“I have one word for you: boomers!” wrote Diane from Arizona. “We are the ones who came of age during the sexual revolution. People had casual sex before settling down, and they are back at it after divorce, separation and death of partners. My single friends are on dating apps and having hookups as much their grandchildren are, except they aren’t using condoms.”
Janie Steckenrider, an associate professor of political science at Loyola Marymount University, has data to support Diane’s observations. Her research shows that the aging of the baby boomer generation tracked with the rapid rise in STIs in older age groups. “All the baby boomers are over 55 and comprise 73 million of the nearly 100 million persons over age 55,” she explained. Between 2010 and 2023, the 55-plus group has seen a nearly sevenfold increase in gonorrhea and a nearly ninefold increase in syphilis.
Steckenrider recently conducted a survey of people older than 60 regarding their sexual attitudes and behaviors. One of the questions was how often they worried about contracting an STI. An astounding 91 percent answered rarely or never.
“This is an indication that the risk of getting an STI is not on the radar of older adults,” Steckenrider told me.
As my column explored, this is partly because health-care providers are not proactively speaking to older patients about sexual health. But there are notable exceptions. Steve from Wisconsin, a family physician, says he discusses sexual behavior with everyone, no matter their age. “In my experience, some patients are uncomfortable at first, but most are glad and then relieved to be talking about it,” he wrote.
Often, these conversations evolve to other sexual health topics, including incontinence, decreased libido, vaginal atrophy, erectile dysfunction and other potentially treatable conditions that could impede a fulfilling sex life. “I learn all kinds of things that patients are too embarrassed to bring up on their own,” Steve explained.
I think Steve has a terrific approach. In medical training, health-care professionals are taught that assumptions can be dangerous. Stereotyping patients can lead to missed diagnoses and inappropriate treatment. This is especially true when it comes to older adults and sexual activity, for which there is a clear disconnect between reality and physicians’ perceptions.
Addressing sexual health during older adults’ medical visits should become the norm, as it is for younger people. But cultural changes shouldn’t just be limited to doctors’ offices, as several readers noted.
“It seems to me that we might try to treat the sexual life changes of the elderly as we do for teenagers entering puberty,” wrote James from Vermont. “There is a lot of general information that could be given about what to expect, when to be concerned and how to seek more advice.”
“Why not work with retirement communities to give talks to seniors?” asked Maryanne from Maryland. “I spend my winters in Florida along with other ‘snowbirds,’ and I bet a lot of them would come to a talk about sex.”
I think Maryanne is right. When I served as Baltimore’s health commissioner, our team delivered a series of talks on healthy living at the city’s senior centers. The seminars on heart disease, nutrition and exercise were popular, but nothing compared to the one on sexual health, which drew an unprecedented number of attendees. There is a hunger for information.
These outreach efforts are important touch points to provide up-to-date information on STI risk and prevention. Such events could also be used to distribute condoms to overcome another barrier that a few readers brought up.
Chris from South Carolina is among those who wrote that he didn’t like getting funny looks from the cashier when he’s buying condoms. “They’re probably thinking, what’s the old guy doing with those?” He, too, thought that making condoms available at congregate living facilities could reduce perceived stigma and increase usage.
In the meantime, Dinah from Florida recommended that people take matters into their own hands. “I’m a retired science teacher, and I do what I told my students,” she wrote. “New partners: Use condoms. Always. I bring condoms in case the guy doesn’t have them. If he doesn’t want to use them, he can’t be sleeping with other people, and I make him take a test [for STIs].”
That’s solid advice for everyone who is sexually active. We already know how to stem the rise of STIs in older adults. It’s the same playbook used over the years to reduce the spread of STIs among young people: Educate people, test them, provide condoms and talk openly about sexual health, without stigma or judgment.