Sexually Transmitted Diseases New Concern in Geriatrics, Narrates Review

While STIs are a major public health priority, clinical focus remains predominantly on younger adults because of the widespread misconception that the elderly are not sexually active, despite 2011 census data showing that 8% of India's population is over 60. To bridge this clinical gap, Bhushan Kumar from Shalby Hospital and Tarun Narang from the Postgraduate Institute of Medical Education and Research (PGIMER) performed the narrative review to evaluate the rising incidence of infections and the multifaceted reasons behind geriatric vulnerability

Therefore, the narrative review analyzes global and Indian data to assess STI prevalence and clinical outcomes in older adults. By avoiding rigid age cutoffs, the study identifies key biological vulnerabilities and healthcare barriers, providing clinicians with essential insights for improving screening and management in the geriatric population.

Key Clinical Findings of the Review Include:

• Persistent Sexual Activity: Research indicates that 73% of adults aged 57 to 64 remain sexually active, yet 87% of those over age 55 reported failing to use barrier protection during their last sexual encounter

• Escalating HIV Trends: Mathematical modeling predicts that the proportion of HIV-infected individuals over age 50 in India will significantly increase from 19% in 2005 to 37% by 2025

• Regional Infection Patterns: An Indian study identified vaginal discharge (25%) and candidal balanoposthitis (19.5%) as the most frequent clinical presentations among geriatric patients

• Viral Malignancy Risks: Investigation links Human Papillomavirus (HPV) infection to 30% to 50% of penile cancer cases in aging males, emphasizing the need for better screening in this group

• High-Risk Subgroups: The prevalence of urethral gonorrhea reached 15% among men who have sex with men (MSM) aged 45 to 54, highlighting substantial risks in specific aging populations.

The results suggest that addressing the rising burden of STIs in older populations is imperative, as current data reveals an age-standardized incidence rate of 2607.1 per 100,000 population for non-HIV infections. Healthcare providers must recognize the unique sexual needs of the elderly to ensure timely diagnosis and optimum management.

Thus, the review concludes clinicians should incorporate routine sexual history inquiries and tailored screening protocols for older patients to overcome barriers related to stigma and under-diagnosis.

While the review highlights critical trends, the scarcity of regional epidemiological data and community trials necessitates further investigation into age-inclusive sexual health policies to bridge the existing knowledge gap in geriatric care.

Reference

Kumar B, Kaushal I, Narayanan B, Narang T. Sexually transmitted infections in the elderly: A growing concern in geriatric care. Indian J Sex Transm Dis 2025;46:16-21