White Coat Underground

Confound it!

This article is going to be about sex. I promise. But first, some reflections.

Well, Pepsipocalypse continues. The Management pulled the ill-conceived PepsiCo nutrition blog, which is a Good Thing. This doesn’t change my misgivings about what has happened. As many other bloggers have already stated, the Pepsi fiasco is a single, highly-public event, but there are non-public problems that are important to some bloggers, including me.

Removing the “advertorial” blog was the right thing for SEED to do. It removes a clear ethical conflict (remember, this isn’t about PepsiCo, it’s about ScienceBlogs). But significant damage has been done. That being said, I write because I like to write, and whether I stay at Sb or move on to another venue, I’m going to keep doing this. If I move, you’ll be nearly the first to know.

Anyway, it turns out that having sex predisposes you to sexually transmitted infections (STIs). What, you don’t believe me? It’s science!

A study published this week in the Annals of Internal Medicine looked at (male) users of erectile dysfunction drugs and rates STIs both before and after having them prescribed.

It should come as no surprise that men who have sex more are more at risk for STIs. The interesting twist here is that we generally think of STIs as being diseases of young people, and erectile dysfunction as being a disease of older people.  

A recent article for the BMJ journal Sexually Transmitted Infections found that older people who “swing” have a high rate of STIs. This is also not surprising, but what was surprising was that so many older people swing. (The study was done in the Netherlands, and maybe they do things differently there, but I’m probably just naive.)  

Studies have suggested that older folks have a lot more sex than their kids would like to imagine, and our ability to keep people relatively healthy as they age makes this plausible and possible.  

This gives us a lot to chew on. I write prescriptions for ED drugs all the time, but do I counsel all of these patients properly?  The Annals article pointed out that:

Although middle-aged and older adults generally take fewer risks with their health, their decreased need for contraception may imply less-than-optimal safe sexual practices compared with younger populations.

One interesting tidbit from this study was that HIV was one of the most common STIs.  I certainly have counseled older folks who are “back on the market” about safe sex, but this article certainly drives home the need to be even more vigilant.  

References

Dukers-Muijrers, N., Niekamp, A., Brouwers, E., & Hoebe, C. (2010). Older and swinging; need to identify hidden and emerging risk groups at STI clinics Sexually Transmitted Infections DOI: 10.1136/sti.2009.041954

Anupam B. Jena, MD, PhD; Dana P. Goldman, PhD; Amee Kamdar, PhD; Darius N. Lakdawalla, PhD; and Yang Lu, PhD (2010). Sexually Transmitted Diseases Among Users of Erectile Dysfunction Drugs: Analysis of Claims Data
Annals of Internal Medicine, 153 (1), 1-7

Comments

  1. #1 History Punk
    July 8, 2010

    Somewhere in MD had a program for educating the elderly about STDs and prevention. I recall reading one of the big problems was getting old people to grasp AIDs and a lot of resistance from people who thought such talk was “unchristian” and were frankly upset and offended that the public health people involved even thought providing them with such information was necessary.

  2. #2 regis
    July 8, 2010

    Here’s a vote hoping you stay at Sb.

  3. #3 Pascale
    July 8, 2010

    “Get off my lawn… unless you want to do it…”

  4. #4 History Punk
    July 8, 2010

    I already miss the Pepsi blog. I was hoping they detail the science of Mountain Dew and maybe some product history. There are few things better in life than summer time armed with a milk jug of chilled Mountain Dew.

  5. #5 D. C. Sessions
    July 8, 2010

    Speaking of confounding …

    My workout reading right now is Mark Van Name’s Jump Gate Twist — and you just had to name this affair something a bit to close to the nonsensical name “Pinkelponker” that occurs all too often in that book, didn’t you.

    Maybe I’ll inflict an electronic copy of it on you just for spite.

  6. #6 D. C. Sessions
    July 8, 2010

    Although middle-aged and older adults generally take fewer risks with their health, their decreased need for contraception may imply less-than-optimal safe sexual practices compared with younger populations.

    Many of us who grew up with the Pill and STDs that almost universally responded to antibiotics didn’t acquire the condom habit young, and then a lot of us spent the next few decades being monagamous.

    Not really all that surprising, to me at least.

  7. #7 SKM
    July 8, 2010

    Well, whatever you decide about where you want to blog, Pal, I’ll keep reading.

    Many of us who grew up with the Pill and STDs that almost universally responded to antibiotics didn’t acquire the condom habit young,

    This is a good point. I was a kid in the 80′s in the San Francisco Bay area, so sex ed was all about condoms, all the time. From what I’ve heard These Kids Today ™ saying, that might have been a blip, though. I’ve heard younger (male) lab-mates talk about “getting” unprotected “oral” like it’s a human right (whether that sort of talk creates a hostile work environment is a topic for another post).

    Studies have suggested that older folks have a lot more sex than their kids would like to imagine,

    Makes sense to me–the older I get, well, the more I want (Freudian typo admission: I first typed, “males sense to me”).

  8. #8 Mu
    July 8, 2010

    I think it’s a simple numbers game, the more sex partners you have the more likely you are to catch something. Doesn’t matter if you’re an active co-ed or a swinging 50. And the 50 is probably less likely to think “safe sex”, assuming that his or her partners aren’t doing drugs or other nasty things to increase there risk.

  9. #9 Michael Lisieski
    July 8, 2010

    I’d like to see longitudinal data on how (or whether) promiscuous sexual habits change throughout life. Did all these old swingers suddenly start swinging at 50, or had they been doing it (or something like it) all along?

    Also, I am told by the few people I know in the swingers scene in Pittsburgh, it seems that most swingers are old couples who have been married for a while. Neat.

  10. #10 mrn
    July 8, 2010

    I agree with #1; this is a subject ripe for misinterpretation. When my grandmother moved to AZ and found a new doctor, he asked if she wanted a blood test. Obviously, she said yes. When her HIV test results came back negative, she was really offended that her new doctor thought she would need that. She changed doctors.

  11. #11 Kim
    July 9, 2010

    There’s an interesting documentary about swingers, “The Lifestyle”. It’s old enough now that the folks featured in the documentary may have passed on, but it does give you a little qualitative look into the long-married heterosexual swinger demographic (IIRC there is also a younger couple profiled but they are more ambivalent about the experience as of the making of the doc).

  12. #12 Kim
    July 9, 2010

    Ah! Not as old as I remember, just 1999:
    http://www.imdb.com/title/tt0196699/

  13. A few years ago I read an article–I think in the NYT. The article claimed that one factor in HIV transmission among older folks is that widowed older women tend to greatly outnumber widowed older men in retirement communities and so on. Apparently, the able-bodied men get around. It’s supply and demand…

  14. #14 davidp
    July 11, 2010

    I wouldn’t have found out about your blog if not for being on ScienceBlogs. Obviously they have some management-writer relationship problems, but its a helpful site.

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