STI rates are increasing among midlife and older adults. We need to talk about it

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Globally, the rates of common sexually transmissible infections (STIs) are increasing among people aged over 50. In some cases, rates are rising faster than among younger people.

Recent data from the United States Centers for Disease Control and Prevention shows that, among people aged 55 and older, rates of gonorrhoea and chlamydia, two of the most common STIs, more than doubled between 2012 and 2022.

Australian STI surveillance data has reflected similar trends. Between 2013 and 2022, there was a steady increase in diagnoses of chlamydia, gonorrhoea and syphilis among people aged 40 and older. For example, there were 5,883 notifications of chlamydia in Australians 40 plus in 2013, compared with 10,263 in 2022.

A 2020 study of Australian women also showed that, between 2000 and 2018, there was a sharper increase in STI diagnoses among women aged 55–74 than among younger women.

While the overall rate of common STIs is highest among young adults, the significant increase in STI diagnoses among midlife and older adults suggests we need to pay more attention to sexual health across the life course.

Fit Ztudio/Shutterstock

Why are STI rates rising among older adults?

STI rates are increasing globally for all age groups, and an increase among midlife and older people is in line with this trend.

However, increases of STIs among older people are likely due to a combination of changing sex and relationship practices and hidden sexual health needs among this group.

The “boomer” generation came of age in the 60s and 70s. They are the generation of free love and their attitude to sex, even as they age, is quite different to that of generations before them.

Given the median age of divorce in Australia is now over 43, and the internet has ushered in new opportunities for post-separation dating, it’s not surprising that midlife and older adults are exploring new sexual practices or finding multiple sexual partners.

A middle-aged couple cooking.
People may start new relationships later in life. Tint Media/Shutterstock

It’s also possible midlife and older people have not had exposure to sexual health education in school or do not relate to current safe sex messages, which tend to be directed toward young people. Condoms may therefore seem unnecessary for people who aren’t trying to avoid pregnancy. Older people may also lack confidence negotiating safe sex or accessing STI screening.

Hidden sexual health needs

In contemporary life, the sex lives of older adults are largely invisible. Ageing and older bodies are often associated with loss of power and desirability, reflected in the stereotype of older people as asexual and in derogatory jokes about older people having sex.

With some exceptions, we see few positive representations of older sexual bodies in film or television.

Older people’s sexuality is also largely invisible in public policy. In a review of Australian policy relating to sexual and reproductive health, researchers found midlife and older adults were rarely mentioned.

Sexual health policy generally targets groups with the highest STI rates, which excludes most older people. As midlife and older adults are beyond childbearing years, they also do not feature in reproductive health policy. This means there is a general absence of any policy related to sex or sexual health among midlife or older adults.

Added to this, sexual health policy tends to be focused on risk rather than sexual wellbeing. Sexual wellbeing, including freedom and capacity to pursue pleasurable sexual experiences, is strongly associated with overall health and quality of life for adults of all ages. Including sexual wellbeing as a policy priority would enable a focus on safe and respectful sex and relationships across the adult life course.

Without this priority, we have limited knowledge about what supports sexual wellbeing as people age and limited funding for initiatives to engage with midlife or older adults on these issues.

One man, working in a home office, talking happily to another man.
Midlife and older adults may have limited knowledge about STIs. Southworks/Shutterstock

How can we support sexual health and wellbeing for older adults?

Most STIs are easily treatable. Serious complications can occur, however, when STIs are undiagnosed and untreated over a long period. Untreated STIs can also be passed on to others.

Late diagnosis is not uncommon as some STIs can have no symptoms and many people don’t routinely screen for STIs. Older, heterosexual adults are, in general, less likely than other groups to seek regular STI screening.

For midlife or older adults, STIs may also be diagnosed late because some doctors do not initiate testing due to concerns they will cause offence or because they assume STI risk among older people is negligible.

Many doctors are reluctant to discuss sexual health with their older patients unless the patient explicitly raises the topic. However, older people can be embarrassed or feel awkward raising matters of sex.

Resources for health-care providers and patients to facilitate conversations about sexual health and STI screening with older patients would be a good first step.

To address rising rates of STIs among midlife and older adults, we also need to ensure sexual health promotion is targeted toward these age groups and improve accessibility of clinical services.

More broadly, it’s important to consider ways to ensure sexual wellbeing is prioritised in policy and practice related to midlife and older adulthood.

A comprehensive approach to older people’s sexual health, that explicitly places value on the significance of sex and intimacy in people’s lives, will enhance our ability to more effectively respond to sexual health and STI prevention across the life course.

Jennifer Power, Associate Professor and Principal Research Fellow, Australian Research Centre in Sex, Health and Society, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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    An Apple (Cider Vinegar) A Day…

    You’ve probably heard of people drinking apple cider vinegar for its health benefits. It’s not very intuitive, so today we’re going to see what the science has to say…

    Apple cider vinegar for managing blood sugars

    Whether diabetic, prediabetic, or not at all, blood sugar spikes aren’t good for us, so anything that evens that out is worth checking out. As for apple cider vinegar…

    Diabetes Control: Is Vinegar a Promising Candidate to Help Achieve Targets?

    …the answer found by this study was “yes”, but their study was small, and they concluded that more research would be worthwhile. So…

    The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance

    …was also a small study, with the same (positive) results.

    But! We then found a much larger systematic review was conducted, examining 744 previously-published papers, adding in another 14 they found via those. After removing 47 duplicates, and removing another 15 for not having a clinical trial or not having an adequate control, they concluded:

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    ~ Sishehbor, Mansoori, & Shirani

    Check it out:

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    Apple cider vinegar for weight loss?

    Yep! It appears to be an appetite suppressant, probably moderating ghrelin and leptin levels.

    See: The Effects of Vinegar Intake on Appetite Measures and Energy Consumption: A Systematic Literature Review

    But…

    As a bonus, it also lowers triglycerides and total cholesterol, while raising HDL (good cholesterol), and that’s in addition to doubling the weight loss compared to control:

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    How much to take?

    Most of these studies were done with 1–2 tbsp of apple cider vinegar in a glass of water, at mealtime.

    Obviously, if you want to enjoy the appetite-suppressant effects, take it before the meal! If you forget and/or choose to take it after though, it’ll still help keep your blood sugars even and still give you the cholesterol-moderating benefits.

    Where to get it?

    Your local supermarket will surely have it. Or if you buy it online, you can even get it in capsule form!

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    You may be wondering: is this a basic CBT book? And, for the most part, no, it’s not.

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    So, this book has a lot of ideas like that, and if even one of them helps, then it was worth reading.

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  • The Sweet Truth About Glycine

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    Make Your Collagen Work Better

    This is Dr. James Nicolantonio. He’s a doctor of pharmacy, and a research scientist. He has a passion for evidence-based nutrition, and has written numerous books on the subject.

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    We haven’t reviewed that research so we won’t comment on it here, but we thought it worth a mention as a point of interest. We’ll investigate his claims in that regard another time, though!

    Today, however, we’ll be looking at his incisive, yet not controversial, work pertaining to collagen and glycine.

    A quick recap on collagen

    We’ve written about collagen before, and its importance for maintaining… Well, pretty much most of our body, really, buta deficiency in collagen can particularly weaken bones and joints.

    On a more surface level, collagen’s also important for healthy elastic skin, and many people take it for that reason alone,

    Since collagen is found only in animals, even collagen supplements are animal-based (often marine collagen or bovine collagen). However, if we don’t want to consume those, we can (like most animals) synthesize it ourselves from the relevant amino acids, which we can get from plants (and also laboratories, in some cases).

    You can read our previous article about this, here:

    We Are Such Stuff As Fish Are Made Of

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    However, there is also more:

    Let’s assume that your body has collagen to process. You either consumed it, or your body has synthesized it. We’ll skip describing the many steps of collagen synthesis, fascinating as that is, and get to the point:

    When our body weaves together collagen fibrils out of the (triple-helical) collagen molecules…

    • the cross-linking of the collagen requires lysyl oxidase
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    • but moving it around the body requires vitamin A

    So in other words: if you are taking (or synthesizing) collagen, you also need copper and vitamins A and C.

    However! Just to make things harder, if you take copper and vitamin C together, it’ll reduce the copper too soon in the wrong place.

    Dr. DiNicolantonio therefore advises taking vitamin C after copper, with a 75 minutes gap between them.

    What does he want us to know about glycine?

    Glycine is one of the amino acids that makes up collagen. Specifically, it makes up every third amino acid in collagen, and even more specifically, it’s also the rate-limiting factor in the formation of glutathione, which is a potent endogenous (i.e., we make it inside us) antioxidant that works hard to fight inflammation inside the body.

    What this means: if your joints are prone to inflammation, being glycine-deficient means a double-whammy of woe.

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    First, the problem: as we age, glycated collagen accumulates in the skin and cartilage (that’s bad; there is supposed to be collagen there, but not glycated).

    More on glycation and what it is and why it is so bad:

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    See for example:

    Glycine Suppresses AGE/RAGE Signaling Pathway and Subsequent Oxidative Stress by Restoring Glo1 Function

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    Dr. DiNicolantonio therefore advises getting glycine at a dose of 100mg/kg/day. So, if you’re the same size as this rather medium-sized writer, that means 7.2g/day.

    Where can I get it?

    Glycine is found in many foods, including gelatin for those who eat that, eggs for the vegetarians, and spinach for vegans.

    However, if you’d like to simply take it as a supplement, here’s an example product on Amazon

    (the above product is not clear whether it’s animal-derived or not, so if that’s important to you, shop around. This writer got some locally that is certified vegan, but is in Europe rather than N. America, which won’t help most of our subscribers)

    Note: pure glycine is a white crystalline powder that has the same sweetness as glucose. Indeed, that is how it got its name, from the Greek “γλυκύς”, pronounced /ɡly.kýs/, meaning “sweet”. Yes, same etymology as glucose.

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    That does mean you should buy from a reputable source though, as a con would be very easy!

    this does also mean that if you like a little sugar/sweetener in your tea or coffee, glycine can be used as a healthy substitute.

    If you don’t like sweet tastes, then, condolences. This writer pours two espresso coffees (love this decaffeinated coffee that actually tastes good), puts the glycine in the first, and then uses the second to get rid of the sweet taste of the first. So that’s one way to do it.

    Enjoy (if you can!)

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