The incidence of HIV and other STIs among people aged 60 to 89 is increasing in some parts of the world. According to a new study published in The Lancet: healthy longevity.
People around the world are living longer than ever before. The number of people over 60 will almost double by 2050, according to the WHO.
As we age, our health generally declines. The immune system weakens and we become more susceptible to infections. This includes HIV and other sexually transmitted infections (STIs) such as syphilis, chlamydia, gonorrhea, trichomoniasis and genital herpes.
“HIV and other STIs are just as prevalent among the sexually active older population as among the younger population,” says Evandro Fei Fang, associate professor at the Institute of Clinical Medicine at the University of Oslo.
“We need to pay attention to STIs in older people,” he continues.
Fang and colleagues analyzed global trends in the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of HIV and other STIs, among people aged 60 to 89 years from 1990 to 2019, using data from 204 countries.
Increase in cases of HIV and other STIs in some regions
Globally, the number of older people living with HIV and STIs has declined in recent decades.
Despite this, the number of new cases indicates that STIs among older adults continue to pose a public health challenge. Globally, there were more than 77,000 new cases of HIV and almost 26.5 million new cases of other STIs among older people in 2019.
Furthermore, in some regions the number of infected people is increasing.
“Despite the global decline in the age-standardized incidence rate of HIV and other STIs among older people between 1990 and 2019, many regions showed increases. The largest increases were recorded in Europe from the East, Central Asia and the high-income Asia-Pacific region,” Fang said. explain. “This is a worrying trend.”
Sexually active older people are often more susceptible to HIV and other STIs than younger people. Various health conditions, including weakened immune systems in older adults, may explain why.
However, the situation is more complex. Various biological, psychological, cultural and societal factors contribute to this higher susceptibility.
Prevention programs often exclude older populations
As we live longer and more of us divorce, older people are having new partners more often than before. Despite this, fewer people in this age group use protective methods such as condoms and are less likely to get tested for STIs.
“In general, there is a lot of attention paid to preventing HIV and other STIs in younger populations. Older people are often excluded from prevention programs,” says Fang.
In addition, health professionals are not always aware of the sexuality and sexual health of older people.
This can lead to inadequate communication with older people about sexual health and the risk of HIV and other STIs.
On the other hand, advances in the treatment of HIV and STIs are also likely contributing to higher incidence in some parts of the world, as people with these diseases live longer than before.
Traveling abroad has become more accessible to a considerable portion of the world’s population in recent decades.
Researchers describe that the widespread use of erectile dysfunction medications and accessible sex industries in some countries and regions further contribute to the spread of HIV and other STIs among older adults.
Subtle increase in STIs among older people in Norway
The study analyzed data from different countries and regions separately.
In Norway, HIV infections are very rare among older people. Nevertheless, the incidence of other STIs in this age group has increased slightly in recent decades, from around 1,600 cases in 1990 to 1,700 cases in 2019.
“This is a first alert for the elderly population in general and for the Norwegian public health authorities,” says Fang.
Overall, the study shows that Norway is doing a good job in the fight against HIV and STIs.
Fang has some recommendations for the Norwegian health authorities.
“The most important interventions are those focused on education and awareness of health personnel and older people on this subject. Combating stigma and misconceptions is also essential,” he says.
“Healthcare providers could also collaborate with senior centers and relevant organizations to solve the problem,” Fang adds.
More information:
Leiwen Fu et al, Global, regional and national burden of HIV and other sexually transmitted infections among people aged 60 to 89 years from 1990 to 2019: results from the Global Burden of Disease Study 2019, The Lancet: healthy longevity (2024). DOI: 10.1016/S2666-7568(23)00214-3
Provided by the University of Oslo
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