For a lot of people, the thought of an elderly relative getting it on in the retirement home might be a bit disturbing.
But doctors say they are seeing a surge in the number of patients in their 60s, 70s and beyond coming into clinics with sexually transmitted infections (STIs).
Dr Shannon Dowler, a sexual health expert, told DailyMail.com the average patient in her clinic in North Carolina was now well above middle age.
‘Once I had someone coming in dragging their oxygen tank behind them and I thought, “What in the world?”, but it’s not uncommon to see people in their 60s at all.’
The trend is emerging across the rest of the country — rates of STIs have more than doubled between 2010 and 2020 in American adults aged 65 and above, according to the Centers for Disease Control and Prevention (CDC).
Experts blamed the rise on the growing popularity of senior-specific dating apps, the increase in divorces and ease of access to Viagra, as well as reduced fears about pregnancy and care-free attitude.
Chlamydia rates have shot up in America in the past years. The bacterial infection is the most common STI in the US
Gonorrhea, also known as ‘the clap’, is a bacterial infection which often has no symptoms
The District of Columbia consistently tops the charts for STIs in over-55s and has the highest rates for overall STDs, chlamydia, gonorrhea, syphilis and HIV.
It is closely followed by New York, California and Alaska. But rates in states such as Montana, Wyoming, Iowa and Vermont are also taking off, with rates having more than tripled there between 2008 and 2017, according to TheSeniorList.com.
Dr Dowler told DailyMail.com: ‘Across the board we are seeing doubling, tripling or even quadrupling of rates in the 55 to 64 and 65 plus pop for the infections we track like chlamydia, gonorrhea and syphilis.’
Dr Shannon Dowler has made rap videos to raise awareness of the rising STI rates in seniors
Dr Dowler was inspired to write a book after seeing a demographic change in the patients coming into her sexual health clinic starting in the mid-2010s.
She said: ‘The other day I was in clinic and my average age was close to 50. We’re still seeing young people, obviously, they still get lots of infections and have lots of sex.
‘But the difference is that we’re seeing adults as they’re aging coming in more than they were before.’
She said she now sees adults in their 60s and 70s ‘consistently’ in her North Carolina STD clinic.
Dr Dowler said: ‘I diagnosed syphilis in someone in their 60s just last week.’
DC tops the STD list, with almost 900 STIs per 100,000 adults aged 55 and above
Reduced fears about pregnancy, a carefree attitude and a lack of sexual education mean STI outbreaks at retirement and nursing homes are rife
Meanwhile, Gradonia Smith, a clinical health educator for his county’s health department, who drug and STI tests people, said on TikTok: ‘There’s at least six different nursing homes and assisted living facilities in my area that have STD outbreaks. And they’re contributing so much that gonorrhea is becoming incurable.’
Gonorrhea, also known as ‘the clap’, is a bacterial infection which often has no symptoms, which means people can pass it on unknowingly. Signs can include a burning sensation while peeing and discharge from the genitals.
Mr Smith added: ‘I was just recently at a facility with 60 residents and all 60 tested positive for chlamydia, which is the most common STD for people over the age of 50.’
Dr Dowler said: ‘Anecdotally, I am seeing and hearing about increases in herpes but that is not tracked.
‘Of course, HPV is the cause of increasing head and neck cancers as well. Over half of the adults living with HIV are over 55 in the US.’
Herpes commonly manifests as painful blisters on the genitals of both men and women.
Syphilis is a bacterial infection. Primary syphilis which usually begins as a sore on the penis or around the mouth.
It develops into a rash on the palms of your hands and soles of your feet and can be cured in most cases with a single penicillin shot.
Secondary syphilis manifests as a rash, lesions and swollen lymph nodes.
In serious cases and if left untreated, syphilis can lead to organ failure, blindness and even death.
Dr Dowler said she was aware of STI outbreaks happening in retirement communities too.
She said: ‘That is a very common finding in all over the country where people are living in that communal living. It’s very easy for infections to start spreading.’
Well-known Florida retirement community The Villages is known for its thriving swingers’ scene and a black market for Viagra.
One of its most popular extracurricular clubs is the ‘singles club’ and there is a special sexual health clinic on site.
There is even a rumor that senior swingers there use a color-coded loofah system to indicate their sexual preferences.
Florida retirement community The Villages has an infectious disease clinic to deal with allegedly high sexually transmitted diseases
With over 20,000 single residents, The Villages ‘singles club’ is one of the most popular extracurriculars on campus, sometimes dubbed as ‘the widower’s paradise’
The rise in STIs in the elderly is thought to be due to multiple factors. Older people underestimate their risk of catching something in bed.
On the whole, the age group is no longer fertile, meaning there is less pressure to use protection — and thus a higher chance of contracting a sexual infection.
Women’s fertility begins to decline by the age of 30. By 45, they are unlikely to get pregnant naturally. Male fertility tends to decrease around 40-45 years.
Dr Dowler said: ‘Failure to use barrier methods is really important to consider. No one is worried about pregnancy in this demographic.’
The current uptick is due to pharmaceuticals to treat erectile dysfunction elongating men’s sex lives, as well as a rising divorce rate.
A Pew Research report using data from the National Center for Health Statistics and US Census Bureau found that in adults aged 50 and above, the divorce rate has doubled since the 1990s.
This means more people are dating and becoming participating in hook-up culture later on in life, putting them at a great risk of STDs.
Monogamy is also dwindling in popularity. Dr Dowler said: ‘The idea of monogamy is sort of an outdated concept and polyamory is alive and well in multiple age groups and demographics.
‘Whether it’s multiple partners at the same time, or is it sequentially having different partners, the risk ends up being the same, as far as more partners equals more exposure to infections.’
The introduction of Viagra in 1998 for men and hormone replacement therapies (HRT) for women improved sexual function.
Dr Dowler said: ‘We are seeing seniors living longer and healthier and we have better drugs to enhance sexual function and satisfaction.’
There is an element of timing, as those born during the sexual revolution between the 1960s and 1980s, and their children, are now starting to retire.
Plus, many of the older generation are lacking proper sex education.
‘They haven’t had sex education in 40 or 50 years and are not aware of all the new and emerging infections on the scene,’ she said.
‘There are so many new and different sexually transmitted infections in the world today than there were when the older demographic last had sex education, if they even ever had it.’
Dr Dowler added: ‘Every now and then I run into a senior who is just excited to be having sex and aren’t worried about a pesky ulcer or two.
‘The majority of the time though people experience a tremendous amount of shame and regret when faced with an STI.’
Our immune system can wane with age, which could contribute to an increased risk for the elderly of catching at STI.
Dr Dowler said another big factor is ‘technology and dating apps — it’s never been easier to find a partner to meet your needs and seniors are tech savvy and using these apps.’
eHarmony, SilverSingle and SeniorMatch are all targeted at an older demographic.
Dr Dowler added: ‘There’s all sorts of dating apps for seniors. You can look for a long term relationship, someone that you just want to watch sunsets with, or group sex… The hookup apps are really being used by all ages.’
Many older adults have retired and are getting it on because there isn’t much else to do.
Dr Dowler said: ‘There are more seniors retiring comfortably in communities than ever before so harken back to those college days — now they don’t even have to worry about work and classes.’
She added: ‘These are the children of the sexual revolution retiring — why would we expect anything different?’
Conditions such as dementia can also contribute to risky sexual behaviors, as some people with dementia become hypersexual in nursing homes.
Dr Dowler said: ‘When older adults develop dementia, oftentimes their inhibitions are reduced. Just like if you drink too much alcohol, you’re disinhibited and you might make decisions you wouldn’t make when you were sober.
Primary syphilis which usually begins as a sore on the penis or around the mouth. It develops into a rash on the palms of your hands and soles of your feet and can be cured in most cases with a single penicillin shot. Secondary syphilis manifests as a rash, lesions and swollen lymph nodes
‘With dementia, sometimes you get disinhibited and so people will become very sexual and what we describe as hypersexual, and become very sexually active.’
Dr Dowler also highlighted the important part physicians have to play.
She said: ‘Doctors are often guilty of assuming older adults are asexual and don’t necessarily ask the probing questions we do with younger adults.’
‘There’s a lot of apprehension around fully disclosing sexual history. In the older demographic, it does seem like it’s a harder conversation. They’re less comfortable having those open conversations,’ she said.
‘If your family doctor is someone you sing in the choir with, you might not feel really comfortable [talking to them about STIs],’ she added.
The National Center for Assisted Living (NCAL) told DailyMail.com: ‘Intimacy and the desire for sex does not stop just because people are aging. Intimacy is an essential component of being human, as well as quality of life and well-being.
‘It’s important for older adults to also understand that they can still contract a sexually transmitted disease.’
It added: ‘We encourage older adults and residents of long term care communities to talk to their doctor or healthcare provider about how they can protect themselves as well as conduct routine tests, such as pap smears and HIV screenings.
‘We also encourage health care providers and long term care settings to work together to help educate residents regarding about safe sex practices.’