Sexual Health | Sex As We Age

Sexual Health

Know Your Status.
Know Your Options.

STIs are rising fastest in adults over 50. Screening rates are falling. Most infections produce no symptoms. This hub gives you the clinical information, practical tools, and honest conversation you need to take your sexual health seriously — at any age.

Psychologist-authored  ·  Peer-reviewed sources  ·  Clinically grounded tools
500%
increase in STI rates among adults over 55 in the U.S. between 2000 and 2022
CDC Sexually Transmitted Infection Surveillance, 2022
63.5%
of adults in the U.S. carry HSV-1. Most do not know it — because most STIs produce no symptoms
Bhosale et al., 2024 — systematic review & meta-analysis
< 20%
of sexually active older adults report being screened for STIs in the past year
Schick et al., 2010 — Journal of Sexual Medicine
17%
of new HIV diagnoses in the U.S. now occur in adults over 50 — a population frequently overlooked in prevention efforts
CDC HIV Surveillance Report, 2022

STIs, Screening & Sexual Health Basics

These articles address what every sexually active adult needs to know — and what most healthcare providers are not proactively discussing with older patients.

In-Depth Article

Complete Reference

The Complete Guide to Sexually Transmitted Infections

A comprehensive clinical reference covering every major STI — herpes, HPV, HIV, chlamydia, gonorrhea, syphilis, hepatitis B and C, trichomoniasis — including how each spreads, what symptoms look like (or don't), how it's tested for, and how it's treated. The foundational read for everything else on this page.

In-Depth Article

Screening

What Is on a Full STI Panel?

A standard blood test is not an STI screen. This article explains exactly what a comprehensive STI panel should include, why each test needs to be requested by name, how site-specific swabs work, and what the gaps in routine testing look like — so you can advocate for yourself in a clinical setting.

In-Depth Article

Prevalence · Over 50

STI Prevalence in Adults Over 50

The data is clear and largely ignored: STI rates in older adults have climbed sharply over the past two decades, while screening rates remain low and physician-initiated conversations about sexual health are rare. This article covers the epidemiological picture and what it means for you.

In-Depth Article

Healthcare Advocacy

Your Doctor Won't Bring It Up — So You Need To

Research consistently shows that healthcare providers rarely initiate conversations about sexual health with older patients. This article explains why, what the clinical consequences are, and exactly how to raise the topic with your own provider — including the language that works.


What You Need to Know About Specific STIs

These articles address the infections that most commonly affect adults over 50 — and the ones most commonly misunderstood, underdiagnosed, or carrying disproportionate stigma.

In-Depth Article

Herpes

Herpes Is More Common Than You Think

With HSV-1 seroprevalence near 64% and HSV-2 carried by millions of people who have no idea, herpes is arguably the most common and most stigmatized STI. This article covers the actual epidemiology, what the diagnosis does and does not mean, and how to think about risk and disclosure with clarity rather than shame.

In-Depth Article

HPV

HPV After 50: What You Need to Know

HPV is the most common STI globally — most people who are or have been sexually active will acquire it at some point. This article covers how HPV behaves in older adults, what the current evidence says about screening and vaccination past 45, and the specific concerns around cervical cancer risk in postmenopausal women.

In-Depth Article

HIV & Aging

HIV and Aging: What the Research Shows

HIV is not a young person's diagnosis. Seventeen percent of new diagnoses now occur in adults over 50, and older adults are being diagnosed later — often after the disease has progressed. This article covers HIV risk in older adults, PrEP eligibility, the experience of aging with HIV, and what makes this population clinically distinct.



Sexual Health in Complex Contexts

These articles address situations that are clinically important and almost never discussed openly — sex in residential care, sexuality and dementia, and what it means to navigate sexual health in environments that were not designed with older adults' needs in mind.

In-Depth Article

Residential Care

Sex in Retirement Communities & Long-Term Care

Older adults living in retirement communities and long-term care facilities retain the right to a sexual life — but institutional environments frequently fail to accommodate or respect that right. This article covers the clinical, ethical, and practical dimensions of sexuality in residential care settings.

In-Depth Article

Dementia & Consent

Sex, Dementia & Consent: A Clinical Overview

Dementia raises some of the most ethically complex questions in sexual health — about capacity, consent, protection, and the rights of people whose cognitive function has changed. This article addresses the clinical and ethical framework clearly and without avoidance, including guidance for families and caregivers.


Contraception After 50

Contraception is not just for younger adults. The perimenopausal transition is a common time for unintended pregnancy, and understanding your options — and when you can safely stop — matters more than many clinicians communicate.

In-Depth Article

Contraception

A Complete Guide to Contraception After 50

Covers the full contraceptive landscape for perimenopausal and postmenopausal adults — what is still needed, what the options are, how different methods interact with hormonal changes and health conditions common in later life, and how to know when contraception is no longer necessary.


Downloadable Tools

These tools are designed to be completed privately and brought to clinical appointments. They do the preparation work so the conversation with your provider can be specific and efficient.

Clinical Tool

Screening

Tool 1: STI Screening Checklist

A comprehensive tracking sheet covering every infection you should be tested for, with space to record test dates, results, and next steps by name. Includes a curated list of questions to ask your provider by name — because a standard blood panel is not an STI screen.

Clinical Tool

Disclosure

Tool 2: The Disclosure Planner

A structured four-part writing exercise to prepare for an STI disclosure conversation. Covers what to disclose and why, the specific fears underneath the avoidance, what you want from the conversation, and practical planning including how to open the conversation. Designed for private use before the disclosure happens.

Clinical Tool

Stigma & Beliefs

Tool 3: STI Stigma & Beliefs Reflection

A reflective exercise to examine the specific beliefs you hold about STIs — where they came from, whether they are accurate, and how they may be shaping your behaviour around testing, disclosure, and help-seeking. Based on cognitive-behavioural and psychoeducational frameworks.

Clinical Tool

Provider Conversation

Tool 4: Provider Conversation Prep

A structured preparation guide for your next appointment — covering what to disclose, what to ask for by name, what to say if the conversation feels difficult, and what information to bring. Designed so that the clinical conversation is efficient and productive, even if the topic has felt awkward to raise in the past.

Clinical Tool

Contraception

Tool 5: Contraception Decision Guide

A structured decision-support guide to help you think through your contraceptive options in the context of your current health, relationship, and life stage. Designed to be completed before a provider appointment so the conversation can be specific rather than starting from scratch.


Do It Now: Interactive Exercises

These tools let you start the work directly in the browser. They are starting points — the downloadable tools above go deeper, and a conversation with your provider or a therapist goes deeper still.

Interactive Tracker

STI Screening Status Tracker

Mark which tests you have had, which are due, and which you still need to request. Use this to walk into your next appointment prepared.

Test Status
HIV4th-gen antigen/antibody test
SyphilisBlood test
ChlamydiaUrine or swab — NAAT
GonorrheaUrine or swab — NAAT
Herpes IgGType-specific — must request; not in standard panels
Hepatitis B & CBlood tests
HPV / Cervical screenPap + HPV co-test, if applicable
TrichomoniasisSwab — must request specifically
0 / 8
up to date
Track your status above, then download Tool 1 to bring to your appointment.

Belief Reflection Tool

STI Stigma: Check Your Beliefs

These are common beliefs about STIs that affect testing, disclosure, and help-seeking. Select your response — then see what the evidence actually says.

Only people who are promiscuous get STIs.
Not supported by the evidence. HSV-1 seroprevalence is approximately 64% in U.S. adults — including people who have had very few or even one lifetime partner. Many STIs are transmitted through a single encounter, or acquired from a long-term partner whose own prior exposure was never known. STI diagnosis reflects exposure, not character.
If I had an STI, I'd have symptoms — so I'd know.
This is one of the most clinically dangerous misconceptions about STIs. The majority of STIs — including HIV, chlamydia, gonorrhea, HSV-2, and hepatitis C — are asymptomatic in most people who carry them. The only reliable way to know your status is testing.
STIs are a young person's problem — at my age, the risk is low.
The data says the opposite. STI rates in adults over 55 increased by approximately 500% between 2000 and 2022 (CDC, 2022). Contributing factors include lower rates of condom use, a cohort that came of age before HIV awareness, and the reduced fear of pregnancy. Risk is real at any age if sexual activity is present.
Getting tested means I don't trust my partner.
Testing is a health behaviour, not a relationship statement. Many STIs are carried without anyone's knowledge — including the person who transmitted them. Routine screening is about knowing your own status, not making claims about a partner's fidelity. Many couples find that mutual testing actually increases trust and reduces anxiety.
An STI diagnosis means my sex life is over.
This is not what the evidence shows. Many STIs are fully curable (chlamydia, gonorrhea, syphilis, trichomoniasis). Others are highly manageable with treatment — people with herpes have fulfilling sexual relationships; people living with HIV who are on effective treatment and have an undetectable viral load cannot transmit HIV to a partner (U=U: Undetectable = Untransmittable, CDC, 2022). Diagnosis is a starting point, not an ending.

Guided Writing Exercise

Disclosure Conversation Planner

A shorter digital version of Tool 2. Work through four steps privately to prepare for an STI disclosure conversation.

Step 1 of 4

What do I need to disclose, and what do I actually know about it?

Include what you know about transmission, current status, and any risk-reduction steps you are taking. Also note what you genuinely do not know — being honest about uncertainty is part of a good disclosure.

What am I most afraid of in this conversation?

Name the fear specifically. Then ask: is this fear based on evidence, or on the stigma I have absorbed about this diagnosis? What would I tell a close friend who came to me with this same fear?

What do I want from this conversation?

What would a good-enough response from my partner look like? What is the one thing I most want them to understand? What will I do if the response is hurtful or dismissive?

When, where, and how will I start?

Choose a calm, private setting. Write the first sentence you might actually say — not a perfect sentence, just one you could begin with. Having that opening sentence ready reduces the likelihood that you will avoid the conversation entirely.

Your disclosure prep summary

What you're disclosing:

Your fear:

What you want:

Your plan:

For the full exercise — including space to examine your fears in more depth — download Tool 2: The Disclosure Planner above. If this exercise has brought up significant distress, consider speaking with a registered psychologist before the conversation happens.

A note on this content: The articles and tools on this page are written by a Registered Psychologist and grounded in peer-reviewed research. They are educational resources, not a substitute for clinical assessment, diagnosis, or treatment. If you have concerns about your sexual health, please speak with your family physician, a sexual health clinic, or a registered specialist. In Canada, sexual health clinic services are available without a physician referral in most provinces.