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An escalating problem

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Never too old to learn — or be tested

STDs are not just for kids anymore. At least that’s what people aged 45 and older are now learning. It could be because people are living longer or maybe it’s the baby boomers that just refuse to admit to advancing age. In all probability, the biggest culprit is ignorance.

Regardless of the reason, older adults — even those well into their 70s and 80s — are engaging in sex. And, according to a survey by AARP, a non-profit organization for people 50 and older, it’s not just once in a blue moon, particularly for older singles.

Chlamydia, once considered the bane of females 25 and younger, is increasing in people 45 to 64, according to a recent surveillance report by the Centers for Disease Control and Prevention (CDC). Between 2006 and 2010, the rate in that age group escalated more than 33 percent.

And that “little blue pill” is causing its share of problems. Dr. Anupam B. Jena, an internist at Massachusetts General Hospital, examined the rates of STDs in men who use erectile dysfunction (ED) drugs and those who don’t. Jena and his fellow researchers found that all STDs — particularly HIV and chlamydia — are higher in users versus nonusers of ED drugs. The study also found that the rate of STDs was higher in users both before and after the prescription.

In an interview, Jena cautioned that “anyone who does not practice safe sex, no matter their age, can contract an STD.”

Ronald F. Dixon, M.D.
Associate Medical Director
Massachusetts General Hospital
Beacon Hill
And that’s part of the problem. Older adults associate condoms with protection against pregnancy and that STDs are the purview of the young and inexperienced. But a national divorce rate hovering around 40 percent propels newly designated — and ill prepared — singles into the dating scene. In its study on sex, Indiana University determined that the percentage of condom users drops with age and that only 10 percent of women between the age of 45 and 60 use them as protection.

No state is more familiar with this problem than Florida, where 19 percent of the residents are elderly. Between 2001 and 2010, the number of cases of chlamydia in residents between the ages of 45 and 64 more than doubled.

Dr. Ronald Dixon, medical director at MGH Beacon Hill, sees first hand the increase in STDs among older adults. “They are more active (sexually) than they used to be,” he explained.

The uptick is in the most common infections — chlamydia, gonorrhea and syphilis. About half of the patients infected present with symptoms.

Counseling about STDs is imperative, according to Dixon. “First I find out the relationship status,” he explained. If his patients are single — particularly those who are considering dating — he talks about the use of condoms.

“People who are entering into a new relationship need to be tested,” he emphasized. And that includes both partners. A clean slate is the first step in a monogamous, or single-partner, relationship.

He warns patients who initiate relationships without taking precautions. “If your partner has slept with 10 people, multiply that [your risk] by 10,” he explained. If those 10 have slept with 10 others, the number increases to 100.

The point Dixon is trying to make is that a person may be sexually involved with only one person, but if that person is having sex with others, the risk of exposure to STDs increases significantly.

A primer on STDs

Explaining the positive results of an STD test takes a couple of conversations, Dixon admitted. The first reaction is shock. “You can almost see their mind whirring trying to come to grips with the situation,” he said. “How did I get this?” or “Who gave it to me?” are questions they are asking themselves.

He allows the patient to get over the shock before recommending treatment and advice on future sexual behavior.

It’s not uncommon for STDs to come in pairs or even triplets. “If you have one STD, you’re likely to have others,” he explained. The CDC agrees. There is biological evidence that the presence of other STDs increases the likelihood of both transmitting and acquiring HIV, the virus responsible for AIDS.

That’s why when Dixon tests, he tests for everything — just to be sure.