Unit 5: sexually transmitted infections in the third age

Sexually transmitted infections (STIs) or diseases (STDs) are passed from person to person usually through sexual contact (some can be passed on in other ways too, such as by sharing intravenous injecting needles). STIs can be passed on through many types of sexual activity (oral, vaginal, anal) although some (e.g. thrush) can occur in the absence of sex.

   Introduction

Sexually transmitted infections (STIs) or diseases (STDs) are passed from person to person usually through sexual contact (some can be passed on in other ways too, such as by sharing intravenous injecting needles). STIs can be passed on through many types of sexual activity (oral, vaginal, anal) although some (e.g. thrush) can occur in the absence of sex.

STIs are categorised as either viral, bacterial, parasitic or fungal:

  • Bacterial STIs include – chlamydia, gonorrhoea, syphilis, bacterial vaginosis (BV)
    Viral STIs include – HIV, hepatitis, genital herpes, genital warts
  • Parasitic STIs include – trichomonas vaginalis (TV), scabies, pubic lice
  • Fungal STIs include – thrush, balanitis

For further information on STIs, see the World Health Organisation resource page: http://www.who.int/topics/sexually_transmitted_infections/en/

Many industrialised countries have seen high increases in diagnoses of STIs in older people recently. High figures have been reported for the UK, USA, Australia, and China. A number of reasons have been suggested to explain why STIs are increasing in older age groups. These include: a lack of awareness of safe sex methods; a lack of knowledge about STIs and who is at risk; and connecting condoms, which can help protect against STIs, with prevention of pregnancy.

Studies have demonstrated that knowledge of STIs among older people is mixed, and that there can be confusion about who can be infected with a STI and how to identify the symptoms. Indeed, older people are more likely than younger people to present late at services (e.g. genito-urinary medicine clinics in the UK), which is worrying as a late diagnosis is associated with poor outcomes for older adults.

In spite of this, health promotion campaigns aimed at educating people about STIs and reducing the transmission of STIs focus predominantly on younger people. There have been a few exceptions, but these are in the minority. STI campaigns aimed at older people include:

Family Planning Association (UK) Middle aged spread

http://www.fpa.org.uk/sexual-health-week/middle-age-spread-stis-over-50s

Family Planning, New South Wales (Australia) Little Black Dress

https://www.youtube.com/watch?v=o5CFDZJR9zo

ACRIA (North America) Age is Not a Condom

http://ageisnotacondom.org/EN/

Safer Sex for Seniors (North America) Safer Sex for Seniors

http://safersex4seniors.org/

Proper use of condoms (both male and female) is one of the most effective ways to prevent the transmission of STIs. Dental dams can be effective too as they create a barrier between the wearer’s mouth and the partner’s vagina or anus.

STIs can sometimes have negative health consequences, including: vaginal, cervical, vulval, penile, anal and oral cancers from certain strains of Human Papillomavirus (HPV) (Centers for Disease Control and Prevention, 2015a); damage to the brain from the long-term effects of untreated syphilis (Centers for Disease Control and Prevention, 2015b); and liver damage from hepatitis B (Centers for Disease Control and Prevention, 2015c). Having a STI at any age can affect psychological well-being and quality of life.

   Key messages

  • STIs can affect anyone at any age
  • Incidence of diagnoses in older people increases year on year in many industrialised countries
  • Older people tend to present late at services when they have a STI
  • Older people require age-appropriate information about STIs; how they are spread and how they can be prevented

  Learning outcomes

At the end of this unit students are expected to:

  • Understand that age is not barrier to contracting a STI
  • Be aware of ways to prevent STIs
  • Explain why STI diagnoses in older people continue to increase
  • Have an insight into the relationship complexities and gender issues which might prevent an individual from using safer sex practices

  Content

 
Activity

Identify four STI prevention campaigns aimed at younger people (there are hundreds to choose from!). Compare them to the four campaigns above that are aimed at older people.

  1. What are the key differences between the campaigns aimed at older people and those aimed at younger people?
  2. Why do you think the campaigns are different?
  3. Could the campaigns aimed at older people be improved? if so, how would you improve them?

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This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein