‘I’ve just had chlamydia and I’m 74!’ proudly announced a well-spoken, white-haired woman at an event I attended a few years ago. She’d contracted her first-ever sexually transmitted infection (STI) from a new partner, who was aged 78. Her symptoms were not picked up by her GP, and it was only after a number of failed tests and treatments that a nurse found out about her new relationship and suggested that she was tested for chlamydia.
We are seeing increasing rates of STIs reported among older people, although numbers are still much lower than younger age groups. Between 2017 and 2018 the largest proportional increases of gonorrhoea and chlamydia were reported in people 65 years and older (gonorrhoea up 42%, from 236 to 336; and chlamydia up 24%, from 416 to 517).
Similarly, the proportion of new HIV diagnoses reported in the over 50s has increased from 13% in 2009 to 21% in 2018, and the rate of late diagnoses continues to be highest in this age group (58% in 50-64 years; 64% in 65+).
Despite this trend, the sexual activity of older people remains taboo in many areas of society. There is a tendency to desexualise people once they reach a certain age, resulting in a reluctance among many health professionals to openly discuss sexual health with older patients. We cannot separate our sexual health from our physical or mental health. Not only does this influence potential health outcomes, but it can also impact self-esteem, confidence and how relationships are perceived. Ultimately, this may make people avoid seeking help with problems related to their sexual health in the future.
Older people often report that they feel invisible, and this is certainly true in the area of sexual health. How often do we see an older person in an advert for condoms or testing for HIV? Hopefully, campaigns such as Jiggle Wiggle, which gave out free contraceptives to people in their 40s, 50s, and 60s in Derbyshire, and Age UK Wiltshire’s HIV: Age is No Protection raising awareness of HIV in older people, are starting to address this. But we must see older people represented more in health promotion campaigns, particularly as we are living longer, healthier lives than ever before.
Sexual health has changed considerably over the last few decades, but people entering into new relationships in later life may not be aware of these changes. Just as we are advocating for meaningful relationships and sex education for our young people, so must we call for better sexual health information and resources for people of all ages. Sexual health services must be more inclusive of older people, with advice and information tailored to our changing needs as we age, as recommended by the State of the Nation report.
We must recognise the sexual relationships of our older population. They might change over the years but they are still enjoyable, valid and important for wellbeing. It’s time to change the negative narrative surrounding sex and older people and address the barriers that exclude older people from getting the support and services they need. Only then can we help to improve the sexual health of the whole nation.