STI rates soar in older patients
An epidemiological study has found that STIs in patients aged 45 and over have doubled over the past decade.
The study looked at trends in STI diagnoses in patients aged 45 and over attending 19 GUM clinics in the West Midlands between 1996 and 2003. Epidemiological, demographical and clinical data were collected, as KC60 returns from GUM clinics, used to compile annual reports for the Heath Protection Agency, do not provide breakdowns for age and sex.
There were 4,445 episodes of STI diagnosed in patients aged 45 and over during the study period, of which 67% were in men. The mean age of patients was 50 years.
Overall, patients ? 45 years accounted for 3.9% of STI diagnoses in 1996, and around 4.5% in 2003. Infection rates for chlamydia, gonorrhoea, herpes, genital warts and syphilis all increased significantly during the study period (P=<0.0001). The rate ratio was greatest in patients aged 55-59 (3.18, 95% CI 2.15-4.7), although the rate in all age groups and both sexes increased significantly (P=<0.0001).
This paper highlights a forgotten generation in terms of STIs. The authors propose some sociological perspectives on why these patients are at increased risk of STIs: higher rates of relationship changes (eg divorce and separation), more opportunities to engage in unprotected sex abroad, increased use of the internet to find sexual partners and the use of drugs for erectile dysfunction.
The paper argues that current sexual health programmes, such as Choosing Health and the National Strategy for Sexual Health and HIV, do not address the needs of older people. Risk-taking behaviour is not confined to young people and safe sex messages should be targeted at older patients as well.
Bodley-Tickell AT, Olowokure B, Bhaduri S et al. Trends in sexually transmitted infections (other than HIV) in older people: analysis of data from an enhanced surveillance system. Sex Transm Inf 2008;84:312-7Reviewer
Dr Richard Ma
GP principal, North London and staff grade in sexual and reproductive health, Margaret Pyke Centre, London