Journal of Gerontological Nursing

Feature Article 

Sexually Transmitted Infections and Older Adults

Beverly K. Johnson, PhD, RN

Abstract

Older adults continue to be sexually active in their later years. A range of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among older adults. Risk factors for STIs in older populations include (a) normal sexual changes associated with aging (e.g., increased time to attain an erection, decreased vaginal lubrication, decreases in sexual hormones); (b) psychosocial changes (e.g., loss of partner or spouse and re-entering the dating scene); and (c) risky sexual behaviors, including no or infrequent use of condoms. Screening of adults for STIs should occur regardless of age based on guidelines such as those from the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force. As discussed in this article, nurses can use assessment guides and engage in interventions such as counseling and education with older adults to reduce STI risk or refer for treatment. Numerous online resources exist for both nurses and older adults to increase knowledge of STIs. [Journal of Gerontological Nursing, 39(11), 53–60.]

Dr. Johnson is Faculty, College of Nursing, Seattle University, Seattle, Washington.

The author has disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Beverly K. Johnson, PhD, RN, Faculty, College of Nursing, Seattle University, 901 12th Avenue, Seattle, WA 98122; e-mail: johnsob@seattleu.edu.

Received: August 10, 2013
Accepted: August 16, 2013
Posted Online: September 24, 2013

Abstract

Older adults continue to be sexually active in their later years. A range of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among older adults. Risk factors for STIs in older populations include (a) normal sexual changes associated with aging (e.g., increased time to attain an erection, decreased vaginal lubrication, decreases in sexual hormones); (b) psychosocial changes (e.g., loss of partner or spouse and re-entering the dating scene); and (c) risky sexual behaviors, including no or infrequent use of condoms. Screening of adults for STIs should occur regardless of age based on guidelines such as those from the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force. As discussed in this article, nurses can use assessment guides and engage in interventions such as counseling and education with older adults to reduce STI risk or refer for treatment. Numerous online resources exist for both nurses and older adults to increase knowledge of STIs. [Journal of Gerontological Nursing, 39(11), 53–60.]

Dr. Johnson is Faculty, College of Nursing, Seattle University, Seattle, Washington.

The author has disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Beverly K. Johnson, PhD, RN, Faculty, College of Nursing, Seattle University, 901 12th Avenue, Seattle, WA 98122; e-mail: johnsob@seattleu.edu.

Received: August 10, 2013
Accepted: August 16, 2013
Posted Online: September 24, 2013

Sexually transmitted infections (STIs) are defined as infections passed from person to person through intimate sexual contact. Routes of transmission include oral, vaginal, and anal. The term STI is interchangeable with the term STD (sexually transmitted disease) (Office on Women’s Health, 2009). STIs that are reported to the Centers for Disease Control and Prevention (CDC) state health departments include syphilis (primary and secondary, early latent, late and late latent, and congenital), chlamydia, gonorrhea, and chancroid (National Center for Health Statistics, 2013). According to the CDC (2013b), many cases of chlamydia, gonorrhea, and syphilis go undiagnosed and unreported. Other STIs including human papilloma virus (HPV), herpes simplex virus, and trichomoniasis are not reported routinely to the CDC.

The total number of STIs in the United States has been estimated to be 110 million, with approximately 20 million new STIs occurring each year; one half of these occur in individuals ages 15 to 24 (CDC, 2013a). According to AARP’s 2009 study on midlife and older men and women, 1,110 older adults reported having or having had an STI (525 men, 585 women) (Fisher, 2010). Thirty-five percent of the women reported vaginitis or yeast infections, and 5% reported HPV (genital warts). Other STIs reported by women including gonorrhea, herpes, syphilis, and HIV/AIDS ranged in frequency from 0.5% (HIV/AIDS) to 1% for syphilis and 3% for genital herpes. For men, 7% reported gonorrhea, 5% reported HPV, and 1% reported syphilis or HIV/AIDS.

An STI can have potential short- and long-term effects on an individual’s health. For example, an STI can increase the risk for HIV infection. U.S. health care costs related to STIs are approximately $16 billion annually (CDC, 2013a). The purpose of this article is to discuss the occurrence and risk of STIs among older adults. Screening strategies will be reviewed, and nursing strategies for assessment and treatment of STIs discussed. This article will conclude with resources for nurses working with older adults to facilitate prevention and treatment of STIs.

Prevalence

The CDC reported that in 2011, 12,214 cases of HIV were diagnosed among individuals ages 45 to 65+, by the following age groups (a) 45 to 49, n = 4,835 ; (b) 50 to 54, n = 3,454; (c) 55 to 59, n = 2,021; (d) 60 to 64, n = 1,077; and (e) 65 and older, n = 827. Among men of all ages, the most important risk factor was having sex with men (63%), whereas for women of all ages, 43% were at risk due to heterosexual contact and 50% described as “other” (CDC, 2013d).

According to the CDC (2008), 15% of the new cases of AIDS diagnosed in 2005 were among individuals 50 and older, and the percentage of these individuals living with HIV/AIDS increased from 17% in 2001 to 24% in 2005. Those 50 and older represented 19% of all AIDS diagnoses, 29% of individuals living with AIDS, and 35% of all deaths of those with AIDS. For race and ethnicity, the rates of HIV/AIDS in older adults was 12 times as high for Black individuals and five times as high among Hispanic as for White adults. Total numbers and rates for other common STIs are displayed in Table 1.

Rates of Sexually Transmitted Infections (STIs) Reported in The United States

Table 1:

Rates of Sexually Transmitted Infections (STIs) Reported in The United States

STI Risk Increases with Age

As the number of older adults in the population increases, so will the number of STI cases around the country. Infections are especially high in states with many retirees (Jameson, 2011). Several examples from an analysis of CDC data by the Orlando Sentinel support this increase in STIs. In two counties surrounding Phoenix, in which there are numerous retirement communities, reported cases of syphilis and chlamydia among individuals 55 and older increased by 87% from the years 2005 to 2009. According to the Florida Department of Health, in central Florida, which houses several retirement communities, reported cases of syphilis and chlamydia increased 71% in the same time period. In the Palm Springs area, reported cases of STIs increased up to 50% over the 5-year period. Jameson (2011) reported that the increase in STIs among older adults was higher than the national increase in STIs. Possible reasons proposed for the increase in this population were loss of spouse, living among peers who had also experienced such a loss, and use of hormone replacements by both men and women (Jameson, 2011).

Despite the increased risk of STIs among older adults, health care providers do not routinely discuss STIs or HIV with this population. Moreover, older adults themselves may not ask questions or raise any concern about risk factors, prevention, or symptoms of STIs with their health care providers (National Institute on Aging, 2013).

Physiological Changes with Aging

As adults continue to age, a number of normal and pathological changes of aging place them at higher risk for the development of STIs. For both older men and women, immune systems may not be as robust as that of younger adults and thus less responsive to the resistance and treatment of infections. Also, older adults potentially may have other health conditions that increase the chance for negative health events and may affect treatment effectiveness.

For older men, normal sexual changes associated with aging include declining testosterone levels, which affect testicular size, viability and mobility of sperm, and increased time for erection to occur. These changes may indirectly increase the man’s risk for STIs when he uses a drug for erectile dysfunction (ED) and engages in risky sexual behavior by failing to wear a condom during vaginal or anal sexual activity (Imparato & Sanders, 2012).

For older women, decreased estrogen leads to physiological changes such as thinning and increased dryness of the vaginal mucosa. Such an environment makes the vagina more likely to have abrasions and tears during sexual intercourse and a greater chance of viral entry. Also, the added decline in progesterone may lead to more vaginal infections, which could promote the risk for STIs. The use of progesterone and estrogen creams to make sexual activity more comfortable for women potentially leads to increased sexual activity (Imparato & Sanders, 2012).

Older Adult Participation in Risky Sexual Behaviors

According to Herbenick et al. (2010), men and women ages 14 to 94 participate in a range of solo and partnered sexual activities throughout the life span. Of particular relevance to older adults and STIs, study findings included the following for adults 50 and older: (a) 22% to 58% of men and women participated in vaginal intercourse with a decrease with age, especially for women; (b) anal sex for this age group ranged from 1% to 6% with decreased activity with age; and (c) oral sex behavior also occurred in both men and women and likewise decreased with increasing age.

The results of the AARP’s 2009 survey of sexuality among midlife and older adults reveal that the use of condoms during sex was not prevalent among the 91 adults who reported having had sexual intercourse at least once per month during the past 6-month time period. The sample responded to the question “Do you use any protections, such as condoms or other methods, when you have sex?” Of 48 men who described themselves as single and dating, 12% reported they used condoms all the time, whereas 50% reported “rarely or not at all.” Forty-three percent of women who described themselves as single and dating reported they used condoms all the time; 29% reported “rarely or not at all” (Fisher, 2010). Older adults who have been married for years in monogamous relationships and then find themselves single through death or divorce may not see themselves at risk for STIs at their age nor see the need for practicing safe sex with a condom because unwanted pregnancy is not a current concern. They may see STIs as related to younger individuals, not themselves (Jameson, 2011).

Jena, Goldman, Kamdar, Lakdawalla, and Lu (2010) completed a retrospective cohort study of 1,410,806 men, of whom 33,968 had filled at least one prescription for an ED medication. Study results showed that men who had used an ED medication had higher rates of STIs than nonusers both during the year preceding the use of the ED medication and in the year after beginning the use of such a medication. The observed association between use of an ED medication and STIs may have more to do with the types of patients who use such medications than a direct effect of the drug availability on STI rates. Study results suggested that discussion about safe sex and STD screening should occur when providers prescribe such interventions for ED.

Another study (Karlovsky, Lebed, & Mydlo, 2004) of public information available from the CDC, Florida State Department of Health, the Senior HIV Intervention Project, and the National Association on HIV Over Fifty found that of the number of sildenafil (Viagra®) prescriptions written in the United States, 20% were for men in their 40s, 32% for men in their 50s, and 25% for men in their 60s. Florida data suggested a general trend of an increase in gonorrhea in men 65 and older with almost double the number for men between ages 55 and 64. One educational program in Florida that trains peer educators to provide sex education to older adults in retirement communities found that often individuals believe that any blood test will detect HIV and do not use condoms on a regular basis.

Screening for STIs

The CDC (2013a) has described several recommendations for screening for STIs for the general population, as summarized in Table 2. According to Meyers et al. (2008), there is no evidence to support discontinuation of screening for STIs at any specific age, as individuals are at risk for an STI if exposure occurs regardless of age. For women who are sexually active and may be at increased risk for STIs because of race, ethnicity, or geographical location, the U.S. Preventive Services Task Force (USPSTF) found that there was no optimal age at which to discontinue screening for STIs. However, if there is no direct evidence of risk, the USPSTF suggested that routine STI screening could be stopped at menopause or age 55 (USPSTF, 2008).

Recommendations for Screening for Sexually Transmitted Infections (STIs) among Older Adults

Table 2:

Recommendations for Screening for Sexually Transmitted Infections (STIs) among Older Adults

The USPSTF does not recommend STI screening for men who are not at increased risk. The USPSTF recommends syphilis screening for men engaging in high-risk sexual behavior. Also due to variation by community and geography, health care providers should consider these potential risks in deciding to screen men for syphilis (Meyers et al., 2008).

Screening recommendations for women have been suggested by the USPSTF, CDC, American Association of Family Physicians, and American College of Obstetricians and Gynecologists for chlamydia, gonorrhea, and syphilis. The phrase “increased risk” crossed all organizations as a reason to screen, regardless of age (Meyers et al., 2008).

Moyer (2013) stated that in response to the USPSTF’s updated recommendation on HIV screening, older adults at increased risk for infection should be screened for HIV. The net benefit of screening for HIV infection was described as “substantial.” The conventional tests are repeatedly reactive immunoassay followed by confirmatory Western blot or immunofluorescent assay. High-risk groups included homosexual men, active injection drug users, and individuals who have an STI or have requested a test for an STI.

Currently Medicare, Part B covers screening for chlamydia, gonorrhea, and syphilis once every 12 months for older adults. Medicare also covers up to two individual 20- to 30-minute, face-to-face, high-intensity behavioral counseling sessions annually for sexually active adults at increased risk for STIs. There is no cost to an individual on Medicare for this screening if the primary care provider accepts Medicare assignment (Centers for Medicare & Medicaid Services, n.d.).

Nursing Role in STI Assessment and Management

The CDC (n.d.b) has developed a sexual history guide to identify individuals at risk for STIs, including HIV. The guide provides sample questions and discussion points for history taking. Areas for discussion have been described as the five “Ps” of sexual health: partners, practices, protection from STIs, past history of STIs, and prevention of pregnancy. Sample questions are provided in this guide for each of the five areas. For older adults, however, the pregnancy question is not relevant unless a woman is of childbearing age. For example, for “partners,” questions include “Are you currently sexually active?” and if no, “Have you been sexually active in the past?” and related questions ask about time periods for sexual activity and if sexual activity occurs with men or women or both. For “practices,” a suggested question inquires about specific types of sexual contact (oral, vaginal, and anal). For the area of “protection,” questions revolve around use and type of protection. For “past history of STIs,” questions may be “Have you ever been diagnosed with an STI? When? Were you treated?” as well as questions about the STI history of partner(s) and STI testing. Individuals’ responses to the above questions allow for education about aspects of STIs based on the older adult’s knowledge, attitudes, and behaviors related to STI risk. Another guide (Association of Reproductive Health Professionals, 2008) for talking with individuals about sexuality and sexual health provides sample questions to illustrate the four components of the PLISSIT (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) model for sexual assessment and intervention (i.e., giving permission, providing limited information, offering specific suggestions, and referring to a sex therapist).

Jeffers and DiBartolo (2011) suggested the following strategies nurses may use in the assessment and treatment of STIs with older adults: (a) acknowledge the significant health concern of STIs in sexually active older adults; (b) conduct a thorough sex and drug use assessment/screening with individuals 50 and older and continue these assessments with periodic health examinations; (c) encourage the development of educational programs to increase discussion of STI awareness, strategies for prevention, and treatment options in a variety of settings; d) assist older adults to cope with or manage a diagnosis of a STI or HIV; (e) encourage integration of education about older adults’ sexuality, including STIs into the educational programs for health care providers; and (f) promote dissemination of information about older adult sexuality, including STIs, at community health fairs and older adult living sites.

Condoms

According to the CDC (n.d.a), “consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STI transmission” (p. 1). The best epidemiological studies of condom effectiveness have focused on HIV infection. Studies have also shown that condom use has been effective in reducing risk for other STIs, but the strength of this evidence is not as strong as for HIV due to less well-designed studies for STIs (CDC, n.d.a). With these limitations in design, the studies may have underestimated condom effectiveness. When used consistently and correctly, condoms have thus been described as highly effective in (a) prevention of sexual transmission of HIV; (b) reducing the risk of transmission of STIs such as gonorrhea, chlamydia, and trichomoniasis; and (c) reducing the risk of genital herpes, syphilis, and chancroid only when the site of infection or exposure is covered.

A study by Herbenick et al. (2010) of individuals ages 14 to 94 reported on condom use across the life span. Results showed that 14% of men and 9.7% of women ages 45 to 60 used condoms, whereas only 5.1% of men and 7.4% of women ages 61 and older used condoms. Condom use was dramatically decreased from that of young adults ages 14 to 17, when 79% of the men used condoms and 58% of the women used condoms. This reduced use of condoms among adults 45 and older—and especially among adults 61 and older—leads to the need for counseling and education about ways to reduce STI risk factors in these age groups.

Counseling

Project RESPECT, a national study conducted from the years 1993 to 1996, evaluated the efficacy of HIV prevention counseling on high-risk behavior change over 6 years in 5,876 men and women (CDC, 2007). Research participants, who were primarily heterosexual men and women at risk for STIs and HIV, participated in diagnosis and treatment of STIs at one of five public STI clinics across the United States. They were randomized to one of three interventions: (a) four interactive counseling sessions based on behavioral science, (b) two short interactive counseling sessions based on the CDC’s client-centered HIV Prevention counseling model, or (c) two brief information-only sessions without counseling. Study results found that participants in both of the interactive counseling sessions (a) reported significantly more condom use at 3 and 6 months postintervention compared to the information-only group, and (b) had fewer STIs. The two interactive counseling groups also had fewer STIs after 6 and 12 months. This STI reduction was similar for both men and women. The subsequent Project RESPECT-2 was implemented from 1999 to 2002.

The USPSTF (2008) reviewed evidence on the benefits and harms of counseling to prevent STIs. This review included studies of evaluation of behavioral counseling interventions that were (a) conducted in primary care settings, (b) could feasibly be studied in primary care settings, and (c) were interventions to which individuals might be referred to from primary care settings. The USPSTF defined behavioral counseling interventions as those that included some education, skill training, or encouragement for sexual behavior change to reduce risk. The review did not find evidence of increases in unsafe sex or number of sexual partners (i.e., no harm to individuals) among participants in the behavioral counseling intervention studies. The USPSTF found “there is at least moderate certainty that high-intensity behavioral counseling interventions can lead to moderate net benefits for sexually active adolescents and adults who are at increased risk for STIs” (USPSTF, 2008, Estimate of Magnitude of Net Benefit section).

Education

Idso (2009) described four areas for safe sex education for health promotion for newly single older women. The areas include sex education, STIs, safe sex practices, and communication with partner(s) to wear a condom. These education areas can be applied to both older women and men. The author suggested that nurses use a nonjudgmental, genuine, and accepting attitude during sexual education about STIs. In beginning sexual education and teaching, older adults should be informed of physiological changes related to aging such as delayed penile erection, decreased vaginal lubrication and vaginal dryness, and fragility. Information about ED and related drugs may be discussed as well as information about vaginal lubricants. Information on self-pleasuring for self and partner could also be included. Information about STIs; types of infection (viral versus bacterial); transmission (oral, vaginal, anal); signs and symptoms; treatments; and types of testing and locations for STI testing are also important areas for discussion. Discussion of safe sex may include information about safe sex practices and the importance of using these safe practices before engaging in sexual activity and getting STI testing prior to engaging in intimate activity. Finally, in the area of communication with partner(s) about condom use, nurses must encourage older adults (a) to be open and nonjudgmental, (b) discuss safe sex practices before intimacy occurs, (c) reinforce one’s belief of no sex without condoms, (d) have condoms easily accessible, (e) learn about different kinds of condoms and share information with one’s partner(s), (f) be aware of potential ED issues and discuss alternative forms of sexual expression, and (g) use a female condom. These areas for discussion and education provide a holistic framework for sexual education related to STIs.

Treatment of STIs

The CDC (2011) is a primary source of treatment guidelines for a range of STIs. The website is updated as needed with new information and provides information for clinicians regarding STI prevention, STI treatment, and special populations. Further resources for teaching prevention and treatment of STIs for nurses working with older adults can be found in Table 3. In addition, there are an array of websites for older consumers including information on STIs that can be found in Table 4.

Sexually Transmitted Infection (STI) Resources for Nurses Who Work With Older Adults

Table 3:

Sexually Transmitted Infection (STI) Resources for Nurses Who Work With Older Adults

Sexually Transmitted Infection (STI) Web Resources for Older Adults

Table 4:

Sexually Transmitted Infection (STI) Web Resources for Older Adults

According to the CDC (2012), expedited partner therapy (EPT) is the treatment of partners of individuals identified as having chlamydia, gonorrhea, or syphilis by providing prescriptions or medications to the focal person to give to one’s partner. In 2006, the CDC recommended that health care providers who treat an individual for chlamydia or gonorrhea also provide treatment for the individual’s sexual partner. This treatment would occur even if the partner has not been seen by the provider. Twenty-six states allow health care practitioners to provide at least some STI treatment for the partner of an individual diagnosed with an STI without an examination of the partner by the provider. Eleven states encourage or require that providers provide educational information about STIs to the diagnosed individuals to give to their partners (Guttmacher Institute, 2013). For an example of state policy regarding EPT, New York has developed a two-page summary of EPT for health care providers in the state (New York State Department of Health, 2011).

Conclusion

All sexually active older adults must consider their risks for STIs. Preparation through education, use of safe sex practices, discussion with partner(s) about sexual risks, safe sex, STI testing, awareness of the physiological or bodily changes affecting sexuality of older men and women, and seeking assessment and treatment promptly if an STI is suspected can enhance older adults’ sexual experiences. Nurses who work with older adults can provide assessments and a range of interventions such as education and counseling, as well as referrals for testing and treatment of STIs, and thus play an important role in promoting the sexual health of older adults.

References

Rates of Sexually Transmitted Infections (STIs) Reported in The United States

STI Total No. of Cases Reported in 2011 Men Ages 45 to 54 Men Ages 55 to 64 Men Ages 65+ Women Ages 45 to 54 Women Ages 55 to 64 Women Ages 65+
Chlamydia 1,412,791 44.8 13.1 3.3 35.8 10.1 2.1
Gonorrhea 321,849 37.1 12.9 2.8 9.7 2.5 0.4
Syphilis 13,970 9.0 2.9 0.8 0.5 0.2 0.0

Recommendations for Screening for Sexually Transmitted Infections (STIs) among Older Adults

• Adults who are sexually active should talk to their health care provider about STI testing and which tests may be right for them.
• All adults should be tested at least once for HIV.
• All sexually active older women with risk factors such as new or multiple sex partners should be screened annually for chlamydia.
• At-risk sexually active women (e.g., those with new or multiple sex partners, women who live in communities with a high burden of disease) should be screened annually for gonorrhea.
• Trichomoniasis screening should be conducted at least annually for all women with HIV.
• Screening is recommended at least once per year for syphilis, chlamydia, gonorrhea, and HIV for all sexually active gay men, bisexual men, and other men who have sex with men (MSM).a

Sexually Transmitted Infection (STI) Resources for Nurses Who Work With Older Adults

Website URL
Centers for Disease Control and Prevention (CDC)’s main website for information on STIs http://www.cdc.gov/std
CDC’s ready-to-use STI curriculum modules for clinical educators whose target audience is faculty in clinical education programs, including those that train advanced registered nurse practitioners, physician assistants, and physicians http://www2a.cdc.gov/stdtraining/ready-to-use
Home of the CDC’s manual, Practical Use of Program Evaluation among Sexually Transmitted Disease (STD) Programs http://www.cdc.gov/std/program/pupestd.htm
The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention http://www.cdc.gov/nchhstp
The National Institute of Allergy and Infectious Diseases—Sexually Transmitted Diseases http://www.niaid.nih.gov/topics/std/Pages/default.aspx
California STD/HIV Prevention Training Center http://www.stdhivtraining.org
University of Washington Center for AIDS and STD training resources http://depts.washington.edu/cfas/training/

Sexually Transmitted Infection (STI) Web Resources for Older Adults

Website URL
Medline Plus: Sexually Transmitted Diseases http://www.nlm.nih.gov/medlineplus/sexuallytransmitteddiseases.html
Medline Plus’ interactive tutorial on STIs from the Patient Education Institute http://www.nlm.nih.gov/medlineplus/tutorials/sexuallytransmitteddiseases/htm/index.htm
National Institute on Aging (NIA): Sexuality in Later Life http://www.nia.nih.gov/health/publication/sexuality-later-life
NIA: HIV, AIDS, and Older People http://www.nia.nih.gov/health/publication/hiv-aids-and-older-people
Centers for Disease Control and Prevention (CDC)’s website for adults 50 and older related to HIV/AIDS. Site contains information regarding prevention challenges, what the CDC is doing, what this population can do, resources, bibliography, and related links. http://www.cdc.gov/hiv/topics/over50/index.htm
CDC’s consumer-friendly fact sheets http://www.cdc.gov/std/healthcomm/fact_sheets.htm
CDC’s website on HIV/AIDS http://www.cdc.gov/hiv
American Sexual Health Association: Sexually transmitted diseases/infections http://www.ashasexualhealth.org/std-sti.html
U.S. Department of Health and Human Services’ Office on Women’s Health http://www.womenshealth.gov
Journal of the American College of Obstetricians and Gynecologists: Frequently asked questions—Gynecologic problems http://www.acog.org/~/media/For%20Patients/faq009.pdf?dmc=1&ts=20130707T1843441764
Association of Reproductive Health Professionals—What You Need to Know: Talking to Patients About Sexuality and Sexual Health http://www.arhp.org/uploadDocs/sexandsexfactsheet.pdf#search=”talking with patients about sexuality
New England Association on HIV Over 50 http://hivoverfifty.org/en
National Association on HIV Over Fifty http://hivoverfifty.org/en/about/neahof/national.html

Keypoints

Johnson, B.K. ( 2013). Sexually Transmitted Infections and Older Adults. Journal of Gerontological Nursing, 39( 11), 53– 60.

  1. Common sexually transmitted infections (STIs) such as chlamydia, gonorrhea, syphilis, and HIV have been reported among U.S. adults 50 and older.

  2. Changes associated with aging (physiological and psychosocial) as well as sexual behaviors have been associated with increased risk for STIs in the older population.

  3. Screening for STIs as well as education and counseling regarding STI risk factors and prevention and treatment strategies are important nursing interventions with older adults.

  4. An array of online resources about STIs and older adults exist for both nurses and older adults.

10.3928/00989134-20130918-01

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