A taboo is emerging around health issues among America’s older population.
They are having record numbers of unprotected sex without strings attached, leading to historic rates of sexually transmitted diseases (STDs).
The number of chlamydia diagnoses in people over 65 has more than tripled since 2010, while cases of gonorrhea have increased about sixfold and cases of syphilis have increased almost tenfold.
As DailyMail.com maps show, the problem does not appear to be geographically defined: rural Alaska and California, the country’s most populous state, score the highest when it comes to common sexually transmitted diseases.
And it doesn’t appear to be political: deep-red South Dakota and ultra-blue Washington, DC, also have high rates of the diseases.
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Public health experts say the prevalence of sexually transmitted diseases is increasing among older Americans because they are poorly understood about sexually transmitted diseases and their symptoms, and because they engage in behaviors that make them vulnerable.
Many older Americans grew up without comprehensive sex education in schools, with the emphasis being on encouraging abstinence until marriage.
But in the past decade, a new sexual revolution has taken place, turning the norms and morals of casual sex upside down.
Once women are out of menopause, the fear of unintended pregnancy disappears. And with so little education about the risk factors for and ways to prevent STDs, condom use declines.
The vast majority of older people who are sexually active do so without condoms.
A survey by the AARP found that only eight percent of sexually active seniors reported having sex with sex toys on a regular basis. Another study put the figure closer to three percent.
Janie Steckenrider, an expert on aging and sexuality at Loyola Marymount University in Los Angeles, said in the Lancet: ‘Given the past and present sexual experiences of this generation of older adults, their sexual risks should come as no surprise.
‘This generation rarely considers using protection because they grew up in a time when sex education in schools was non-existent, HIV was virtually unknown and their main concern when seeking protection was to avoid pregnancy.’
Nationwide, South Dakota topped the list of adults 65 and older diagnosed with syphilis in 2022, the most recent year for which data are available. There were more than six cases per 100,000 people 65 and older, according to federal data.
Syphilis is on the rise across the country at all ages, with an increase of nearly 80 percent in the past five years. This increase is a concern for public health authorities because the disease can progress and damage the brain, nerves, eyes and heart if left untreated.
Symptoms begin with small open sores on the genitals, mouth, or rectum, and with enlarged lymph nodes.
The second stage involves a rash, genital ulcers, fever, muscle and joint pain, changes in vision, and loss of appetite.
As the infection progresses, the heart valves can become inflamed and damaged. The brain can also slowly break down. This can lead to personality changes, memory loss, difficulty making decisions and strokes.
Washington, DC, led the way in gonorrhea diagnoses, with about 29 cases per 100,000 people, and Alaska recorded the highest rate of chlamydia among the elderly, with nearly 18 cases per capita.
Between 2018 and 2022, the number of chlamydia cases among seniors increased from about one per 100,000 people to about two per 100,000 people, an increase of 125 percent.
After Alaska in first place, Washington, DC, had the second highest per capita chlamydia rate among people over 65 – 16 per 100,000 people – followed by California, with 11.5 cases per capita.
In Alaska, public health officials have linked rising rates of sexually transmitted diseases to the general difficulty in accessing preventive care.
Chlamydia diagnoses more than tripled between 2010 and 2023, while gonorrhea cases increased about sixfold among adults 65 and older. Syphilis cases increased nearly tenfold
The state is vast and largely remote, with towns and villages scattered across the country, though not connected by roads. Many are only accessible by plane or boat, and getting to a doctor for a check-up can be nearly impossible.
In Washington DC, drug use, poverty and insecure housing limit access to preventive sexual health care.
The number of cases of gonorrhea among the elderly has also increased sharply: from 1.3 per capita in 2010 to 3 in 2016 and even 6 per capita in 2022.
The number of gonorrhea cases was highest in Washington DC, with about 30 per 100,000 older adults, followed by Alaska with 15 cases and New Mexico with 11 cases per capita.
The number of syphilis cases among the elderly is at its highest in about two decades, rising from just 0.1 cases per 100,000 people in 2003 to nearly two cases per capita in 2022.
South Dakota, a predominantly rural state where people have less access to preventive care such as health checkups, education, condoms and vaccinations, tops the list for syphilis cases among seniors with more than six cases per capita, followed by Delaware with 5.7 cases per capita.
In third place was New Mexico with five cases per capita, followed by DC with 4.6 cases per 100,000 seniors.
Older Americans are more likely than younger Americans to live in congregate living settings, such as senior living communities, assisted living facilities, and nursing homes. Elder care advocates have noted an increase in the number of sexually transmitted diseases in nursing homes over the past 20 years. However, estimates are difficult to come by, since numbers are typically tracked by age group rather than by residence.
Reports of sexual abuse in nursing homes by residents of fellow residents, including forced sex without mutual consent, are common, but often go unreported.
Sex education in schools in the United States has changed significantly over the past century. Thousands of people born in the 1930s, 1940s, and 1950s received a very different education. The emphasis was on the dangers and moral consequences of premarital sex, not on safe sex practices or sexually transmitted diseases.
In the 1960s, students learned about sex by studying animal and plant reproduction, although teachers generally did not discuss human sexuality.
Young men were told to stay away from ‘loose’ women to avoid venereal diseases, while women were taught the importance of ‘chastity’ and ‘purity’.
This has led to a generational reluctance to talk openly about sex, ask partners about their preferences in the bedroom, and ask if they’ve recently been tested for STDs.
Researchers from several American universities surveyed four dozen adults between the ages of 65 and 94 using a 27-item questionnaire about sexual health.
On average they only answered 11 out of 27 questions correctMore than half believed that human papillomavirus (HPV) – a group of viruses that can cause warts and even cancer – could cause HIV, were unaware of vaccines for gonorrhea and chlamydia, and wrongly believed that frequent urinary tract infections caused chlamydia.
Dr. Mark Gold, a Florida psychiatrist and researcher, wrote in Psychology Today: ‘Many older people think that condoms are only intended to prevent pregnancy.
‘Doctors regularly ask young people about their sexual history and screen for STDs. They should do the same with older adults.’
Rates may also rise because people are living longer and generally healthier than older generations.
Public health researchers have also linked it to the rise of the little blue pill Viagra, which has revived men’s libidos worldwide.
There are also a growing number of dating apps that help seniors meet other seniors, including OurTime and SeniorMatch.
Partners who meet in this way are usually unaware of each other’s sexual history. This puts both, and future partners, at risk of infection.