Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

STD knows not your DOB


Sex can be an important part of life in older age. My patient reminded me to address STD prevention and other intimacy concerns consistently in all sexually active adults. 

As I was finishing a visit with my patient, a 70-year-old man with hypertension and asthma, he nervously asked one additional question. He was a retired engineer in generally good health who had lived alone for the last three years since his wife died of cancer. After he mentioned that he was starting to date a little, I thought I knew exactly where the conversation was heading. His fidgety body language and awkward, meandering explanation made it hard not to jump to the rescue and offer a prescription for Viagra for what I presumed was erectile dysfunction (ED). It was a good thing I resisted. 


Finally, he asked, “Do you think I should use condoms?” It was a great question and shouldn’t have been so unexpected.  


Sexually transmitted disease (STD) has no way of knowing your age or date of birth (DOB). All sexually active adults are at risk. As it turns out, STDs in older adults have increased considerably in recent years, especially among those who are widowed or divorced. This patient reminded me not to overlook a sexual history in all my well visits, especially with older patients where it has become less than routine. This should include the following questions:  


1. Is the patient sexually active? 


2. Does sexual activity involve high-risk behaviors? 


3. What precautions are they taking to prevent STD? 


4. Are there any physical or emotional issues disrupting sexual activity? 


Most of all, provide a safe space, along with time for any needed discussion and education. 










This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.