Many healthcare professionals, particularly non-specialists, do not consider older men to be at risk of sexually transmitted infections (STIs). Recent Health Protection Agency data show that the percentage of STIs in older age groups in the UK is increasing and are considerably higher for men than women. Men who have sex with men (MSMs) remain at high risk of STIs throughout the age groups.
There is a scarcity of published data on older men attending genito-urinary medicine (GUM) clinics. This project aimed to review men aged 50 and over presenting to a GUM outpatient clinic in the first 3 months of 2012.
4056 men attended during the 3 months, of whom 105 (3%) were 50 years and older. Records were available for 102 men. The age range was 50 to 90 years (mean 58; SD 7.2) and 31 (30%) were MSMs.
12/31 (39%) MSMs and 35/71 (49%) heterosexuals reported that they never use condoms. 7/31 (23%) MSMs and 7/71 (10%) heterosexuals were married to women. A significantly higher proportion of MSM-episodes (17/31; 55%) reported > 1 partner in the preceding 3 months compared to heterosexual-episodes (17/72; 24%; P value 0.004). An STI was diagnosed in 6/31 (19%) MSM and 23/72 (32%) heterosexuals: including non-specific urethritis, proctitis, epididymo-orchitis, warts, gonorrhoea, chlamydia, herpes, syphilis, scabies, pubic lice, HIV and hepatitis B.
This case note review found significant numbers of older men presenting to the GUM clinic. There was a high prevalence of STIs. A surprisingly high proportion of MSMs were married, which suggests that, if they were to attend a non-specialist setting, it is unlikely they would be identified as being at risk of STIs.
Many people remain sexually active into their 80s and beyond. These data support the need to challenge preconceptions regarding sexual health and STI risk in older men.
- sexually transmitted infections
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