America's geriatric STD crisis revealed: The states where seniors have the most unprotected sex

A taboo health problem is secretly brewing among America's older population.

They are having more casual sex and unprotected sex than ever before, so that the number of sexually transmitted diseases (STDs) has reached a record high.

Since 2010, chlamydia diagnoses in people over 65 have more than tripled, while gonorrhea cases have increased about sixfold and syphilis cases have increased nearly tenfold.

As DailyMail.com's maps show, the problem does not appear to be geographical: rural areas in Alaska and California, the US's most populous state, have the highest rates of the most common sexually transmitted diseases.

And it doesn't seem to have a political cause either – the incidence rate is high in both deep-red South Dakota and ultra-blue Washington, DC.

Public health experts believe that the number of sexually transmitted diseases is increasing among older Americans because of a lack of knowledge about these diseases and their symptoms and because of behaviors that put them at risk.

In addition, many older Americans grew up without comprehensive sex education in school, which focused primarily on promoting abstinence until marriage.

But over the past decade, a new sexual revolution has taken place among older people, turning the norms and morals surrounding casual sex on their head.

Once women have gone through menopause, the fear of unwanted pregnancy disappears. And because there is so little education about the risk factors and ways to prevent sexually transmitted diseases, condom use drops rapidly.

Therefore, the vast majority of older adults do not use condoms during sex.

According to an AARP study, only eight percent of sexually active seniors reported using them regularly, while another study put the percentage closer to three percent.

Janie Steckenrider, an expert on aging and sexuality at Loyola Marymount University in Los Angeles, told the Lancet: “Given the past and present sexual experiences of this generation of older adults, their sexual risks should come as no surprise.”

“This generation rarely thinks about contraception because they grew up in a time when there was no sex education in schools, HIV was virtually unknown and their main concern in seeking protection was to avoid pregnancy.”

Nationwide, South Dakota led the country in syphilis diagnoses among adults 65 and older in 2022, the latest year for which data is available, with more than six cases per 100,000 people 65 and older, according to federal data.

Syphilis is increasing across all age groups nationwide, with an increase of nearly 80 percent in the past five years. This increase is a concern for health authorities because if left untreated, the disease can damage the brain, nerves, eyes and heart.

Symptoms begin with small open sores on the genitals, mouth or rectum, as well as enlarged lymph nodes.

In the second stage, there is a rash and ulcers in the genital area, fever, muscle and joint pain, visual disturbances and loss of appetite.

As the infection progresses, it can cause inflammation and damage to the heart valves and slow damage to the brain, which can lead to personality changes, memory loss, difficulty making decisions and strokes.

Washington, DC, led the way in gonorrhea diagnoses, with about 29 cases per 100,000 residents, and Alaska had the highest chlamydia rate among seniors, with nearly 18 cases per capita.

From 2018 to 2022 alone, the rate of chlamydia among older people rose from about one per 100,000 people to about two per 100,000 people – an increase of 125 percent.

Behind Alaska at the top, Washington, DC had the second highest per capita chlamydia rate among those over 65 – 16 per 100,000 people – followed by California with 11.5 cases per capita.

In Alaska, public health officials attribute the explosion in sexually transmitted diseases to a general lack of access to preventive care.

The state is huge and largely remote, with towns and villages scattered throughout, but not connected by roads. Many are only accessible by plane or boat, and it can be nearly impossible to reach a doctor for an examination.

In Washington, DC, however, drug use, poverty and unstable housing conditions make access to preventive sexual health care difficult.

The rate of gonorrhea among older people has also skyrocketed, from 1.3 per capita in 2010 to three in 2016 and even to six per capita in 2022.

The rate of gonorrhea cases was highest in DC at about 30 per 100,000 seniors, followed by Alaska with 15 cases and New Mexico with 11 cases per capita.

The rate of syphilis among older people has reached its highest level in about two decades, from just 0.1 cases per 100,000 people in 2003 to nearly two cases per capita in 2022.

South Dakota, a predominantly rural state where people have less access to screenings, education, condoms and vaccinations, led the nation in the number of syphilis cases among the elderly, with more than six cases per capita, followed by Delaware with 5.7 cases per capita.

New Mexico ranked third with five cases per capita, followed by DC with 4.6 cases per 100,000 seniors.

Older people are more likely than younger Americans to live in community settings such as senior residences, assisted living, and nursing homes. Elder care advocates have noted that rates of sexually transmitted diseases have increased in nursing homes over the past 20 years, but estimates are difficult to obtain because figures are typically recorded by age group rather than by place of residence.

Reports of sexual abuse of roommates by nursing home residents, including forced sexual intercourse without their consent, are not uncommon but often go unreported.

Sex education in U.S. schools has changed significantly over the past century. Thousands of people born in the 1930s, 1940s, and 1950s received a very different education, focusing on the dangers and moral consequences of sex before marriage, but not on safer sex practices or sexually transmitted diseases.

In the 1960s, students were taught about sex through the reproduction of animals and plants, although teachers generally did not talk about human sexuality.

Young men were told to stay away from “easy” women to prevent venereal disease, while women were taught the importance of “chastity” and “purity.”

This has resulted in a generation that no longer talks openly about sex, asks partners about their preferences in the bedroom or inquires whether they have recently been tested for sexually transmitted diseases.

Researchers from various US universities surveyed four dozen adults between the ages of 65 and 94 about their knowledge of sexual health using a 27-question questionnaire.

On average, they answered only 11 of 27 questions correctly. More than half believed that the human papillomavirus (HPV) – a group of viruses that can cause warts and even cancer – could cause HIV, did not know that there are vaccines for gonorrhea and chlamydia, and mistakenly thought that frequent urinary tract infections cause chlamydia.

Dr. Mark Gold, a Florida psychiatrist and researcher, wrote in Psychology Today: “Many older people think the only reason for condoms is to prevent pregnancy.”

“Doctors routinely ask young people about their sexual history and test for sexually transmitted diseases. They should do the same with older adults.”

Rates may also be rising because people are living longer and are generally healthier as they age than older generations.

Health experts have also made a connection to the rise of the little blue pill Viagra, which revitalized men's libido around the world.

There is also a growing selection of dating apps designed to help seniors meet other seniors, including OurTime and SeniorMatch.

Partners who meet in this way are usually unaware of each other's sexual health history, thereby exposing themselves and future partners to a risk of infection.