March 10, 2011
Among Americans ages 65 to 74, 67 percent of men and 39 percent of women surveyed reported engaging in sex the prior year, according to a 2007 study published in the New England Journal of Medicine. Factors leading to more prevalent sexual activity among seniors include the advent of drugs to treat erectile dysfunction, diminished threat of pregnancy, improved senior health, and increased divorce rates.
Now, Medicare is considering covering STD screenings of elders and other Medicare clients. "Removing age-based profiling with respect to STD screenings is a good idea," said Stacey Lindau, a lead author of the study and an OB/GYN at the University of Chicago.
Lindau said elders may be more vulnerable to STDs due to prevention messaging that overlooks them, stigma related to disclosing sexual activity, and condom aversion due to physiological or perceived trust issues.
Medicare, which insures nearly 40 million American seniors and 7.6 million disabled people, already covers HIV testing. The Centers for Medicare and Medicaid Services (CMS) is weighing whether to cover testing for early detection of syphilis, gonorrhea, and hepatitis B as a means to avoid costly future treatments.
To accommodate the additional benefit, CMS will conduct a national coverage analysis of STD screenings for certain sexually active Medicare populations, including pregnant women and "those at increased risk." CMS must decide whether the services, inclusive of counseling for sexually active elders and young people, are necessary. "Having an STD ... affects not only you, but others around you," said Dr. Anupam Jena, an internist at Massachusetts General Hospital.
CMS aims to publish its revised Medicare testing suggestions by Aug. 24. It will receive public response on the pending benefits modifications through the fourth week of March.