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Elena Iglesias, The Miami Herald: Age is no reason to stop worrying about STDs

Age is no reason to stop worrying about STDs
by Elena Iglesias, September 11, 2011
special to  El Nuevo Herald

photo: The number of people over the age of 50 who have sexually transmitted diseases has been growing steadily for years.
Dr. Anthony Japour, an infectous disease specialist at Jackson North Medical Center, specializing in STD/AIDS patients that are at least 50 years old and older. C.M. Guerrero / El Nuevo Herald

The number of people over 50 living with HIV/AIDS has been growing in recent years.

In 2005, persons over age 50 accounted for the following, according to the Centers for Disease Control and Prevention:

• 15 percent of new HIV/AIDS cases.

• 24 percent of persons living with HIV/AIDS, up from 17 percent in 2001.

• 35 percent of all deaths of persons with AIDS.

Moreover, the rate of HIV/AIDS among persons 50 and older was 12 times as high among blacks and five times as high among Hispanics, compared with non-Latin whites.

Dr. Anthony Japour is a specialist in infectious diseases at Jackson North Medical Center and an adjunct professor at the department of Molecular Microbiology and Infectious Diseases at Florida International University’s Herbert Wertheim College of Medicine.

“When I began my medical studies in 1981, I never thought I would be doing AIDS research, though there was a great need at the time. For me, the emergence of AIDS was like the Third World War due to the number of people dying every day. By the time I finished my studies in 1986, it was already known that HIV was the cause of AIDS. Yet there was no treatment,” Japour said.

Japour says there are two reasons for people in their 50s to be living with AIDS. “One of them is the success achieved with medications. Individuals last longer than before. They can be infected with HIV in their 30s or 40s and still live longer than 50 or 60 years. In 2001 there were only 15 percent of 50+ people with HIV, and in the study we did in 2007 it went up to 25 percent.’’

Japour also notes that earlier diagnoses are being done. “To have HIV nowadays doesn’t mean a sure death. Virus patients are dying from other causes such as heart problems, dementia or cancer, among other diseases,” he says.

Besides HIV and AIDS, the predominant sexually transmitted infectious diseases include syphilis, chlamydia and gonorrhea. And while reported cases of STDs for middle-age Americans have been going up, the national rate has remained relatively stable for the over-65 set, according to the CDC data. The same is true in Florida. In 2000, there were 205 reported cases of syphilis, chlamydia and gonorrhea for those 65 and older. In 2010, there were 203.

Older people who are at risk of being infected with HIV run the same risk with syphilis, chlamydia and gonorrhea if they do not practice safe sex.

“The main problem with gonorrhea is that it is becoming resistant to all drugs with which it was treated until now, like penicillin and other antibiotics,” Japour said.

People carrying the HIV virus are also at higher risk of being infected with Hepatitis B and C because their immune system is weak.

Japour recommends that every sexually active person, of any age, be tested for HIV once a year and always use condoms. “The older generation has this idea that condoms are only used to prevent pregnancies and they don’t use it because they are no longer worried about them,” he says. “However, even at age 80, you should use a condom if you are sexually active. Now, with medications like Viagra, people remain sexually active until a very advanced age. It is important for doctors to emphasize the use of condoms to older people.”

Dr. Giorgio Tarchini of the Cleveland Clinic Department of Infectious Diseases considers genital herpes the most common of infectious diseases and says he has seen an increase of syphilis. “The biggest challenge of all STDs is genital herpes and HIV, because they are incurable,” says Tarchini.

There are also cases of chlamydia and gonorrhea, which are treatable and do not stay in the body. “Syphilis is curable, but the person can get reinfected. HIV poses the highest danger since it can turn fatal if it goes untreated,” Tarchini says.

The doctor explains that the best way to prevent these diseases is with male and female condoms. He also recommends limiting the number of couples and to choose not to have sex with someone with signs of these diseases.

Tarchini cites various reasons to explain why these diseases are growing among people 55 and older. One is that they have a more active sexual life thanks to medications treating erectile dysfunction. Second, people are living longer and are healthier. And thirdly, people tend to not protect themselves because they do not pay attention to STDs. Finally, after menopause, women no longer worry about getting pregnant and stop using condoms for birth control.



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