Risky Business: The ABC’s of STI’s

Let’s get it on? No glove, no love? Why learning the new ABCs of STIs could save your health – and even your life.

Health issues for boomers once began with a simple ABC: arthritis, blood pressure, cardiovascular disease. Now there’s another trio of letters: STI.

It used to be that people got into gardening and other harmless hobbies as they aged. These days, they get into bed – with each other.

Sometimes there isn’t even a bed. “Fornicating pensioners in public” was the news last year from The Villages in Florida, a retirement community where 100,000 people over 55 live and mingle. A 68-year-old married woman and a younger man who was not her husband were each sentenced to 180 days in jail for demonstrating their sexual technique in the public square of The Villages. The copulating couple likely had more to worry about than six months of celibacy behind bars and embarrassed explanations to the grandkids.

Rates of sexually transmitted infections among free-range boomers and seniors are rising like a penis at a porno fest. With better health and pharmacological support, they’re having more sex with more partners – especially in environments like cruise ships, retirement communities and assisted living homes where they come together cheek by jowl and other body parts, too.

“We’re seeing relationship switch-ups and serial monogamy after divorce or death ends long marriages, says Robin Milhausen, University of Guelph associate professor of family relations and human sexuality. More sex with more partners with no protection equals more sexually transmitted disease.

“Bacterial STIs are now more common than they were even a decade ago,” says Milhausen. “Bacterial STIs (gonorrhea and syphilis) have shown dramatic increases, although these can be treated with antibiotics. The viral STIs, also increasing, include the four Hs: HPV (genital warts), herpes, hepatitis B and C, and HIV. Drugs can generally keep them in check, but there’s no cure.”

To wit, some newly single boomers are opting for the HPV vaccine indicated for young people, says Dr. Greenberg, Toronto general practitioner and president of the Canadian Society for the Study of the Aging Male.

In the U.S., free tests for bacterial STIs have been as popular as colonoscopies among seniors eligible for Medicare. In Canada, nearly a third of unmarried boomers admitted to having unprotected sex with a new partner since turning 40 in a survey reported by the Canadian Medical Association Journal. One result: among senior Canadian men, the rate of gonorrhea increased by 99.5 per cent from 1999 to 2008.

So are Canadian men now more concerned about STIs? “Of course they’re not,” says Greenberg. “And of course they should be. The fact that these diseases still exist and that you can get them is a shock to most people.”

Often, magical thinking and cognitive dissonance is part of the problem: “I’m 63. No way am I going to get an STI.” Also, “Anybody I would pick to be intimate with, no way they would have an STI.” Those at the greatest risk: people over the age of 45 who terminated long-term relationships and dived into the dating pool.

“Many are asymptomatic so they don’t know they have a disease and they spread it around,” says Dr. Stephen Holzapfel, director of the sexual medicine counselling Unit at Women’s College Hospital in Toronto. “I just put an IUD in a woman of 45. She was divorced and sexually active, so I tested her for STIs. She had chlamydia and probably had had it for more than six months or longer.”

These frisky boomers may have had one partner for the last 20, 30 or 40 years. If they were having affairs or divorcing when AIDS became a crisis, they may have flirted with condom use for safe sex. But for most boomer men and women, condoms were only good for one thing: contraception.

A scene in the much loved boomer movie Something’s Gotta Give shows characters played by Jack Nicholson and Diane Keaton having sex with each other for the first time. He pauses during foreplay to inquire, breathlessly, “Condom?”

She replies, “Menopause.”

“Who’s the lucky guy!” he practically purrs. Well, maybe not so lucky.

“Anybody sexually active needs to be aware of the risk of getting an STI,” says Holzapfel. Keaton’s character in the movie would have been wise to have a condom handy despite no longer needing it to prevent pregnancy. But, says Holzapfel, “A lot of older women aren’t comfortable with buying condoms. It was never their job.”

But many are comfortable with pursuing sex, says Greenberg. “For a lot of women who are divorced or separated, there may have been a degree of discord in the marriage predating the break-up. Some of these women haven’t had sex in years. And they miss it and seek it. There are guys I know who are relatively newly single, and it’s almost a turn-off for them how easy it is [to find sexual partners] and how aggressive some women are.”

It’s doubtful that insisting on a condom when there’s no danger of pregnancy is part of an eager woman’s game plan. Nevertheless, emphasizes Holzapfel, “Women need to care for their own sexual health. For younger women in their 20s, it’s cool to have a condom in their purse.” Maybe it’s the message about being ready for sex that’s cool for the young hotties. Because, let’s be honest, condoms may be useful for preventing pregnancy and disease, but enhancing sexual pleasure is not their role in life.

“Condoms can decrease sensation, which can interfere with getting and maintaining an erection,” says Holzapfel. Many older men already have problems with erectile dysfunction; Holzapfel says seven out of 50 men age 60 and over are using ED drugs. The figure is much higher in nursing homes where, Greenberg says he’s been told by his geriatrician colleagues, “the amount of sex is shocking.” ED drugs are coveted, condoms not so much.

Sexuality expert Milhausen, speaking on behalf of Trojan condoms, acknowledges the lack of love for the organ armour. But she notes that new styles are looser through the sheath, allowing for movement and reduced friction within the condom. “It’s totally different than it was 50 or 60 years ago,” she says. “There are so many ways to enhance sensation.”

And no condom should ever have to go it alone, without its partner, a lubricant, she emphasizes. Lubricants should go inside and outside the condom, and water-based is best for condom use. She insists, “No sexual encounter should happen without lubricants. Everything sexual is better when it’s slippery. ”

It’s important, she says – and maybe even fun – for sexually active boomers to explore different types of condoms and different types of lubricants.

“They vary in terms of texture. Some people prefer a thinner lubricant. Start with one without extra scent or features. You don’t need tingling to begin with, or something scented or perfume-y.”

As with all things sexual, at any age, she advises, “Start simple and expand from there.”