mention, though. Even though she knew I’d recently been divorced, the doctor didn’t ask if I’d become sexually active, nor did she talk to me about screenings for chlamydia, syphilis, gonorrhea or HIV. I’m a little embarrassed to admit that I didn’t ask her about sex, either.

In my younger years, checkups typically included at least a mention of safer sex. Granted, the topic wasn’t as pressing during my married years, but now that I was single, why wasn’t sexual health on the checklist? Because I’m… “old”? Because older people don’t have sex?

“Unfortunately, a lot of providers perceive that older adults don’t have sex, that they don’t want to have sex, or they cannot have sex, and that’s simply not true,” says Matthew Lee Smith, an associate professor in the health behavior department at Texas A&M’s School of Public Health.

Well, in fact, older people are having sex. Not only that, they like having sex. According to a new study from the National Poll on Healthy Aging, 4 in 10 adults ages 65 to 80 report being sexually active. More than half say sex is important to their quality of life. That’s the good news.

Here’s the bad: Sexually transmitted infections, or STIs, are surging among older adults, according to the Centers for Disease Control and Prevention. Cases of gonorrhea among those 55-plus have grown about 600 percent since 2010. Chlamydia cases have quadrupled, while syphilis cases are now nearly 700 percent higher than in 2010.

What’s going on?

“Rising divorce rates, forgoing condoms as there is no risk of pregnancy, the availability of drugs for sexual dysfunction, the large number of older adults living together in retirement communities, and the increased use of dating apps are likely to have contributed to the growing incidence of STIs in the over 50s,” said Justyna Kowalska, a professor of medicine at the Medical University of Warsaw and author of a 2024 study on how to manage STIs among older adults, in a news release about the study.

Mary Susan Fulghum, a retired OB/GYN in North Carolina, is on a mission to educate older people, primarily women, about rising rates of STIs, and often speaks to church groups, book clubs, community groups — such as nursing homes and retirement villages.

“I have felt a need to explain and identify risk factors,” she told me, “and let people know it’s okay to talk about it to the doctors.” On occasion, the women she talks to seem shocked — at one event an older woman told her, “I can’t believe you are actually talking to a group about this.” But more often the older women exhibit a mix of curiosity, gratitude and some denial.

Experts offered some reasons that help explain why STI rates are rising among older people:

Older adults tend to underestimate their risk. “These individuals have limited knowledge about STIs — transmission, symptomology and ways to prevent them,” Smith said. He notes that educational resources are not readily available in senior centers, residential communities or doctors’ offices. And who wants to be the one to ask for them? Fulghum agrees, which is why she goes to those in need of resources. “These people have been smart their entire lives . ... They want to know what to do and they will do it,” she said, noting that older adults may need encouragement and support about how to make smarter choices.

Providers have their own issues about discussing sex.Texas A&M’s Smith acknowledges that most health-care providers don’t talk to their patients aboutsexual needs, behaviors and desires — a significant proportion of providers believe that their older patients aren’t generally having sex, so “they’re not testing older adults for sexually transmitted infections.”

Fulghum suggests that if doctors feel uncomfortable having these sorts of discussions, “it’s their responsibility to make sure they have the resources in their office to make things as comfortable as possible” for patients.