The burden of chlamydia, gonorrhea, and syphilis in older adults in the United States: A systematic review

Abstract

Background Increases in life expectancy, the availability of sexual performance enhancing medication, and changes in sexual partnering suggest that sexually transmitted infections (STIs) among older persons could be on the rise, yet there have been relatively few studies examining STIs in this demographic. Our systematic review aimed to further characterize the incidence and prevalence of chlamydia, gonorrhea, and syphilis, along with associated risk factors among older adults (45 years or older) in the United States. Methods We searched five electronic databases (PubMed, Embase, Cinahl, Web of Science, and Global Health) for data published from inception to January 2021. The retrieved articles were screened based on eligibility criteria, and subsequent review of relevant article bibliographies was conducted. Results Of 4748 articles identified, 23 studies met our inclusion criteria and one additional article was identified through bibliography review. Of the 23 included articles, only 3 (11.5%) were focused exclusively on evaluating STIs in an older population. We found prevalence to be the following ranges: syphilis (0–18%), chlamydia (0–14.2%) and gonorrhea (0–15%). Few studies specifically investigated risk factors in this demographic. Conclusions The understudied burden of STIs in the older adult population substantiates the need to recognize issues surrounding sexuality in this demographic.

Evaluating the global, regional, and national impact of syphilis: results from the global burden of disease study 2019

“…These groups had received comparatively less attention. In a study conducted in the United States, a similar finding was reported, revealing an increase in the burden of syphilis among older adults; notably, this population has always been overlooked or neglected 11 .…”

Temporal Trends in Syphilis Incidence among Men with HIV in Busan, Korea, 2005–2022: A Retrospective Cohort Study

“…In higher-income countries, syphilis infection is less common and occurs disproportionately in racial, ethnic, and sexual minority populations [ 2 ]. However, recently, an unexpected increase in syphilis has been seen, particularly in populations that had previously received comparatively less attention or were overlooked [ 3 ], such as in women, congenital syphilis [ 4 , 5 , 6 , 7 ], and syphilis in older adults [ 8 , 9 ].…”