Trends in sexually transmitted infections (other than HIV) in older persons: Analysis of data from an enhanced surveillance system

A T Bodley-Tickell ¹, Babatunde Olowokure ^2*, S Bhaduri ³, D J White ⁴, D Ward ⁵, J DC Ross ⁶, G Smith ⁷, H V Duggal ⁸ and P Goold ⁶

¹ Health Protection Agency West Midlands, United Kingdom
² Health Protection Agency, United Kingdom
³ Arrowside Unit, Alexandra Hospital, United Kingdom
⁴ Hawthorn House, Heartlands Hospital, United Kingdom
⁵ HPA West Midlands East Health Protection Unit, United Kingdom
⁶ Whittall Street Clinic, United Kingdom
⁷ Health Protection Agency, West Midlands Public Health Laboratory, United Kingdom
⁸ HPA West Midlands North Health Protection Unit, United Kingdom

^* To whom correspondence should be addressed. E-mail: babatunde.olowokure{at}hpa.org.uk.

Accepted 26 March 2008

Abstract

Objective: This study examines the distribution of selected sexually transmitted infections (STIs) in older persons (aged 45 years) attending Genitourinary Medicine (GUM) clinics in the West Midlands, England.

Methods: Analysis of data from the regional enhanced STI surveillance system for the period 1996-2003. Selected STIs were Chlamydia, genital herpes, genital warts, gonorrhoea and syphilis.

Results: Altogether 4 445 STI episodes were reported among older persons during the study period. Between 1996 and 2003 older persons accounted for 3.7% and 4.3% (respectively) of all GUM clinic attendances. The rate of STIs in older persons more than doubled in 2003 compared with 1996 (p<0.0001). Rates for all five selected diagnoses were significantly higher in 2003 compared to 1996. A significantly increasing trend over time was seen overall (p<0.0001), as well as for each of the selected diagnoses. Overall, males and those aged 55-59 years of age were significantly more likely to be affected.

Conclusions: This study provides evidence of significant increases in attendance at GUM clinics by older persons. While it is recognised that young people should remain the focus of sexual health programmes, the results indicate that sexual risk-taking behaviour is not confined to young persons but also occurs among older persons. There is therefore a need to develop and implement evidence-based multifaceted sexual health programmes that while aiming to reduce STI transmission among all age groups should include interventions aimed specifically at older persons and address societal and healthcare attitudes, myths and assumptions regarding sexual activity among older people.