Years ago, I worked at the federal agency that administers the Medicare program. And hardly anyone would ever say that Medicare is very forward-thinking, and socially aware. But I think that might change. Did you hear that Medicare might start to cover testing for sexually transmitted infections (STI) for Medicare beneficiaries?
I remember the first time I had to ask an older woman about her sex life. I was still in medical school, just learning how to be a doctor. Here was this gray-haired lady who could have been my grandmother. As part of her routine check-up, I was supposed to ask if she was sexually active. I had to find out if she needed advice on safe sex. I even had to ask if she had sex with men, women -- or both. Like most medical students, I'd never really thought about older adults having sex. And I'll be honest -- I didn't really ask those questions. A lot of us assumed that sex just sort of stopped somewhere around retirement age.
Now, I know better. I've talked to 70-year-old women about whether it's safe to use sex toys. I've listened to men in their 80s who were concerned about the quality of their erections. Today, I'm aware that even in nursing homes, people are getting up to all kinds of things behind closed doors.
It's a fact of life -- older adults do have sex. Back around 2005, more than 3,000 American adults aged 57 to 85 answered questions about their sex lives. And yes, a substantial number of them were still having sex, even in the oldest age group! Up to age 75, about one-third of the men and women with partners were getting busy at least two or three times a month. (That could be any kind of sex with a willing partner, by the way, not just sexual intercourse.) And after age 75? Ok, it was a lower percentage, but it was still more than half.
Given the number of divorces in today's society as well as the large number of widowers, more and more older people are re-entering the dating world. It's important to protect oneself. One is not immune to sexually transmitted diseases just because one is not young anymore. In fact, STI rates are increasing among the elderly. For instance, the number of cases of chlaymdia has nearly tripled in the last decade.
I find that a lot of older adults aren't thinking about sexually transmitted diseases' infections when they re-enter the dating world. It's just not on their radar screen, and unfortunately, people are getting infected.
Maybe it's a "generational thing." Younger adults grew up in the shadow of HIV and AIDS. They're used to the idea of using condoms and getting tested. Not that they always do the right thing, mind you -- but it's part of their sexual culture. Older adults just don't have that same mindset; they especially don't think that they need condoms.
Even if you don't need condoms to prevent pregnancy anymore, you still need them to stay safe. Remember when AIDS was first discovered, and we thought it was mainly a disease of gay men? These days, people often contract HIV, the virus that causes AIDS, through heterosexual sex. Not only that, but older adults make up a lot of new cases. In fact, people over the age of 50 made up 15 percent of new HIV diagnoses. (Medicare does cover testing for HIV, and it makes sense that it would now cover the range of STI.)
Condoms can also reduce your risk of other sexually transmitted diseases, including chlamydia, gonorrhea, and syphilis. They're not foolproof, though. The safer-sex advice for older adults is the same as for younger ones: wait until you know you can trust your partner ... talk about your sexual histories and risk of infections ... use condoms. Be aware that drugs and alcohol can cloud your judgment. Consider asking your potential partner to be screened for sexually transmitted infections -- and get tested, yourself. And if you're using lubricant, make sure it's water-based. Oil -- or petroleum-based lubricants can cause latex condoms to break.
Follow John Whyte, M.D., MPH on Twitter: www.twitter.com/drjohnwhyte