Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. C URRENT O PINION Sexually transmitted infections in older populations I. Mary Poynten a , Andrew E. Grulich a , and David J. Templeton a,b Purpose of review People are living longer and healthier lives. In recent years, there has been a focus on recognition of ongoing sexual activity among older adults and leading from this, the potential for an increase in diagnoses of sexually transmitted infections (STIs). Data on STI rates, sexual behaviour and factors affecting susceptibility to STIs are discussed. Recent findings There is limited published literature in this field and few recent longitudinal studies of STI acquisition in people older than 50 years. Although there is evidence of an increase in incidence, STIs remain rare in older compared with younger populations. Compared with their heterosexual counterparts, older men who have sex with men are at higher risk of incident HIV and some other STIs. The HIV epidemic is ageing as a result of increasing life span and acquisition of HIV at older ages. Improved longevity, evolving societal norms and physiological changes may place older people at risk of HIV and other STIs. Summary Routine STI screening is not warranted in all older people. Education and prevention strategies for all people at greater risk of HIV, regardless of age are required. Age-appropriate interventions designed to impart knowledge and provide the requisite skills needed to reduce STI risk in older age would be beneficial. Keywords ageing, HIV, older age, sexual behaviour, sexually transmitted infections INTRODUCTION There is no question that sexually transmitted infec- tions (STIs) are primarily a health issue of young people, both in terms of incidence and health sequelae. However, the population globally is age- ing and rapidly increasing numbers of people are living long, healthy and potentially sexually active lives. In recent years, there has been a focus on the need to recognise sexuality and sexual health needs as important components of older people’s lives. Studies of middle aged and older women con- sistently report that sexual relations are important to women in these age groups [1,2]. A reluctance by health professionals and aged care services to acknowledge these needs has been highlighted [3,4]. Despite the growing discussion around the recognition of sexuality and sexual activity in older age, there is limited research available on rates and patterns of sexual practices and STIs in this demo- graphic [5,6]. The published literature is sparse and heterogeneous, with few longitudinal studies of STIs among women older than 45 years, in particular. The WHO generally has reported HIV rates in adults only up to 49 years of age [7]. Some national health agencies do not provide stratified STI data beyond 45 years of age, potentially missing import- ant variations in STI rates within the last three to four decades of life [8,9]. Many national STI and sexuality surveys [10,11] concentrate mainly on younger populations, with the UK National Surveys of Sexual Attitudes and Lifestyles only recently increasing the age cutoff from 44 years [6]. In light of this, many questions remain. First, it is uncertain whether STI rates are indeed increasing in older populations, or increasing diagnoses are simply due to an expanding denominator. Second, little is known about whether specific high-risk sub- groups of older people, such as gay men, experience higher rates. Third, there have been few studies of whether sexual risk behaviours in older people have changed over time. Finally it is not known whether a Kirby Institute, University of New South Wales, Sydney and b RPA Sexual Health, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia Correspondence to Dr Mary Poynten, Kirby Institute, The University of New South Wales, Sydney, NSW 2052, Australia. Tel: +61 2 93850937; fax: +61 2 93850920; e-mail: mpoynten@kirby.unsw.edu.au Curr Opin Infect Dis 2013, 26:80–85 DOI:10.1097/QCO.0b013e32835c2173 www.co-infectiousdiseases.com Volume 26  Number 1  February 2013 REVIEW