Sexual health and the older adult

A 56 year old man has trouble with his “waterworks.” A 61 year old woman reports lower abdominal pain. The chances are that sexually transmitted infections are not high on your list of differential diagnoses—but increasing evidence indicates that they should be. A cross sectional study showed that more than 80% of 50-90 year olds are sexually active1 with cases of many common sexually transmitted infections more than doubling in this age group in the past 10 years.2

The recently published Health Protection Agency report on HIV in the United Kingdom shows that 20% of adults accessing HIV care are older than 50, up from 11% in 2001.3 This is in part because of prolonged survival; however, new diagnoses in over 50s doubled between 2000-9 to account for 13% of the total.4 Although this is low in proportion to the population percentage aged over 50, this is not a group traditionally considered at risk. The result of this low index of suspicion is worrying—62% of new diagnoses in over 50s were “late” (defined as a …