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Sex Health Blog

STD Tests for the Elderly

May 04, 2011

Have you heard that the Centers for Medicare and Medicaid Services (CMS) is considering paying for STD screenings for elderly Americans? 

Testing the elderly for sexually transmitted infections?  Really?

Really.

STDs are on the rise among older people.  The Centers for Disease Control and Prevention (CDC) reports that in 2005, people over age 50 made up 15% of new HIV/AIDs diagnoses.  And 24% of people living with HIV/AIDS were over 50 in that year.  (That number is up from 17% in 2001). 

And that doesn’t include other STDs, such as chlamydia, gonorrhea, syphilis, and hepatitis B.

Why are numbers increasing?  Americans are living longer, staying healthier, and remaining sexually active.  Many are dating again after the death of a spouse or divorce.  People who are already HIV positive are also living longer, increasing the chances of transmitting the infection if they’re not careful.

What’s more, older generations are not always consistent about practicing safe sex.  For example, in 2010, AARP published a study seniors’ sexual habits.  Among single respondents who had had sex at least once a month during the previous six months, only 20% said they used condoms regularly.  Only 12% of men and 32% of women reported using a condom every time they had intercourse.

STD testing is important for sexually active people of all ages.  For the elderly, there are some special concerns.

Why get tested?

There are many reasons:

  • Times have changed. Seniors may not have learned much about modern STDs and safe sex practices, since these messages are usually geared to young adults.
  • People don’t always know their partner’s full sexual history.  Internet dating has made it even easier to meet new partners who might not disclose their status.  Some aren’t even aware they have an infection when they pass it on. 
  • A person can have an infection and not even know it.  Some STDs, like HPV, can have no symptoms.  Someone with genital herpes does not have symptoms all the time.
  • Physiological changes can make older people more susceptible to infections.  Many people over age 65 have weaker immune systems.  And older women often have thinner vaginal membranes that can tear, creating greater risk of infection.

Where and When To Get Tested

Which STD screenings are best for you?  And how often do you need them?  You doctor can help you with these questions.  Many people get tested before they start dating again or before they start a sexual relationship with a new partner.  Frequent testing is recommended for people who are not in monogamous relationships and/or have many sexual partners.

If your clinic does not perform particular types of tests (and not all of them do), your doctor can refer you to another clinic.

What Are The Tests Like?

Whatever your age, you might feel nervous about STD testing.  Consider bringing a trusted friend or family member with you.

Here’s a brief overview of different STD tests:

  • HIV.  Most HIV tests look for antibodies – cells that fight off infections.  If you have an HIV infection, special antibodies will develop.  The antibodies don’t form right away, however.  Sometimes it takes up to 8 weeks. 

Usually, HIV screenings are blood tests, but they can be done using saliva or urine, too. 

RNA tests are a special type of HIV test.  They look for the genetic material of HIV, not the antibodies that fight it.  This means you can be tested sooner.  But RNA tests are more expensive and aren’t available in all areas.

All positive HIV tests should be followed up with a second test to confirm the results.

 

  • Syphilis and hepatitis.  These screenings are also blood tests.  Like the HIV test, they look for antibodies.  Since it takes time for antibodies to develop, infections might not be detected right away.

 

  • HPV.  Human papillomavirus (HPV) is an umbrella term for many viruses.  Most HPV infections don’t have symptoms and don’t cause problems.  But stronger types can cause genital warts and cervical cancer.

There are no specific HPV tests for men, unless they are diagnosed with genital warts.

For women, a Pap test can check for any cancerous or precancerous cells on the cervix.  These cells can form because of an HPV infection.

 

  • Chlamydia and gonorrhea.  Doctors usually screen for these STDs through a urine sample.  Alternatively, they might collect cells from inside a man’s penis or a woman’s cervix.  The cells are then sent to a lab for analysis.

 

  • Genital herpes.  It’s difficult to screen for genital herpes.  Doctors can analyze cells from blisters or ulcers, but not everyone has those symptoms.  Blood tests are another option.  Unfortunately, results are not always reliable.  You can test positive for herpes when you don’t actually have the infection and vice versa.

Testing Yourself at Home

In some cases, you can screen for STDs in the privacy of your own home. 

The Home Access HIV-1 Test System is the only kit available that is approved by the U.S. Food and Drug Administration (FDA).  Most pharmacies carry it.  The test involves sending a blood sample (obtained by pricking a finger) to a licensed lab.  You then call to get your results.  Counselors are on duty to answer any questions and provide support.  If you test positive, they will provide information about getting a confirmatory test and help you with your next steps.

At-home tests are also available for chlamydia and gonorrhea.  However, these tests have a higher rate of false-positive results, which means you might test positive for an STD when you don’t actually have one.  Your doctor can help you interpret any results and provide a follow-up test, if necessary.