STD Rates Soar Among America’s Older Adults

• Rates of gonorrhea (383%), chlamydia (200%) and HIV (92%) all increased among adults ages 55 and over between 2010 and 2019.
  
  
• South Dakota ranked in the top 10 states for the sharpest increases across all three types of STDs.
  
  
• Rates of gonorrhea among the 55-and-up population have increased by more than 1,000% in some states.

Older adults are still plenty sexually active. According to the National Poll on Healthy Aging conducted by the University of Michigan, 65% of adults ages 65 to 80 are still interested in sex, and 40% remain sexually active.

But are all these sexually active seniors engaging safely? Has continued sexual activity among a growing age population coincided with an uptick in sexually transmitted diseases among this demographic?

To find out, we analyzed data from the Center for Disease Control and Prevention (CDC) to examine how the rates of chlamydia, gonorrhea and HIV – the three most common STDs in the aging population – changed in every state during a 10-year period from 2010 to 2019.

The table below shows the percent increase of chlamydia, gonorrhea and HIV in every state from 2010 to 2019 among adults ages 55 and over. 

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As you can see from the table, some states experienced high increases across multiple STDs. 

South Dakota

South Dakota was the only state to rank inside the top 10 among all three types of STDs. 

From 2010 to 2019, South Dakota had the third highest increase in gonorrhea rates among adults ages 55 and over, with case rates climbing 1,393%. The state also had the third-highest rate of increased HIV prevalence, at 194%, and the eight-highest rate of increase for chlamydia cases, at 291%.

Oklahoma

Older adults in Oklahoma experienced rates of chlamydia infection in 2019 that were 518% higher than in 2010, which was second only to Rhode Island. In addition, gonorrhea cases were up 695% among the older population in Oklahoma, good enough for the sixth highest rate of increase in the U.S.

Idaho

Seniors in Idaho had a 2019 HIV prevalence rate that was 162% higher than it was in 2010, which was the seventh-highest rate increase in the nation. Idaho also had the ninth-highest increase in chlamydia infections, at 286%. 

Iowa

Iowa had the eighth-highest rates of increase for both gonorrhea infections (578%) and HIV prevalence (149%). 

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Nationwide, chlamydia infection rates among adults ages 55 and over increased 200% from 2010 to 2019. 

• Rhode Island topped the charts with a 525% rate of increase during the study period.
  
  
• Seven states reported insufficient data, but no states reported a decrease in chlamydia during this time.
  
  
• Maine had the lowest reported increase of chlamydia rates but still saw an increase of more than 9% from 2010 to 2019. 

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Gonorrhea infection rates among older adults have skyrocketed in several states.

In Oregon, rates among the 55-and-up population increased 1,902% from 2010 to 2019, from 4.8 per 100,000 to 16.4 per 100,000. 

Oregon was joined by Minnesota, South Dakota, Arizona and New Mexico as having rates of increase of more than 1,000%. Interestingly, the rate of increase then drops off significantly until Oklahoma, at 695%. 

Nationwide, the rate of gonorrhea increased 383% from 2010 to 2019. Each of the 41 states with sufficient data reported an increase in gonorrhea rates among older adults, and Arkansas’ 88% increase was the smallest in the nation. 

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New HIV diagnoses among all U.S. adults decreased nearly 10% from 2015 to 2019, but the rate continues to rise for the 55-and-older population, specifically. 

• In Wyoming, North Dakota and South Dakota, the rate of increase since 2010 approached 200%.
  
  
• All 50 states and the District of Columbia reported an increase in HIV incidence rates during the study period.
  
  
• The smallest rate of increase was in Hawaii, though HIV diagnoses in the state were still more than 55% higher in 2019 than 2010. 

Rates of reported cases of chlamydia, gonorrhea and HIV among adults ages 55 and over rose substantially from 2010 to 2019. 

Possible reasons for the trend vary.

• Medications have enabled both men and women to remain sexually active later in life.
  
  
• Menopause causes a thinning of vaginal tissues, which can increase susceptibility to STDs.
  
  
• Divorce rates among those 55 and over are on the rise, which lends itself to a potentially higher diversity of sexual partners among the demographic.
  
  
• Pregnancy is not a concern for most adults at this age, so condom usage rates may be low.
  
  
• Many older adults may not have received the same safe sex education in school that younger generations have.    

Another possible reason for a rise in reported cases of STDs is an increase in testing and the adoption of more advanced testing methods. According to the CDC:

"Trends in rates of reported cases of chlamydia and gonorrhea are influenced by changes in incidence of infection, as well as changes in diagnostic, screening, and reporting practices. As both chlamydial and gonococcal infections can be asymptomatic, the number of infections identified and reported can increase as more people are screened – even when incidence is flat or decreasing…Consequently, increasing case rates over time may reflect more complete reporting, as well as increases in incidence of infection, screening coverage, and use of more sensitive tests. Likewise, decreases in case rates may suggest decreases in incidence of infection or screening coverage."

Below are some helpful resources for sexually active senior adults. 

STD and STI Testing

• The CDC provides an online search tool for locating STD testing centers. Search by zip code or state to find a center near you. 
  
  
• STD Check offers a directory of testing centers with available STD tests and pricing, with test results typically available in 1-2 days.
   
• CVS Pharmacy Minute Clinics provide STD testing, with locations all over the U.S.

STD Services and Care

• The Ryan White HIV/AIDS program provides a phone hotline in every state to connect callers to local HIV/AIDS services and care.
  
  
• The American Academy of HIV Medicine offers a search tool to help you find HIV health care providers. 
  
  
• Local health departments typically provide testing and treatment for STDs, often at low or even no cost. 

Sexual Health Education and Information

• The National Institute of Child Health and Human Development (NIH) offers a list of informational resources about STDs for patients.
  
  
• Planned Parenthood hosts an extensive library of information about all types of STDs, including chlamydia, gonorrhea and HIV.
  
  
• The National Coalition of STD Directors provides several tools for finding STD testing and treatment, along with facts and information about STDs. 

The data analyzed in this study came from Centers for Disease Control and Prevention (CDC) surveillance data, using the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) Atlas Plus tool.

We focused on data from 2010 to 2019 for two primary reasons:

• To account for the widespread adoption of more sensitive STD diagnostic tests and expanded availability of STD testing that started in 2000.
  
  
• Data reported to the National HIV Surveillance System (NHSS) are “considered preliminary until a 12-month reporting lag has been reached,” according to the NCHHSTP