Background Many older patients remain sexually active well into their eighth decade of life. Surveillance data suggest that rates of sexually transmitted infections (STIs) in this age group may be increasing. We sought to compare demographics, risk behaviours and predictors of acute infections in patients 50 years and older versus younger patients attending STI clinics in Baltimore, Maryland.

Methods Retrospective study from a large electronic database of all visits to two urban STI clinics between 2005 and 2010. Proportions were compared using the c² test. Logistic regression was used to assess predictors of acute STIs in older versus younger groups.

Results 4461 first visits for patients over 50 and 4893 visits for patients under 50 were included in the analysis. Patients over 50 frequently reported high-risk behaviours [35.4% (CI 0.34–0.37) vs. 52.7% (CI 0.51–0.54) in those <50] but they were more likely than younger patients to report never using condoms [32.6% (CI 0.31–0.34) vs. 24.1% (CI 0.23–0.25)]. The overall prevalence of acute STIs was 18.1% (CI 0.17–0.19) in older patients and 25.8% (CI 0.25–0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis [21.5% of those tested (CI 18.6–24.5) vs. 13.1% (CI 11.5–14.8)]. Black race was predictive of having an acute STI in younger men [OR 2.2 (CI 1.47–3.35)] and women [OR 2.7 (CI 1.34–5.30)] but not in older men [OR 1.2 (CI 0.79–1.73)] or women [OR 1.2 (CI 0.43–3.15)].

Conclusion Older patients who seek care at STI clinics engage in significant risk behaviours. Race, a factor strongly predictive of acute STIs in young men and women is not a significant predictor of STIs in older persons.

Disclosure of interest statement No sources of funding or conflicts of interest to disclose.