STD Tests For Elderly People

According to the latest data reported by Centers for Disease Control and Prevention, the number of STD cases in the elderly people are on the rise. Investigators reported that more than 24% of all the HIV/AIDS patients in the US are over the age of 50 years (1). According to another report, more than 15% of all newly diagnosed HIV/AIDS cases are reported in males over 50 years of age. It is imperative to keep in mind that these statistics does not account for other more common sexually transmitted infections such as gonorrhea, chlamydia, hepatitis B and syphilis.

Why STDs Are On The Rise In Elderly?

Due to high standard of living and availability of excellent healthcare resources, Americans tend to live healthier and longer lives. It is also believed that most Americans continue to engage in regular sexual activities throughout their lives. Here are a few reasons that may explain why HIV is on the rise in elderly subjects:

• Individuals who have been infected with HIV or other STDs, have more chances to transmit their virus to non-infected contacts due to higher life expectancy.
• Most individuals use protection to prevent unwanted pregnancies and what’s more alarming than the fact most elderly people don’t have any incentive to engage in safe sexual practices, which also aggravates the risk of STD transmission.

Screening Of STDs In Elderly Population

Although, STD screening should be performed in all sexually active individuals, it is of utmost importance in elderly population because:

• It has been observed that safe sex education and STD awareness programs are targeted to entice young adults to adopt heathy sexual practices; but no such efforts are made to educate elderly people (especially regarding transmission, prevention and symptomatology of modern sexually transmitted diseases).
• Sometimes people don’t know that their partner is an STD carrier. Cherry on top, online dating has made it even easier to hide such vital pieces of information. Also, in some cases, people are not aware that they are a carrier and can infect their partner unknowingly.
• As people grow older their immune system gets weaker; thereby making them more prone to infections and diseases. As a woman ages, her vaginal membrane becomes thin and prone to easy tearing (which further aggravate the risk of catching STDs in case of an unprotected encounter).
• Some STDs such as genital herpes and HPV are asymptomatic due to which people don’t readily know if they are suffering from an active infection.
• A lot of elderly people don’t sign up for periodic STD screening, which can delay the diagnosis of STD in such patients.

When And Where To Get Tested?

Whenever you are dating a new person or starting a new relationship, you must get yourself tested for STDs. People who have multiple sex partners should see their doctor more often. All clinics do not perform these tests and if your doctor does not have the diagnostic facility then ask for a laboratory or tertiary hospital referral.

Various STD Tests

1. Hepatitis And Syphilis:

These infections are diagnosed through detection of antibodies in the blood of patient. These infections may not get detected readily after the exposure; because antibodies takes time to develop.

2. HIV:

HIV is also diagnosed via antiviral antibodies circulating in the blood stream and these antibodies may take up to 8 weeks to develop after the risky sexual encounter. Besides blood specimen, HIV can also be diagnosed through saliva and urinary HIV screening.

RNA testing is another way to diagnose HIV; but in this test genetic material (or RNA) is detected instead of antibodies. This test gives quicker results but is more expensive and has limited availability. If a person tests HIV positive with a screening test then a confirmatory test is needed to make sure.

3. Genital Herpes:

Screening for genital herpes is difficult as sometimes conventional blood tests may give false positive results (i.e. results shows that you have herpes while in reality you don’t), and sometimes it may give false negative results (i.e. you have herpes but test results indicate that you don’t). Usually doctors diagnose these infections by closely observing the symptoms (such as sores and blisters on the genitals) and patient history.

4. Chlamydia And Gonorrhea:

Screening for chlamydia and gonorrhea is performed by serological investigation (via detection of antibodies in the blood) or vaginal/ cervical swab examination. Characteristics of penile discharge or cervical discharge also helps in establishing a probable diagnosis.

5. HPV:

Human papilloma virus refers to a family of viruses that are known to cause serious infections in humans. In some cases, patient may remain asymptomatic for months/ years and continue to infect others; while in others, patients may develop genital warts or sores soon after the contact.

In poorly managed cases, some strains of HPV (such as 16 and 18) may lead to penile or cervical cancer. According to latest recommendations, women of reproductive age group should opt for Pap test at periodic intervals to detect precancerous or cancerous cervical cells (due to HPV infection)

Self-Testing

Fully equipped kits are now available as over-the-counter products to test STDs at home. Test kits for gonorrhea and chlamydia are available but the risk of false positive results is fairly high, which is why it is recommended to see a doctor at intervals. For diagnosing HIV, US FDA has approved The Home Access HIV-1 Test System that can be obtained from any US drug store.

References

1. Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C. B., ... & Weinstock, H. (2013). Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sexually transmitted diseases, 40(3), 187-193.

2. Ali, H., Donovan, B., Wand, H., Read, T. R., Regan, D. G., Grulich, A. E., ... & Guy, R. J. (2013). Genital warts in young Australians five years into national human papillomavirus vaccination programme: national surveillance data. Bmj, 346, f2032.

3. High, K. P., Brennan-Ing, M., Clifford, D. B., Cohen, M. H., Currier, J., Deeks, S. G., ... & Justice, A. C. (2012). HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group. Journal of acquired immune deficiency syndromes (1999), 60(Suppl 1), S1-18.