J Korean Med Assoc.  2019 Jun;62(6):315-319. 10.5124/jkma.2019.62.6.315.

What is the current status of sexually transmitted infections in the elderly?

• Lee SJ

• KMID: 2449578
• DOI: http://doi.org/10.5124/jkma.2019.62.6.315

Abstract

Sexually transmitted infections (STIs) in the elderly are a social problem that can no longer be ignored due to rapid population aging and the growing proportion of elderly people who continue to engage in sexual activity. An accurate assessment of the current status of STIs in the elderly, as well as their sexual behavior, is a prerequisite for public STI prevention and education campaigns and for future studies on the subject. Numerous studies have found a growing incidence of STIs among the elderly population. In South Korea, a recent analysis of the Health Insurance Review & Assessment Service database between 2010 and 2016 showed that the prevalence of STIs was not high and that it had remained stable in recent years, implying that STIs are not currently a significant public health issue in South Korea, unlike in other countries. The reported proportion of sexually active elderly individuals was higher than expected (40% to 60%, for both sexes). The rate of condom use is generally very low among the elderly, usually because they are past their reproductive age. In a South Korean survey-based study, approximately 42% of elderly South Koreans were sexually active, and the rate of condom use was also very low (under 15%). Although STIs are not currently a significant public health issue in South Korea, several sexual health behaviors found in numerous studies, such as the very low rate of condom use, together with rapid population aging, call for ongoing monitoring of STIs in the elderly population.

Keyword

Aged; Sexually transmitted diseases; Sexual behavior

MeSH Terms

Aged*
Aging
Condoms
Education
Humans
Incidence
Insurance, Health
Korea
Prevalence
Public Health
Reproductive Health
Sexual Behavior
Sexually Transmitted Diseases*
Social Problems

Reference

1. Poynten IM, Grulich AE, Templeton DJ. Sexually transmitted infections in older populations. Curr Opin Infect Dis. 2013; 26:80–85.

2. Lee HS. The old women prostitutes serving the old men: a research on the actual condition of “Bacchus Azumma” and the basic-setting of the elderly counseling process. J Korean Gerontol Soc. 2011; 31:489–503.

3. Bodley-Tickell AT, Olowokure B, Bhaduri S, White DJ, Ward D, Ross JD, Smith G, Duggal HV, Goold P. Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sex Transm Infect. 2008; 84:312–317.

4. Savona N. Older people are at risk of sexually transmitted infections. Sex Transm Infect. 2011; 87:70.

5. Datta SD, Sternberg M, Johnson RE, Berman S, Papp JR, McQuillan G, Weinstock H. Gonorrhea and chlamydia in the United States among persons 14 to 39 years of age, 1999 to 2002. Ann Intern Med. 2007; 147:89–96.

6. Grulich AE, de Visser RO, Smith AM, Rissel CE, Richters J. Sex in Australia: sexually transmissible infection and blood-borne virus history in a representative sample of adults. Aust N Z J Public Health. 2003; 27:234–241.

7. Kleppa E, Holmen SD, Lillebo K, Kjetland EF, Gundersen SG, Taylor M, Moodley P, Onsrud M. Cervical ectopy: associations with sexually transmitted infections and HIV: a cross-sectional study of high school students in rural South Africa. Sex Transm Infect. 2015; 91:124–129.

8. Goodroad BK. HIV and AIDS in people older than 50: a continuing concern. J Gerontol Nurs. 2003; 29:18–24.

9. Moore LW, Amburgey LB. Older adults and HIV. AORN J. 2000; 71:873–876.

10. Centers for Disease Control and Prevention. Division of HIV/AIDS Prevention. Semiannual HIV/AIDS surveillance report 2000. Atlanta: Centers for Disease Control and Prevention;2000.

11. Karlovsky M, Lebed B, Mydlo JH. Increasing incidence and importance of HIV/AIDS and gonorrhea among men aged >/= 50 years in the US in the era of erectile dysfunction therapy. Scand J Urol Nephrol. 2004; 38:247–252.

12. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2017. Atlanta: US Department of Health and Human Services;2018.

13. Liu H, Lin X, Xu Y, Chen S, Shi J, Morisky D. Emerging HIV epidemic among older adults in Nanning, China. AIDS Patient Care STDS. 2012; 26:565–567.

14. Kim HY, Choe HS, Lee DS, Yoo JM, Lee SJ. Sexual behavior and sexually transmitted infection in the elderly population of South Korea. Investig Clin Urol. 2019; 60:202–209.

15. Patel D, Gillespie B, Foxman B. Sexual behavior of older women: results of a random-digit-dialing survey of 2,000 women in the United States. Sex Transm Dis. 2003; 30:216–220.

16. Whipple B, Scura KW. The overlooked epidemic: HIV in older adults. Am J Nurs. 1996; 96:22–28.

17. Stall R, Catania J. AIDS risk behaviors among late middle-aged and elderly Americans. The National AIDS Behavioral Surveys. Arch Intern Med. 1994; 154:57–63.

18. Szirony TA. Infection with HIV in the elderly population. J Gerontol Nurs. 1999; 25:25–31.

19. Wu Z, Rotheram-Borus MJ, Li L, Guan J, Detels R, Yin Y, Wu S, Liu Z, Lin C, Hsieh J. NIMH Collaborative HIV/STD Prevention Trial Group. Sexually transmitted diseases and risk behaviors among market vendors in China. Sex Transm Dis. 2007; 34:1030–1034.

20. Allison-Ottey S, Weston C, Hennawi G, Nichols M, Eldred L, Ferguson RP. Sexual practices of older adults in a high HIV prevalence environment. Md Med J. 1999; 48:287–291.

21. Mack KA, Bland SD. HIV testing behaviors and attitudes regarding HIV/AIDS of adults aged 50–64. Gerontologist. 1999; 39:687–694.

22. Binson D, Pollack L, Catania JA. AIDS-related risk behaviors and safer sex practices of women in midlife and older in the United States: 1990 to 1992. Health Care Women Int. 1997; 18:343–354.