Trends and projections in sexually transmitted infections in people aged 45 years and older in England: analysis of national surveillance data

Abstract

Aims: We describe the epidemiology of sexually transmitted infections (STIs) and HIV in people aged ⩾45 years in England and provide future projections about the burden of STIs in this age group. Methods: Analysis of national surveillance data in England from 2014 to 2019 for chlamydia, gonorrhoea, herpes, syphilis, anogenital warts and HIV was carried out. Time trends were assessed by the Poisson regression and reported using incidence rate ratios (IRRs). Two scenarios were modelled to predict the number of new STI diagnoses and associated costs in 2040. Results: In 2019, there were 37,692 new STI diagnoses in people ⩾45 years in England. Between 2014 and 2019, there was a significant increase in the rate of new STI diagnoses in men (IRR = 1.05, p = .05) and those aged 45–64 years (IRR = 1.04, p = .05). Absolute numbers of new STI diagnoses in men who have sex with men increased by 76% between 2014 and 2019 (IRR = 1.15, p < .001). In adults aged ⩾50 years, the number of episodes of care for HIV increased over time (age = 50–64 years, IRR = 1.10; age = 65+ years, IRR = 1.13; p <.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040. Conclusion: STI rates in England are increasing in people aged ⩾45 years. The population is ageing and older people will contribute an increasing burden to STI costs if this trend continues. The reasons for this trend are not fully understood and further longitudinal epidemiological research is needed. Sexual health promotion campaigns and healthcare interventions targeted at older people should be prioritised.

Prevalence and Vulnerability Factors Associated with HIV and Syphilis in Older People from Subnormal Agglomerate, Brazilian Amazon

“…Data show that the HIV epidemic disproportionately affects people from low and middle-income countries. The same has been evidenced for syphilis [2,3,10,11]. In South China, there were 34,699 new cases of syphilis, which represented 48.8% of the total [12], while there were 28,130 new cases in Brazil (18% of notified cases) [11].…”

“…The Human Immunodeficiency Virus (HIV) epidemic and Sexually Transmitted Infections (STIs) represent concerns in the aging population [1][2][3][4]. Contributing to this scenario is the progress of public policies to combat HIV [5] and STIs [6], and the increase in the number of elderly people who remain sexually active [7].…”

“…In 2019, among adults over the age of 50 years, 110,000 and 5471 new cases of HIV were diagnosed in the world and in Brazil, respectively [3,10]. While, in England, there were only 850 new HIV diagnoses [2]. Data show that the HIV epidemic disproportionately affects people from low and middle-income countries.…”

“…In South China, there were 34,699 new cases of syphilis, which represented 48.8% of the total [12], while there were 28,130 new cases in Brazil (18% of notified cases) [11]. A lower number were reported in England; 2169 cases in people aged 45 and over [2].…”

“…Although previous studies have reported prevalence and factors associated with HIV and syphilis, as well as with co-infection, there is a gap in the primary studies of these infections in older people [22][23][24][25], including in the Brazilian Amazon [25]. Studies have compared age groups, but are not focused on older people [2,23,24]. This is perhaps because priority has been given to young people and key populations [3].…”