A taboo health problem is quietly brewing among America’s elderly population.
They are having casual, unprotected sex at record levels, leading to record rates of sexually transmitted diseases (STDs).
Chlamydia diagnoses in people over 65 have more than tripled since 2010, while gonorrhea cases have increased approximately six-fold and syphilis cases have increased nearly tenfold.
As DailyMail.com’s maps show, the problem does not appear to have a geographic basis: rural areas of Alaska and California, the country’s most populous state, have the highest rates of common STDs.
And it doesn’t seem to be political either: both deeply Republican South Dakota and ultra-Democratic Washington DC also have high rates of these diseases.
Public health experts posit that STDs are on the rise among older Americans due to a lack of awareness about them and the symptoms and behaviors that put them at risk.
Many older Americans also grew up without comprehensive sex education in schools, which focused primarily on promoting abstinence until marriage.
But over the past decade, a new sexual revolution in aging has taken place, upending the norms and morality of casual sex.
Once women have passed through menopause, the fear of accidental pregnancy disappears. And with so little education about risk factors and ways to prevent STIs, condom use plummets.
Therefore, the vast majority of older adults who have sex do so without using a condom.
An AARP study found that only eight percent of sexually active older adults reported using them all the time, while another study put that rate 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 current sexual experiences of this generation of older adults, their sexual risks should not be surprising.
‘This generation rarely considers using protection because they came of age at a time when there was no sex education in schools, HIV was virtually unknown, and their main concern when seeking protection was avoiding pregnancy.’
Nationwide, South Dakota led the country in the number of adults 65 and older diagnosed with syphilis in 2022, the most recent year for which data is available, with more than six cases per 100,000 people 65 and older, according to federal data.
Syphilis among all ages is on the rise nationwide, increasing nearly 80 percent in the past five years, and the rise worries public health officials 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, as well as enlarged lymph nodes.
In the second stage, a skin rash appears, as well as sores on the genitals, fever, muscle and joint pain, vision changes, and loss of appetite.
As the infection progresses, it can inflame and damage heart valves and slowly degrade the brain, causing 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 had the highest rate of chlamydia among older adults, with nearly 18 cases per capita.
Between 2018 and 2022 alone, chlamydia rates in older people rose from about one per 100,000 people to about two per 100,000 people — a 125 percent increase.
Behind Alaska in the top spot, Washington, D.C., had the second-highest rate of chlamydia per capita among people 65 and older (16 per 100,000 people), followed by California, with 11.5 cases per capita.
In Alaska, public health officials have linked rising STD rates to overall difficulty accessing preventive care.
Chlamydia diagnoses more than tripled between 2010 and 2023, while gonorrhea cases increased approximately sixfold among adults aged 65 and older. Syphilis cases increased nearly tenfold.
The state is vast and largely remote, with towns and villages scattered throughout, though not connected by roads. Many of them are only accessible by air or boat, and getting to a doctor for a check-up can be nearly impossible.
Meanwhile, in Washington, DC, drug use, poverty, and unstable housing reduce access to preventive sexual health care.
Gonorrhea rates in older people have also skyrocketed, from 1.3 per capita in 2010 to three in 2016 and up to six per capita in 2022.
The highest rate of gonorrhea cases was in DC, with approximately 30 per 100,000 seniors, followed by Alaska with 15 cases and New Mexico with 11 cases per capita.
The rate of syphilis in older people has reached its highest point in about two decades, from just 0.1 cases per 100,000 people in 2003 to nearly two cases per capita in 2022.
South Dakota, a generally rural state where people have less access to preventive care like health screenings, education, condoms and vaccines, led the nation in 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, which had five cases per capita, followed by DC, which had 4.6 cases per 100,000 seniors.
Older people are more likely than younger Americans to live in congregate settings, such as senior communities, assisted living facilities, and nursing homes, and elder care advocates have identified rising rates of STDs in nursing homes over the past 20 years, although estimates are difficult to obtain given that rates are typically tracked by age group rather than where people live.
Reports of sexual abuse in nursing homes by residents against other residents, including forced non-consensual sex, are not uncommon but often go unreported.
Sex education in American schools has changed considerably over the past century, with thousands of people born in the 1930s, 1940s and 1950s receiving a very different education, one that emphasized the dangers and moral consequences of premarital sex rather than safe sex methods or STDs.
In the 1960s, students were taught about sex by studying animal and plant reproduction, although instructors generally did not discuss human sexuality.
Young men were told to stay away from “naked” women to avoid venereal diseases, while women were taught the importance of “chastity” and “purity.”
This has created a generational reluctance to talk openly about sex, to ask partners about their bedroom preferences and to ask if they’ve recently been tested for STDs.
Researchers from several US universities surveyed four dozen adults between the ages of 65 and 94 using a 27-question sexual health knowledge questionnaire.
On average, they responded only 11 out of 27 questions answered correctlyMore than half believed that human papillomavirus (HPV), a group of viruses that can cause warts and even cancer, could cause HIV, did not know that vaccines against gonorrhea and chlamydia existed, and mistakenly thought that frequent urinary tract infections caused chlamydia.
Dr. Mark Gold, a Florida-based psychiatrist and researcher, wrote in Psychology todayMany older people think that the only purpose of condoms is to prevent pregnancy.
‘Doctors routinely ask young people about their sexual history and screen them for STDs, and they should do the same for older adults.’
Rates may also be increasing because people are living longer and generally healthier in their older years than previous generations.
Public health researchers have also drawn a connection to the rise of the little blue pill, Viagra, which revived men’s libidos around the world.
There is also a growing selection of dating apps designed to help seniors meet other seniors, including OurTime and SeniorMatch.
Couples who meet this way are often unaware of each other’s sexual health history, putting both of them, as well as their future partners, at risk for infections.