Viagra-popping seniors lead the pack for STDs

[highlander]

The headline is a bit misleading. Older guys still have a low STD risk rate-it is is just growing relative to other populations.

I haven't checked out this journal reference yet. What I remember from elsewhere:
there are serious claims that viagra etc. may have a slight increase in per coital risk of STD transmission when other factors are held constant.

This is a rather tricky area of research in part because of the drug interactions are complicated.

Also, this study didn't compare per coital risk of viagra users vs. non-users. It is entirely plausible to me that viagra users simply have more sex.

The question in part becomes:
what kind of STD prevention techniques are appropriate for older folks?

I personally think it is _nutty_ to promote old fashioned male condoms in that population. If guys are having troubles with erections, that male condom isn't going to help that problem at all.

My own favorites for STD/STI reduction in this population include:
a) promotion of use of female condoms(which really can make a huge
difference for guys with an erectile problem)
b) more frequent testing among older men and their partners
c) increased education(i.e. training folks to spot risk factors and STD
symptoms).

[highlander]

Here is a related article from The Body:

According to recent studies, sexually active
heterosexual adults over 50 are one-sixth as likely to
use condoms and one-fifth as likely to get tested as
younger, sexually active age groups.
.....
Older womens’ thinning vaginal walls also increases their
susceptibility to HIV and other STDs.
.......
Studies indicate that 40% of primary
care physicians do not assess HIV risk in
persons over 50. Yet the University of Chicago
conducted a survey on the sexual behaviors of older
individuals and found that 60% of men and 37% of
women reported engaging in sexual intercourse a
few times per month.

The claim on increased susceptibility of older women is somewhat at odds compared to some studies looking at African populations. I personally wouldn't be surprised if we have a U curve here with both older and younger populations being more vulnerable-but I suspect the effect is more profound for very young women.

The pattern of activity suggests that either

a) a few older women are markedly more active than the rest

b) older men are more active with younger women-which
might include a disproportionate number of prostitutes.
Prostitution is tricky because:

Early studies suggest that Canadian female prostitutes are no more likely to be infected with HIV or other sexually transmitted diseases than other women, unless they are also intravenous drug users.

US prostitutes might vary because of the differences in the health
care system and public health in general.

[Chicup]

Originally Posted by highlander

US prostitutes might vary because of the differences in the health care system and public health in general.

Doubtful, I'm going to hazard a guess and say most differences are going to be due to 'cultural' ones of the populations being studied.

Prostitute won't really cover it either. We have those making 6 figure incomes bonking ex-governors and crack whores.

Really I think this is a no brainier type of study, and I stand by that. Being involved in more sex partners will increase the chance of catching an STD period.

Look how many guys on this forum have used or use and ED drug in swinging, I'm going to guess that most are over 40, and would have been part of the 'senior' group for this study.

Part of my training which I found most useful was reading paper after paper and tearing them apart.

This paper made a very minor and not very surprising conclusion, it just seems that the news, as usual decided to run with it. The only medical issue to me is to remind doctors to talk about safe sex with their older patients and not forget they need STD screening just like 20 year olds.

[highlander]

Originally Posted by Chicup

Doubtful, I'm going to hazard a guess and say most differences are going to be due to 'cultural' ones of the populations being studied.

Prostitute won't really cover it either. We have those making 6 figure incomes bonking ex-governors and crack whores.

There are a lot of variables there. I tend to think overall STD/HIV level in the surrounding community is a huge variable there. The thing about canada:
getting drugs for something like Chlamydia is pretty easy compared to parts of the US(i.e. like the parts of the US in the South where HIV is starting to spread more rapidly)-and you see substantial variation in STD rates in various parts of the US. I don't think that has much to do with how many sex partners people have in different regions--but I'd be happy to look at evidence to the contrary.

I've seen the general studies that talk about how HIV and STD's decrease with income/education. I have NEVER seen good studies that look at the VERY high end environments. I Know I sure saw a lot of cocaine and opiates in places like Silicon Valley and the financial district of San Francisco. My own personal experience/prejudice is to think of those sorts of things as concentrated among both the very poor and the very rich.

Really I think this is a no brainier type of study, and I stand by that. Being involved in more sex partners will increase the chance of catching an STD period.

The studies I've seen show something an "adjusted odds ratio" of 1.09 for each additional partner for HIV--which is really a pretty small incremental risk. I'd suspect that is different if we are talking a more highly contagious disease like Chlamydia. The thing is is, those numbers get swamped by other things like the pool of partners we are talking about. A porn actor having sex with folks that have test results less than 30 days old has a VERY different overall risk profile than someone dating IV drug users in Miami.

Lots of things influence overall susceptibility to HIV-stuff like whether someone smokes, whether they are an alcoholic(about 40% of all HIV positive folks qualify BTW), a cocaine user, do they use condoms regularly. What is their past history for other STD's.

This paper made a very minor and not very surprising conclusion, it just seems that the news, as usual decided to run with it. The only medical issue to me is to remind doctors to talk about safe sex with their older patients and not forget they need STD screening just like 20 year olds.

The question that is emerging:
what kinds of testing intervals make sense for various populations-and how are folks that are higher risk to be best identified? I