Sexually Transmitted Infections in the Third Age: Rising Risk Among over 65-Year-Old Persons in Southern Sardinia

Abstract

Background/Objectives: Population ageing and the persistence of sexual activity in later life are reshaping sexual health needs. Older adults are often overlooked in STI surveillance and prevention, and data on infections among those aged ≥65 years remain limited. This study describes the epidemiological and clinical profile of STIs in older adults in Southern Sardinia. Our aim was to describe the epidemiological and clinical characteristics of sexually transmitted infections in adults aged 65 years and older attending a specialist STI outpatient clinic in Southern Sardinia over a 15-year period. Methods. We conducted a retrospective longitudinal study of all new STI diagnoses in patients aged ≥65 years attending the Dermatology STI outpatient clinic at the University Hospital of Cagliari between 2010 and 2024. Demographic, behavioural, clinical, and laboratory data were extracted from medical records and analysed descriptively. Results. Among 2378 new STI cases, 69 (2.9%) occurred in patients aged ≥65 years (median age 74 years; range 65–83), predominantly men (85.5%) and mostly heterosexual. Most patients reported limited or no condom use, with 84.1% stating that they never used condoms. The most frequent diagnoses were condylomata acuminata (52.2%) and syphilis (31.9%), followed by molluscum contagiosum and other viral and bacterial infections. Relevant co-infections were observed: hepatitis B virus in 17.4%, HIV in 5.8%, and hepatitis C virus in 1.4% of cases. Follow-up ranged from 1 month to 5 years; 46.4% achieved complete clinical resolution, 33.3% required ongoing treatment, and 20.3% were lost to follow-up. Conclusions Although they represent a small proportion of all STI cases, infections in older adults constitute a meaningful and likely underestimated public health issue. Low risk perception, limited condom use, and diagnostic delays contribute to underdiagnosis. Integrating systematic sexual health assessment, counselling, and targeted prevention into geriatric and primary care is essential to improve the early detection and management of STIs in this growing age group.

The authors' abstract, as published at the source. Journal of Clinical Medicine, 2026 · DOI ↗