Risk factors that increase STD prevalence in elderly
There are two health conditions that are specifically bad in nature plus bring many other health disorders with them too. These are obesity and aging. As a person gets older, his bones, immunity system, heart, and muscles become weaker. The elders can easily catch infections that take longer to be treated. Hence the aged people are more prone to getting sexually transmitted diseases or commonly known as STDs. Given a weaker recovery and immunity system, the treatment becomes lengthy and painful. STDs among elders have increased over last few years and if not dealt properly, the occurrence of STDs will rise among the elders which will be more costly too. It is therefore necessary to develop STD risk awareness among elders through nursing (Linley, Prejean, an, Chen, and Hall, 2012). Nurses can do a great job in preventing; protecting against and treating STDs for the elders therefore they should be trained and taught how to tell the elders about the risk factors that increase STD prevalence.
Age and Sex
The elders, like the children, are more prone to infections and diseases. The reason why elders cannot actively fight viral attacks, infections and allergies is that their T- cells get weaker that fight agents attacking body. The research conducted on the elders show that they are getting more STDs every year. With the rise in use of sexually helpful medication, the aged people are actively having relationships. About 80% of aged people between the ages of 50 to 90-year are actively involved in sex. The active sexual behavior automatically increases the risks of syphilis, gonorrhea, and chlamydia, as studied in America and England. About 900 cases were registered in year 2000 alone for syphilis in people between ages of 45 to 64 years. The number has grown to above 2,500 by 2010. Also there were 6,700 diagnosed cases of chlamydia in 2000 and 19,000 cases in 2010. People with HIV above age of 50 have doubled between 2000 and 2009. This shows how critical the situation is becoming.
Risk for Elders
The elders do not only have the right to make their personal life decisions but they are as prone to the negative consequences of this as are young people, and some suggest that they are even more vulnerable. Brooks, Buchacz, Gebo, and Mermin (2012) mention the results of a study by Centers for Disease Control and Prevention in their research. They say that about 10.8% of 50,000 patients of HIV are above 50 years age. 5% of these patients were above the age of 60. Brook et. al also mentioned that major reason for getting the worst STD i.e. HIV was not using protection like condoms. 91.5% intercourse was carried out with use of condoms among the casual partners (Illa et al., 2010). It is discussed that another reason for getting more STDs and HIV is that the increasing rates of old age divorces emotionally weaken broken spouses and they do not realize the risks of unsafe intercourse hence they do not adopt safety measures with new partners too. Besides that, even after getting STDs, the elders show less motivation to join treatment and therapy sessions.
Depression and STDs
Often people are less careful about themselves that leads them to risky lifestyles and finally trapping them into diseases. Hutton, Lyketsos, Zenilman, Thompson, and Erbelding, (2004) have a belief, backed by their research on elder patients, that there is high occurrence of clinical depression among the elder people that have HIV. Their depression is evident form not adopting safe procedures, like condoms, for intercourse. Often aged people are stressful and what they are concerned with is to find company and stress releasing activities. They seldom care if their health is at stake or not. Although depression is not directly linked to HIV or STDs, yet it can pave the path for STDs by having a careless behavior towards themselves and their health.
Psychological and Behavioral Correlation with STDs
It is self-care and self-valuing behavior that motivates people to be careful about their physical and sexual health. The increasing rates of diseases that are mental, psychological, physical and sexual, are somehow interlinked. A study by Heckman, Sikkema, Hansen, Kochman, Suhr, and Johnson, (2008) focused on how the behaviors of people lead them to using or not using preventive tools for having safe sex particularly in old age. When people grow beyond 50 years of age, the sexual activity may drop but does continue. It was found that 38% of people above 50 years age were active in last three months. Out of this, 33% activity was found unsafe. It is sad to find that most of the STD and HIV awareness programs in America are directed towards youth and adult awareness (Cooperman, Arnsten, and Klein, 2007). The elders are either not part of target audience or not motivated enough to join these sessions.
Low Acceptance of old age Sex
The old age is so awkwardly associated with decency, elegance and grace that sex is not socially accepted by the aged people. It is therefore that these people find it hard to discuss the problems they face with having intercourse. Minichiello, Rahman, Hawkes, and Pitts (2012) submit that discussing STDs related to old age people is uncommon even in as liberal societies as United States and England. This embarrassment leads them to not buying protections, condoms and not to ask about having safe relationships. While on one hand the healthier lives, increased divorce rates and internet dating has increased the risks of STDs, there are insufficient programs for having safe intercourse in old age. Elder people are also shy joining such courses to maintain their 'grace' in the society. Minichiello et al. (2012) suggest that while there are 73% people above age 57 and below 64 having active life with respect to sex, they have rarely any idea what risks are involved with intercourse with strangers.
State level Awareness Programs for Elders
While nurses are engaged worldwide to tell patients and visitors how badly it is needed to adopt safe sex procedures, they are often not told that elder people are as prone to this problem as the youth. Orel, Wright, and Wagner, (2004) mentioned that public health agencies are offering nursing training and courses to have a system that communicates STDs risks effectively. They found that there are myths, social attitudes and biases behind the non-concern for elders while designing STD awareness programs. Less than 30% elder people aged between 55 and 64 said that they have testing programs for HIV and STDs for elders (Adekeye, Heiman, Onyeabor, O. And Hyacinth, 2012). States are found not only to offer awareness programs mostly to youth but also, the data and information recorded mostly pertains to the youth.
Widowhood and STD Diagnosis
A study is carried on by Smith and Christakis (2009) to find if the increased widowhood is the cause of low or late diagnosis of STDs. Cox Proportional hazard regression method help find the initial STD diagnosis. It was concluded that the widowhood causes STIs more in men than women. The elders often use medicine for erectile dysfunction without complete knowledge or guidance from nursing sector.
Preventing and treating STDs is as critical among elders as it is for youth. Brooks, Buchacz, Gebo, and Mermin (2012) suggest that the nursing practice can adopt many ways in which risks of STDs generally and HIV particularly can be decreased remarkably. These ways are to improve and enhance the behavioral risk assessment, the elders should be routinely screened for infections, and there should be better primary and secondary care conditions. The HIV prevention should be incorporated by testing for diseases in time. Most of the HIV and STD awareness initiatives target people below 50 years of age. Given their low motivation, the elder people should be offer more programs on the awareness and the risks associated with unsafe intercourse, say Heckman, Sikkema, Hansen, Kochman, Suhr, and Johnson (2008). Heckman et al. suggest that the psychological needs and limitations of elder people should be considered while designing awareness programs for them. It is recommended that the society should not feel embarrassed about the sex in old age and there should be guidance for elder people as well (Minichiello, Rahman, Hawkes, and Pitts, (2012). The elders should not be ignored simple on the basis of life expectancy. Orel, Wright, and Wagner, (2004) recommend that the state departments should take interest in developing HIV educational material for elders and there should be increased number of sponsors for conducting research and awareness programs on elders' sexual health. Smith and Christakis (2009) recommend that the nursing efforts should be focused to finding and treating sexual health issues among elder patients particularly those men that use medications for erectile dysfunction.
Adekeye, O.A., Heiman, H.J., Onyeabor, O.S., and Hyacinth, H.I. (2012). The new invincibles: HIV screening among older adults in the U.S. PLoS One, 7(8), n/a. doi:http://dx.doi.org.ezproxy.fgcu.edu/10.1371/journal.pone.0043618
Brooks, J.T., MD, Buchacz, K.,…