Intimacy is an important part of everyone’s life, even if they’re perceived by society to have aged out of their sex years. But with the rise in “grey divorces” (and presumably, the popularity of sexual enhancement drugs like Viagra), it’s no surprise that the over 60 set is still getting busy on a regular basis. What is surprising, health experts say, is the accompanying rise in sexually transmitted infections (STIs) among this age group.
While it may feel awkward to talk to a parent or loved one over 60 about STIs, health experts say safe sex education for this age group is more important than ever, and if we want rates to drop, we have to start with accepting the fact that seniors have sex.
Joan Price, sex advocate and author of The Ultimate Guide to Sex After 50: How to Maintain – or Regain! – a Spicy, Satisfying Sex Life, says the reason why the community has high STI rates is simple: they’re not using condoms.
“Many seniors are dating again after losing a spouse or a late-life divorce, and in their last relationship, they didn’t use condoms,” she tells Global News. “Now that they can’t get pregnant, they think they don’t need to use them.”
How much is it rising?
Between 1998 and 2015 (the most recent national data available), chlamydia — the most commonly reported STI in Canada — has risen from 39,372 to 116,499 annual cases among all ages and genders, and gonorrhea infections increased from 5,076 to 19,845 in the same time period. Infectious syphilis rates rose dramatically from 501 to 4,551 cases.
According to Health Canada, national rates of STIs for people 60 and over are relatively low, but since the early 2000s, the number of cases of syphilis, chlamydia and gonorrhea have increased significantly among seniors.
In 2005, 359 cases of syphilis, 148 cases of chlamydia and 102 cases of gonorrhea were reported in this age group, the agency reports. By 2015, those numbers rose to 526, 507 and 267, respectively. They represent a five per cent increase in syphilis, a 142 per cent increase in chlamydia and an 87 per cent rise in gonorrhea.
“In addition, between 2005 and 2015, men aged 60 and over consistently had significantly higher rates of STIs compared to women of the same age group,” says Anna Maddison, senior media relations advisor for Health Canada.
HIV in this age group has also increased gradually. In 2015, there were 501 new reported diagnoses in people over the age of 50, and 158 diagnoses in those over 60, accounting for 23.9 and 7.5 per cent of all new cases, she notes.
Maddison points to a stronger stigma associated with discussing sexual and drug habits with doctors at this age, while Price adds that since many STIs can be asymptomatic, people may not know they’re infected and pass it on to every new person they engage with sexually.
Seniors as sexual beings
On the other side of the equation is the social perception of seniors and sex. Price points out that family members may not be asking about the status of a senior’s sex life and health professionals may not think to test them for STIs. Most people don’t bring up sex or protection with their senior-aged loved ones, and some retirement homes may not be educating their residents, either.
“Some doctors don’t even think we’re sexually active. They don’t see us as sexual beings” she says.
But she is also aware of the importance of educating yourself, something she says the senior community needs to do a lot more of. “We are in charge of our own sexual selves.”
Barbara Clement, manager of the sexual and blood borne infections (SBBI) program at York Region Public Health in Toronto, says STI rates are going up among all age groups in the city’s region, and with the population over 60, chlamydia rates are the highest.
“The most common risk factor is no condom use,” she tells Global News. “Whether there is condom fatigue or not using them correctly… we haven’t identified what the reasons would be.”
But Clement says there are several things we can do as a community to help lower rates. Doctors and their patients should be aware of how often to test for STIs, although universal screening for all infections can get expensive.
“Promoting [a screening] in a community to self-identify when they may be at risk could be better than universal testing,” she says.
And with so many Canadian seniors living in retirement homes and long-term care facilities, Clement adds it should also be part of the admission process.
“These people now have their own personal spaces and within a building of a lot of their peers,” she says.
Some homes already have safe sex talks set in place, the CBC reports, but after phone calls by Global News to at least a dozen homes in Ontario and British Columbia, STIs among residents don’t seem to be a major concern.
What’s being done in Canada
According to Maddison, the Public Health Agency of Canada released a resource titled Questions and Answers: Prevention of Sexually Transmitted and Blood-Borne Infections (STBBI) Among Older Adults in 2015.
“This resource is intended to address the most commonly asked questions about the prevention of sexually transmitted and blood-borne infections among the older adult population which, for the purpose of this resource, is defined as 50 years of age or older,” she tells Global News.
There is also the goal to help community organizations, health professionals, educators and others develop and implement STBBI prevention interventions and programs that address the needs of older adults, she adds.
Clement says the York region of Toronto is currently working on a set of resources through a poster and flip chart that will be released at the end of the year. The goal is for these resources to be readily available to physicians to help them talk more knowledgeably about STIs, and for patients (who see the poster, for example) to ask to be tested.
Have that (awkward) conversation
In the end, however, the conversation about safe sex needs to go back to the household.
“If your parent is back in the dating scene, [this conversation] could be a part of it,” Clement says.
Part of Price’s advocacy involves teaching people in this age group how to date and how to engage in safe sex. She says just like any age group, the conversation to use condoms is always the hardest one.
“I suggest [to my class] to say [to a new partner]: ‘I always use a condom with a partner, do you have a favourite or would you like to use mine?’ We’re not giving them a choice of not using it.”
She says unless the conversation to use condoms becomes normalized, just like the conversation to use lubricants or a drug like Viagra, the rates will never change.
“It’s not a new phenomenon in our age group [to have sex] — we’ve always had sex. But we’ve aged and we have not continued to educate ourselves.”
Read more from our series Below the Belt: Canada’s STI Problem.