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. Time trends were assessed by Poisson regression and reported using incidence rate ratios (IRR). 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 2014-2019 there was a significant increase in the rate of new STI diagnoses in men (IRR 1.05, p=0.05) and those aged 45-64 (IRR 1.04, p= 0.05). Absolute numbers of new STI diagnosis in men who have sex with men increased by 76% between 2014 and 2019 (IRR 1.15, p<0.001). In adults aged ≥50 the number of episodes of care for HIV increased over time (age 50-64 IRR 1.10; 65+ IRR 1.13; p<0.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040.
Conclusions
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.
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. Time trends were assessed by Poisson regression and reported using incidence rate ratios (IRR). 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 2014-2019 there was a significant increase in the rate of new STI diagnoses in men (IRR 1.05, p=0.05) and those aged 45-64 (IRR 1.04, p= 0.05). Absolute numbers of new STI diagnosis in men who have sex with men increased by 76% between 2014 and 2019 (IRR 1.15, p<0.001). In adults aged ≥50 the number of episodes of care for HIV increased over time (age 50-64 IRR 1.10; 65+ IRR 1.13; p<0.001). The modelled scenarios predicted an increase in STI diagnoses and costs in older people by 2040.
Conclusions
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.
| Original language | English |
|---|---|
| Journal | Perspectives in Public Health |
| Publication status | Accepted/In press - 25 May 2022 |