Question

It is a fact that the incidence of sexually transmitted diseases (STD’s) is the result of unsafe sexual practices. There is concern that this diagnosis is rising. A condition initially related to the young adolescent now is being diagnosed in the older adult.

Misconceptions with regards to sex and sexual practices in the elder population contribute to the poor or absent screening and education. The question to answer is the following: is poor screening due to misconceptions by the patient, the health care provider or both?

Answer 1

Sexually transmitted infections like syphilis, gonorrhoea, genital herpes, hepatitis B, trichomoniasis have been rising in the elderly population. Sexual history as well as diagnosis of STDs are often overlooked in elderly population.

The reason for poor screening for STDs in elderly population is due to the misconceptions by the patient as well as due to the lack of awareness among health care providers.

Many of the elderly patients haven't received proper sexual education during their younger years. Advent of HIV potentiated the sexual education efforts in 1980s. Most elderly people of now didn't receive that formal sex education because most of them were married and middle aged by then, so they did not receive the opportunity like the adolescents of that time. So without formal sexual education, these elderly ignorant about safe sexual practices and this leads to increasing rates of STDs in elderly. Elderly people are often embarrassed to discuss about their sexual problems to doctors due to their misconceptions. This reduces the opportunity to screen for STDs.

While treating patients with multiple comorbidities, Doctors often forget about the importance of sexual history. It's often assumed that when people are old, they don't do sex, which is often not true. Even bedbound patient's can have sex.

Therefore the poor screening for STDs in elderly population is the result of misconceptions among patients as well as health care providers.