Let’s Talk About Sex, Granny

What older adults need to know about sexually transmitted infections

Fact checked by Shannon Sparks

Frisky business doesn’t end at a certain age. Sexuality and sexual health are important parts of well-being at any age, including the over-65 crowd. Many older adults, however, aren’t aware that sexually transmitted infections (STIs) are on the rise. 

Nationwide, STIs have more than doubled among people aged 55 and older in the past decade, according to the American Medical Association. For those aged 65 and older:

• Chlamydia cases more than tripled
• Gonorrhea cases increased sixfold
• Syphilis cases rose nearly tenfold

“One of the things we see is that [older adults] often don’t think about having to be safe when they’re older, because pregnancy risk is not there. However, the STI risk is still very much there,” says Jennifer Woodward, MD, a geriatrician and assistant professor of medicine at Northwestern University Feinberg School of Medicine.

STI risk and older adults

“It may seem awkward or too personal to talk about sexuality, but it really helps to keep you healthy.”

STI risk factors include:

• Lack of condom use during vaginal or anal sex. A 2015 study found that only 3% of adults over
  age 60 used condoms.
• Having multiple sexual partners. “Seniors are moresexually active than before, especially seniors who are moving into assisted living, senior living, or nursing home environments. They have more opportunities for new sexual partners, and that increases their risk,” Woodward says.
• Sharing needles and syringes among those with substance use issues.
• Physiological changes and a weakened immune system with aging. Thinning and tears of the vaginal mucosal lining, which acts as a barrier to infection, increase an older woman’s risk of STIs, Woodward says.

STI signs and symptoms

Doctors don’t routinely screen older adults for STIs unless they know the patient is sexually active. Screening involves simple blood and urine tests. Depending on sexual activity, a doctor might also swab the throat or rectal area to test for chlamydia and gonorrhea.

Regular testing is key, Woodward says, because STI symptoms can be subtle or nonexistent. People should get tested if they are sexually active, have multiple sexual partners, or have unprotected sex. 

“All STIs are pretty easily treated, so it’s really about identifying them,” Trotter says. Signs or symptoms include:

• Lesions or sores around the genitals or anus, or in the mouth or throat
• Unusual discharge from the vagina or urethra
• Irritation, burning, or pain with urination or during sexual intercourse
• Unexplained vaginal or rectal bleeding
• Unexplained skin rashes

Though rare, untreated syphilis can damage internal organs and cause serious complications, including blindness, hearing loss, muscle weakness, and cognitive or memory problems. “Sometimes we run across people in that situation because no one’s ever tested them, because there are assumptions [about sexual activity] that happen,” Trotter says.

Conversations around sexual health

STI prevention starts with talking to older adults about risk. “Their perception of their own risk may not be what it actually is,” Trotter says.

Woodward adds that stigmas around sexual health can complicate these conversations. “We really need to normalize it,” she says. 

For caregivers interested in raising the topic, Woodward and Trotter offer these tips:

Ease into the conversation. Woodward says to start with: “It may seem awkward or too personal to talk about sexuality, but it really helps to keep you healthy.” Express your concern that STIs are increasing among older adults, and ask about new social connections to learn about romantic relationships, Trotter says.

Encourage them to talk to their doctor. About two-thirds of older adults have not sought information about relationships or sex, and those who have typically turned to the internet, friends, or social media, according to AARP’s 2022 survey. 

Ask their doctor about prevention. Vaccines can prevent the spread of some infections, Woodward says, including hepatitis A and B vaccines and the mpox vaccine. Chlamydia, gonorrhea, and syphilis are bacterial infections. Doxy-PEP is a prescription antibiotic patients can take within 72 hours after unprotected sex to help reduce the risk of bacterial STIs like syphilis and chlamydia. PrEP, or pre-exposure prophylaxis, is a highly effective way to prevent HIV by taking medication before potential exposure. 

Notify sexual partners of an STI diagnosis. The Chicago Department of Public Health-Partner Services offers free, voluntary, and confidential partner notification to locate partners and alert them to possible exposure. Contact CDPH-Partner Services at (312) 742-2883.

In the end, these conversations should center on safety — not judgment, Woodward says. “We still want to be respectful of their privacy and their independence, but we want to make sure that older adults are safe.”

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STIs and Sexual Abuse

In older adults, contracting an STI without knowing how may indicate sexual abuse, according to the Illinois Department on Aging. The department defines sexual abuse as “touching, fondling, sexual threats, sexually inappropriate remarks, or any other sexual activity with an eligible adult when he or she is unable to understand, unwilling to consent, threatened, or physically forced to engage in sexual behavior.”

If you suspect your loved one has been sexually abused, the Department on Aging recommends reporting it to the statewide Adult Protective Services Program at (866) 800-1409. The program serves adults 60 and older and adults with disabilities aged 18 to 59.

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Originally published in the Winter/Spring 2026 print issue.