Sexually transmitted infections are rising among older Europeans. This trend could affect Thailand through travel and ageing demographics.
Health authorities report rising diagnoses of gonorrhoea, chlamydia, and syphilis in people aged 45 and older. The trend appears across the UK, France, Denmark, and the EU (ECDC, UKHSA) (ECDC syphilis report 2023; UKHSA STI data tables 2014-2023).
The number of common bacterial STI diagnoses in Britons aged 65 and over rose sharply from 2014 to 2023. UK figures show 576 diagnoses in 2014 and 1,649 in 2023 for gonorrhoea, chlamydia, and syphilis combined (UKHSA data).
Europe-wide surveillance found that people aged 45 and above made up nearly one third of syphilis cases in 2023. This share highlights shifting age patterns in infection burden across the EU (ECDC 2023 report).
Researchers warn that STI cases in older adults will likely continue to rise. A modelling study projects increasing diagnoses and treatment costs for older people in England through 2040 (University of Manchester study).
Experts give several reasons for the rise. They point to a larger older population, changing relationship patterns, low condom use, and new use of sexual performance drugs. These drivers may act together to increase transmission among older adults (Euronews report).
Older women often outlive male partners. This demographic reality can lead to new partnerships later in life. Public health specialists say later-life dating increases exposure to sexual networks.
Many older adults mistakenly assume they face no reproductive risks. That belief can reduce condom use and lower interest in STI testing. Clinicians report that older patients rarely discuss sexual history with doctors.
Sexual performance medications have changed behaviour for some older men. These drugs make sexual activity more feasible in later life. Researchers note this factor may increase STI risk if it pairs with low condom use.
Knowledge gaps compound the problem. Small studies show that many older adults lack clear information on STI transmission and prevention. Public health campaigns historically target younger age groups more often than older ones.
Stigma also blocks open discussion. Health professionals and older adults may avoid sexual health conversations because of embarrassment. A Texas A&M professor called for frank clinician-patient talks about sexual health across the life course (Euronews interview with expert).
Bacterial STIs are curable with antibiotics. This status differs from lifelong viral infections such as HIV or herpes. The World Health Organization clearly distinguishes curable and incurable STIs in its public guidance (WHO STI factsheet).
Public health systems face rising costs. The Manchester modelling study flagged higher future treatment costs if trends continue. Health planners should anticipate more outpatient visits and antibiotic therapy needs (University of Manchester study).
Thailand has its own STI challenges. National data show fluctuating rates of syphilis and other STIs in recent years. Past surveillance found syphilis among the highest-reported STI cases in Thailand by 2021 (Frontiers Chiang Mai study referencing Thai data).
A 2024 community study of Myanmar migrants in Chiang Mai highlighted low STI knowledge. Only 20% of migrants in that sample had good STI knowledge. The study found poor condom attitudes and low condom use with regular partners (Frontiers study, Chiang Mai).
Thailand’s ageing population will grow in coming decades. The country will therefore see more people in older age groups who may remain sexually active. This demographic shift could mirror Europe’s experience if sexual health services do not adapt.
Thai travellers visit Europe often. Thailand receives many European tourists every year. Cross-border sexual networks can move infections between regions. Travel-related STI importation is therefore a practical concern for Thai public health.
Health services in Thailand often focus sexual health messaging on youth and key populations. These groups remain important. However, older adults need tailored information and accessible services too.
Clinics should screen older patients based on risk factors. Current practice often relies on age-based assumptions instead. Provider training can change that approach.
Doctors should ask simple sexual history questions during routine visits. Older patients may not volunteer sexual health concerns. A short standard checklist can open the conversation.
Condom access matters across all ages. Embarrassment prevents some older adults from buying condoms. Public health campaigns can normalise condom use for intimacy and safety in later life.
Public messaging must use clear, simple language. Health authorities should avoid clinical jargon in older-adult materials. Visual aids and community talks may improve understanding.
Religious and cultural norms affect openness about sex in Thailand. Buddhist values stress modesty and family harmony. Campaigns must respect these values while promoting sexual health.
Family-oriented culture can help prevention. Adult children and family doctors often guide older relatives. Educating caregivers and primary physicians creates supportive environments for open discussion.
Workplace and community groups can reach older adults. Senior clubs, temples, and retirement associations provide trusted settings. Health teams can partner with these groups to hold workshops.
Telehealth offers new options for older patients. Many older adults use smartphones for family chat. Telemedicine can enable private sexual health consultations when needed.
Testing should remain confidential and affordable. Cost or stigma should not block access to testing and treatment. Public clinics can offer sliding-scale or free testing for older adults.
Antibiotic stewardship matters. Rising bacterial STI diagnoses will increase antibiotic use. Health systems must balance treatment with monitoring to avoid resistance.
Surveillance systems should include age-specific trends. Current reporting often groups broad age bands. Finer age stratification helps target interventions for people aged 45 and above.
Research must explore behaviour drivers in Asian contexts. Most current studies focus on Europe and North America. Thailand needs local data on later-life sexual behaviours and STI knowledge.
The Manchester projection shows long-term cost implications. Policymakers should use modelling for resource planning. Early action can reduce future strain on health budgets (University of Manchester study).
Clinicians need training on sexual health in later life. Medical education rarely covers intimacy in older patients. Continuing professional development can fill this gap.
Public health curricula should include ageing and sexuality. Schools of public health should teach life-course sexual health approaches. This step will prepare future program managers.
Community health volunteers are valuable assets. Village health workers already advise older residents on many issues. Training them on STI awareness could widen reach.
NGOs can craft culturally sensitive campaigns. Civil society groups often access hard-to-reach older populations. Partnerships can boost trust and uptake.
Pharmacies can help normalise condom sales. Pharmacists can advise discreetly. They can also provide leaflets and referral information.
Media campaigns must avoid sensationalism. Fear-based messages can increase shame and silence. Positive messages about health and intimacy work better.
Hospitals should monitor STI trends in older inpatients and outpatients. Routine data collection can flag local outbreaks. Rapid response teams can then act promptly.
Insurance schemes should cover STI testing for older adults. Universal coverage will encourage testing and early treatment. The Thai universal health system can adapt benefit packages.
Religious leaders can support respectful messaging. Temple-based talks shape community norms. Engaging leaders reduces stigma and encourages care seeking.
Policy makers should include older adults in national STI plans. Current plans often list youth and key populations only. Age-inclusive plans ensure no group gets missed.
Behavioural interventions can teach partner communication. Many older adults rarely discuss sexual history with new partners. Role-play and scripts can help older adults negotiate safer sex.
Healthcare providers should avoid ageist assumptions. Providers must treat sexual health as normal across the life course. Simple training modules can change provider attitudes.
Surveys must include questions about recent sexual partnerships. Data on partner numbers and condom use inform interventions. Consistent survey tools allow trend comparisons.
Thailand can pilot later-life sexual health programs. Pilot projects can test messages, settings, and delivery. Successful pilots can scale nationally over time.
Local researchers should study HIV and STI co-infection in older adults. Co-infections affect treatment planning. Data on co-morbidity will guide clinical care.
Pharmaco-vigilance must track antibiotic resistance trends. Rising gonorrhoea cases worldwide raise resistance concerns. Thailand must monitor resistance and adapt guidelines.
Work with tourism authorities to include sexual health advice. Tourism boards can add discreet guidance for older travellers. Airports and travel clinics present outreach opportunities.
Family doctors should offer routine STI screening for older patients with risk. Screening should depend on behaviour, not age alone. This approach identifies asymptomatic infections early.
Community elders can act as peer educators. Peers can reduce stigma and model health-seeking behaviours. Peer-led groups succeed in other health fields in Thailand.
Digital campaigns should use simple video formats. Short clips can reach older users on social media. Platforms like LINE can distribute content widely.
Measure impact using age-disaggregated indicators. Programs must track testing rates and diagnosis by age. Monitoring ensures resources aim at groups with rising infections.
Thailand should join international knowledge exchanges. European and UK lessons offer practical program designs. Collaboration can accelerate policy learning.
Hospitals must ensure privacy for older patients. Confidential clinics build trust and uptake. Privacy reassures patients who fear social repercussions.
Health promotion should link STI prevention to healthy ageing. Framing sexual health as part of overall wellbeing resonates with older audiences. This approach aligns with Thai cultural respect for elders.
Primary care teams should include sexual health prompts in electronic records. Simple prompts remind clinicians to ask about sexual activity. These nudges increase routine screening.
Local universities should study ageing and sexuality. Academic research can provide evidence for policy. Funding agencies should include ageing in sexual health calls.
The government should review public health budgets for STI prevention. Reallocations may be necessary to cover increasing older-adult needs. Early investment reduces long-term treatment costs.
Civil society must campaign for destigmatisation. Open dialogue reduces shame and encourages care. Campaigns must emphasise dignity and respect.
Families can support older relatives in seeking care. Family encouragement often motivates clinic visits. Educational materials for families can help.
Conclusion: Thailand must act now. The European rise in older-age STIs offers a clear warning.
Recommendations: Add older adults to national sexual health plans. Train clinicians on later-life sexual health. Expand age-inclusive testing and condom access. Use temples, retirement groups, and telehealth for outreach. Monitor age-specific data and resistance patterns. Partner with NGOs, pharmacies, and tourism authorities. These steps will protect older Thai adults and reduce future health costs.