Tuddenham Susan A, Page Kathleen R, Chaulk Patrick, Lobe Erika B, Ghanem Khalil G
1 Johns Hopkins University School of Medicine, Baltimore, MD, USA.
2 Baltimore City Health Department, Baltimore, MD, USA.
Int J STD AIDS. 2017 Mar;28(4):330-344. doi: 10.1177/0956462416646687. Epub 2016 Jul 10.
Many individuals remain sexually active into their eighth decade. Surveillance data suggest that rates of sexually transmitted infections in older patients are increasing. We compared demographics, risk behaviors, and predictors of acute infections in patients 50 years and older versus younger patients attending sexually transmitted disease clinics in Baltimore, Maryland. This was a retrospective study from a large electronic database of visits to two urban sexually transmitted disease clinics between 2005 and 2010. Proportions were compared using the Chi square test. Logistic regression was used to assess predictors of acute sexually transmitted infections in older versus younger groups. It was found that patients over 50 were more likely than younger patients to report never using condoms (32.6% [CI 0.31-0.34] versus 24.1% [CI 0.23-0.25]). The overall prevalence of acute sexually transmitted infections was 18.1% (CI 0.17-0.19) in older and 25.8% (CI 0.25-0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis (21.5% [CI 18.6-24.5] versus 13.1% [CI 11.5-14.8]). Black race was predictive of having an acute sexually transmitted infections in younger men (OR 2.2 [CI 1.47-3.35]) and women (OR 2.7 [CI 1.34-5.30]) but not in older men (OR 1.2 [CI 0.79-1.73]) or women (OR 1.2 [CI 0.43-3.15]). Older age was associated with a decreased risk of acute STI diagnosis in younger men and older women only, while having had sex for money or drugs in the past month was predictive only in younger women. Reporting symptoms and increasing numbers of sexual partners in the last six months was predictive of acute sexually transmitted infection diagnosis in all age groups. Older patients seeking care at sexually transmitted disease clinics engage in important risk behaviors. Race, a factor predictive of acute sexually transmitted infections in younger patients is not a significant predictor of sexually transmitted infections in older persons.
许多人到八十多岁仍有性生活。监测数据表明，老年患者的性传播感染率正在上升。我们比较了马里兰州巴尔的摩市性病诊所中50岁及以上患者与年轻患者的人口统计学特征、风险行为及急性感染的预测因素。这是一项回顾性研究，数据来自2005年至2010年间两家城市性病诊所就诊情况的大型电子数据库。采用卡方检验比较比例。使用逻辑回归评估老年组与年轻组急性性传播感染的预测因素。结果发现，50岁以上患者比年轻患者更有可能报告从未使用过避孕套（32.6%[CI 0.31 - 0.34]对24.1%[CI 0.23 - 0.25]）。老年患者急性性传播感染的总体患病率为18.1%（CI 0.17 - 0.19），年轻患者为25.8%（CI 0.25 - 0.27）。老年女性更易被诊断为滴虫病（21.5%[CI 18.6 - 24.5]对13.1%[CI 11.5 - 14.8]）。黑人种族是年轻男性（OR 2.2[CI 1.47 - 3.35]）和女性（OR 2.7[CI 1.34 - 5.30]）急性性传播感染的预测因素，但在老年男性（OR 1.2[CI 0.79 - 1.73]）或女性（OR 1.2[CI 0.43 - 3.15]）中并非如此。仅在年轻男性和老年女性中，年龄较大与急性性传播感染诊断风险降低相关，而过去一个月以性换钱或换毒品仅在年轻女性中是急性性传播感染诊断的预测因素。在过去六个月中报告有症状及性伴侣数量增加是所有年龄组急性性传播感染诊断的预测因素。在性病诊所就诊的老年患者存在重要的风险行为。种族是年轻患者急性性传播感染的预测因素，但在老年患者中并非性传播感染的重要预测因素。
