Sexually transmitted infections (STIs) have become an emerging public health concern among adults aged 55 and older nationwide (Centers for Disease Control and Prevention [CDC], 2024). Although this demographic represents a small fraction of reported STI cases in Arizona (Arizona Department of Health Services [ADHS], 2024), the increasing rates highlight the need for targeted policy interventions. The regulatory process surrounding STI prevention and management for this population involves multiple levels of legislative and regulatory bodies, each playing a role in addressing gaps in prevention, education, and healthcare provider engagement.
Statutory and Regulatory Landscape
At the federal level, the U.S. Department of Health and Human Services (HHS) oversees national STI prevention efforts through the HHS Steering Committee. It “sets the vision, goals, and priority populations and discussed key challenges to be addressed in the STI Plan” (Crowley et al., 2021). The STI National Strategic Plan (2021–2025) guides policy implementation and funding allocations (HHS, 2020). Despite the growing prevalence of STIs among older adults, the 55+ population is not classified as a priority demographic for STI prevention efforts, which limits funding and targeted interventions (Crowley et al., 2021). The Centers for Disease Control and Prevention (CDC) is responsible for providing recommendations to the public about STI prevention and healthcare provider guidelines for education, testing, and treatment. Expanding the HHS STI Plan to include this demographic would require the director's approval, who will answer to the director of the HHS and Congress.
At the state level, agencies like the Arizona Department of Health Services (ADHS) follow federal guidelines to develop state-specific STI prevention initiatives. State health departments fund STI testing, education, and treatment programs. However, the lack of prioritization for the 55+ community means that many older adults are not receiving adequate screening or education. Amending state health policies incorporating STI prevention for older adults would require legislative approval through the Arizona State Legislature, with input from public health experts and advocacy organizations.
Policy Advocacy for Change
A policy advocate seeking to influence STI prevention efforts for older adults must navigate a complex legislative and regulatory process. Advocacy efforts should focus on several key strategies:
- Legislative Advocacy: Advocates can work with state legislators to introduce bills that mandate STI screening and education for older adults in Arizona. This process involves identifying legislative champions, drafting policy proposals, and testifying at committee hearings (Kingdon, 2010).
- Regulatory Engagement: Advocates can petition HHS and the CDC to update their STI prevention guidelines to include the 55+ population. This may involve submitting public comments, meeting with regulatory officials, and partnering with professional organizations such as the American Medical Association (Lubell, 2025) to emphasize the need for age-inclusive sexual health education.
- Healthcare Provider Education: Only one in five healthcare providers routinely discuss STI risks with older patients (Penhollow, 2024). Advocates should encourage the Arizona Board of Nursing and the Arizona Medical Board to update continuing education requirements for providers, including STI screening and education for older adults.
- Community and Public Health Initiatives: Partnering with organizations such as AARP and other senior advocacy groups can help destigmatize sexual health discussions among older adults. Public awareness campaigns can reinforce messages about STI prevention, safe sex practices, and the importance of regular screening (Goad, 2024).
- Insurance and Coverage Expansion: Medicare and Medicaid cover STI testing and treatment, but many older adults are unaware of these benefits (Crowley et al., 2021). Advocates should work with policymakers to improve awareness and ensure comprehensive coverage for preventive services, including routine STI screenings for older adults.
Conclusion
Addressing the rise of STIs among adults 55 and older in Arizona requires a multifaceted approach involving legislative, regulatory, and community-based strategies. By advocating for policy changes at the federal and state levels to improve healthcare provider education, and engaging with public health initiatives. Policymakers can help mitigate the spread of STIs among older adults. Efforts to destigmatize sexual health discussions and integrate STI prevention into routine healthcare for seniors will be essential in promoting healthier aging and reducing STI-related complications in this growing population.
References:
- Arizona Department of Health Services (2024). Sexually transmitted infections 2022. https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/disease-integrated-services/std-control/reports/2022-std-annual-report.pdf
- Centers for Disease Control and Prevention (2024). Gonorrhea 2000-2023 [Data Set]. CDC. https://gis.cdc.gov/grasp/nchhstpatlas/charts.html
- Crowley, J. S., Geller, A. B., & Vermund, S. H. (2021). Sexually transmitted infections: Adopting a sexual health paradigm. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Prevention and Control of Sexually Transmitted Infections in the United States. https://www.ncbi.nlm.nih.gov/books/NBK573147/
- Goad, K. (2024, November 25). Is it an STI – or something else? AARP. https://www.aarp.org/health/conditions-treatments/info-2024/medical-conditions-that-mimic-sti-symptoms.html
- Lubell, J. (2025, January 6). With STI on rise among older adults, here is what doctors can do. American Medical Association. https://www.ama-assn.org/delivering-care/population-care/stis-rise-among-older-adults-here-s-what-doctors-can-do
- Kingdon, J. W. (2010). Agendas, alternatives, and public policies (2nd ed.). Pearson.
- Penhollow, T. M. (2024). Sexuality in older adults: Comprehensive strategies for clinicians and patient-centered care. American Journal of Lifestyle Medicine. https://doi.org/10.1177/15598276241293100
- S. Department of Health and Human Services (2020). Sexually transmitted infections National Strategic Plan for the United States: 2021–2025. https://www.hhs.gov/sites/default/files/STI-National-Strategic-Plan-2021-2025.pdf
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Hi Claudia,
I am enjoying this post that you are working on to educate the public about sexually transmitted infections (STDs) for older people. I also decided to look at dating applications, policies for promoting sexual health, and media information on the internet. If I were a senior looking for resources, I would want to know as much information as possible to prepare myself. Much of the dating information is tailored to the younger population, but this, too, needs to be addressed to the older population. Some sites are available for older women or men looking for younger partners, and this population is not always technology savvy when navigating online material. The topic of dating should be discussed with all providers during the wellness visit. It is a tragedy that seniors are not made aware or not in tune that STDs are still spreading. I also looked at a retirement community called Revel and was surprised that some residences offer concierge wellness that includes sex therapy. This is an explosive market for growth and an opportunity to discuss topics that may be new for people and an opportunity to ensure patients are prepared to venture into a dating lifestyle that is new to them. Medicare questions for my employer only asks patients if they have an STD, not actively asking if they are sexually active or how many partners they currently have for this year, which could easily open the door for an assessment and prevention. Medicare Part B (n.d) covers STI screenings for chlamydia, gonorrhea, syphilis, and Hepatitis B for pregnant individuals or those at increased risk. It also provides up to two behavioral counseling sessions yearly for sexually active adults at increased risk, with screenings available once every 12 months and during specific pregnancy times. Patients usually only see their providers once or twice a year and may not be aware of this benefit.
I am looking forward to seeing how your blog progresses!
References
Medicare. (n.d.). Sexually transmitted infection screenings & counseling. Medicare. https://www.medicare.gov/coverage/sexually-transmitted-infection-screenings-counseling
Revel. (2024, October 22). Revel living: Wellness. Revel Communities. https://revelcommunities.com/revel-living/wellness/
Hello Claudia,
Great topic choice! Sexually transmitted infections (STIs) in the 55+ community are underrecognized as a public health concern. While discussing problems related to dating, I explained to my grandmother that STIs are a concern for the 55+ age group, and she was genuinely shocked. From what I have seen, primary STI prevention efforts are focused on adolescents and young adults, although this education is clearly indicated for adolescents and adults of all ages. I agree that advocacy efforts need to focus on age-inclusive sexual health education. As you mentioned in your first blog post, many people are experiencing relationship changes at this time of life, such as divorce or widowhood, which leads to new relationships. An older but still relevant article found that the perceived risk of STIs, condom usage, and STI testing rates are low within this population (Syme et al., 2017).
Sexuality in later life is subject to stigma and misconceptions (Smith et al., 2020), and older adults are often viewed as asexual (Syme et al., 2017). The push for destigmatisation of sex within the older adult population is significant for many reasons. Coupled with this stigmatization, many older adults feel they have fewer opportunities to discuss sexual health concerns with their providers (Smith et al., 2020). I appreciate that you included healthcare provider education in your post, because this is an underacknowledged issue, especially in this age group, and I feel that many providers do not routinely assess sexual health in general. This oversight is likely due to limited appointment times, the need to address many other concerns, and potentially a discomfort in discussing sexual health. However, with increased awareness and education, screening for sexual health can become as routine as asking about the person’s last mammogram.
References
Smith, M. L., Bergeron, C. D., Goltz, H. H., Coffey, T., & Boolani, A. (2020). Sexually transmitted infection knowledge among older adults: Psychometrics and test-retest reliability. International Journal of Environmental Research and Public Health, 17(7), Article e2462. https://doi.org/10.3390/ijerph17072462
Syme, M. L., Cohn, T. J., & Barnack-Tavlaris, J. (2017). A comparison of actual and perceived sexual risk among older adults. Journal of Sex Research, 54(2), 149–160. https://doi.org/10.1080/00224499.2015.1124379
Hi Claudia!
Your analysis of the statutory and regulatory mechanisms surrounding STI prevention in the 55+ community is both timely and necessary. Recent data highlights a significant rise in STI rates among older adults. For instance, between 2012 and 2022, gonorrhea cases in individuals aged 55 and older increased approximately fivefold, chlamydia cases tripled, and syphilis cases saw a sevenfold rise (Miller, 2024).
One major challenge is the lack of targeted educational initiatives for this demographic. Many older adults remain unaware of their risk for STIs, largely due to the misconception that these infections primarily affect younger people (Thornton, 2023). This knowledge gap underscores the need for tailored public health campaigns addressing the unique behaviors and risks among the 55+ population.
Healthcare providers also play a pivotal role in STI prevention. However, studies show that only a minority of providers routinely discuss sexual health with older patients (University Hospitals, 2023). Expanding continuing education requirements — as you mentioned — is crucial to equipping providers with the skills and confidence to initiate these conversations.
Your focus on legislative advocacy is particularly impactful. Collaborating with state legislators to introduce bills mandating STI screening and education for older adults could significantly shift public health outcomes. Additionally, partnering with senior-focused organizations like AARP may amplify outreach efforts, ensuring educational materials and resources are widely accessible to this demographic.
Integrating these strategies into existing public health frameworks will be essential in promoting healthier aging and reducing STI-related complications among older adults.
References
Miller, A. (2024). Why STI rates are rising among older adults: CDC data reveals concerning trends. Health.com. https://www.health.com/sti-rates-older-adults-cdc-8624669
Thornton, K. (2023). Addressing sexual health education gaps among older adults: A public health priority. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC7177870/
University Hospitals. (2023). Why STIs are on the rise in older adults. University Hospitals Health Blog. https://www.uhhospitals.org/blog/articles/2023/07/why-stis-are-on-the-rise-in-older-adults
I was surprised to read that despite the growing prevalence of STIs among older adults, the 55+ population is not classified as a priority demographic for STI prevention efforts, which limits funding and targeted interventions (Crowley et al., 2021). The topic of STIs in the 55+ population is increasingly relevant, especially given the rise in sexual activity among older adults. Despite significant evidence of higher STI rates in this demographic, they often remain overlooked in terms of prevention and education (Tuddenham et al., 2016). Factors contributing to this trend include a lack of awareness about STIs, insufficient education on safe sexual practices, and societal misconceptions that older adults are not sexually active.
The impact of STIs on older adults can be severe, leading to complications that affect overall health. Conditions like HIV, chlamydia, and syphilis can have particularly serious consequences in this age group, often due to underlying health issues or weakened immune systems (Tuddenham et al., 2016). Moreover, these infections can complicate existing medical conditions and treatments.
Addressing STIs in the 55+ population should prioritize awareness campaigns, accessible testing, and education tailored to older adults (Tuddenham et al., 2016). Shifting the focus and allocating appropriate resources to this demographic helps reduce the stigma, improve sexual health knowledge, and ultimately lead to better health outcomes for older adults.
Crowley, J. S., Geller, A. B., & Vermund, S. H. (2021). Sexually transmitted infections: Adopting a sexual health paradigm. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Committee on Prevention and Control of Sexually Transmitted Infections in the United States. https://www.ncbi.nlm.nih.gov/books/NBK573147/
Tuddenham, S. A., Page, K. R., Chaulk, P., Lobe, E. B., & Ghanem, K. G. (2016). Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland. International Journal of STD & AIDS, 28(4), 330–344. https://doi.org/10.1177/0956462416646687