Diagnostic testing and treatment are determined based on ability to improve disease process or quality of life/goals of care.

While sexually transmitted infections (STIs) are on the rise among older adults, medical providers may associate this problem with younger populations, missing prevention and treatment opportunities.

Possible Reasons for the increase of STIs in older adults¹:

• Lack of STI screening and treatment
• Physiologic changes (e.g., weakened immune system, thinning mucosal tissue)
• Changing relationships (e.g., widow/widowerhood, divorce)
• Increased availability of medication for intercourse (e.g. sildenafil)
• Misinformation/misunderstanding (e.g., risks of unprotected sex, need for condom use even for postmenopausal women, STI transmission routes)
• Inaccessibility to STI protection in community living environments

Conversations about “safer sex” may be difficult and uncomfortable for providers and patients but are vital to maintain patients’ health.  Having open, nonjudgmental discussions about individual risk factors may lead to safer sexual practices.

Identify and define inappropriate sexual behavior (ISB) in the context of a patient with dementia.