November 14, 2017
By: Jillian Pollard
Image by: The People Speak!

We like to live in a perfect, naive world where grandma and grandpa enjoy shuffleboard and card games in their spare time – a world where holding hands and a kiss on the cheek is the extent of intimacy for older adults. This could not be farther from the truth, and we have the sexually transmitted infection (STI) rates to prove it!

Whether we want to talk about it or not, people engage in sexual activity well into their 80’s and it is becoming increasingly common for older adults to contract STIs. According to the Government of Canada, people 50 and older make up one-third of the population living with HIV/AIDS. The rates of gonorrhea and syphilis have doubled in recent years, and rates of chlamydia among people 60 and older has tripled. Increasing STI rates among older adults is a public health concern requiring action.

The time is now to have the conversation, promote safer sex practices, and help reduce the prevalence of STIs.

So, why the sudden surge of STIs?

First, think about the era in which baby boomers grew up. Infection risk and prevention strategies were not at the forefront of sex education in schools. It was not until the 1980’s when HIV/AIDS was on the rise, that sex education gained momentum. At that time, the vast majority of baby boomers were either married or in a committed relationship, paying little attention to safe sex education information.

Now people are finding themselves widowed or divorced and re-entering the dating scene with little knowledge or awareness of safe sex practice.

People are also living longer and healthier lives; they are continuing to engage in sexual activity into later years. (We can thank erectile dysfunction (ED) drugs for that.) Unfortunately, many ED users missed the memo on safe sex and as a result, have higher rates of STIs than non-users. Adding to this, only one in six men over the age of 50 use condoms.

Finally, our society is structured in a way that has created a discomfort when thinking or talking about older adults having sex. Due to the youth-oriented nature of our society, it is almost taboo to talk about sex after a certain age. Think about the last time you saw a “safe sex” campaign tailored to your mom and dad, or grandma and grandpa. You probably can’t. More frequently, youth are the target audience for safe sex education, even though the risks, including multiple partners, unprotected sex, and reduced STI testing are common in both young and older populations.

The stigma doesn’t stop there. The New England Journal of Medicine reports that as few as 38% of men and 22% of women over 50 discuss sex with their physicians. Consequently, physicians are less likely to engage in conversation with older clients about their sex life, are reluctant to provide education on safe sex practices and will less frequently discuss testing for STIs.

The stigma in assisted care facilities mirrors that of physicians. Sex is not a hot topic of conversation between employees and their clients. You would think that of all places, an assisted living facility would ensure clients are equipped with information and resources about safe sex and accessibility to condoms. However, assumptions formulated in these facilities surrounding client sexual activity and sex drive create an environment in which sex is not an open conversation. If sex is not viewed as a relevant topic, it may be less likely that information sessions and condoms will be available to clients.

So, how can we support sexual health among older populations?

To start, health promotion campaigns need to be created and tailored to older populations to help bridge the knowledge gap. In doing so, people will be equipped with the knowledge to protect themselves and others, while still participating in an active sex life. In addition, physicians, assisted living facility employees, and family members each play a vital role in disseminating information and ensuring there is an open dialogue surrounding sexual health. Physicians need to make it a point to provide their older clients with information about safe sex and STI testing. Whether this is done by engaging in a conversation or by distributing a pamphlet. By doing this, an opportunity is created for clients to ask questions or receive information they may not have had a chance to get because they were uncomfortable discussing their sex life. Similarly, information sessions, pamphlets, and condoms should all be available and accessible in assisted living facilities. Employees should be equipped with information if clients ask and an atmosphere in these facilities should be created that reduces the stigma surrounding sex. Finally, families have a responsibility to be knowledgeable about the current health situation and be open and willing to be a resource for family members or loved ones.

Sex at any age is an uncomfortable topic to broach but it is important to provide information and engage in the “awkward” conversation, no matter the age group. In creating an atmosphere where sex is a normal topic of conversation we can hopefully reduce the stigma and promote safer sex practices, while reducing the prevalence of STIs.