Sexual diseases rise among elderly

Fri, Feb 3, 2012, 00:00

THE INCREASED use by older men of drugs to reverse erectile dysfunction may be producing an unexpected side effect. The incidence of sexually transmitted diseases for men and women in the 50-90 age group has doubled over the past decade.

Cases of syphilis, chlamydia and gonorrhoea rose sharply during the 2000s, according to a study published this morning in the British Medical Journal. While doctors have their suspicions, there is little concrete data to explain why this mini-epidemic is taking place.

More surprisingly, the study shows that there has also been a sharp rise in cases of HIV infection in older men.

Males over 50 now account for 20 per cent of adults accessing HIV care, an 82 per cent increase on figures from 2001, said the report’s authors, Rachel von Simson from King’s College London and Dr Ranjababu Kulasegaram from St Thomas’s Hospital in London.

New diagnoses of HIV in the over-50s doubled in the 10 years to 2009, the authors say. The problem was diagnosis of HIV was often delayed because this group was traditionally considered at low risk, “and late diagnoses in older adults are associated with poor outcomes”. The increased incidence of infections, of course, is associated with the finding that 80 per cent of men in the 50-90 age bracket claim to be sexually active. This also implies, however, that older men are not taking proper precautions to avoid infection.

The findings suggest that GPs should be more proactive in discussing safe sex practices with men arriving at surgeries seeking erectile dysfunction drugs, the authors say.

Doctors must also be more aware that older patients complaining of symptoms associated with sexually transmitted diseases may actually have these diseases despite their age.

The big question is why this is happening. “The reason behind the increase in sexually transmitted infections is unknown and little research has been done,” the authors say.

Older women are known to be more vulnerable physiologically as a direct result of changes that take place during the menopause.

For men, the theory holds that the use of erectile dysfunction drugs allows them to remain sexually active and, therefore, remain at risk beyond previous limits.

The sparse evidence available for this was conflicting, however. Men were as likely to pick up an infection in the year before starting these drugs as after.

“This suggests that the drug does not alter risk-taking behaviour but does facilitate it,” the authors conclude.