Introduction
Sexually transmitted infections (STIs), mainly acquired through sexual contact, be it oral, anal, or vaginal sex, have immense impacts on the reproductive health of the affected if not addressed as early as possible. Some STIs cause significant damage if not treated, but others are not that harmful. STIs include chlamydia, syphilis, hepatitis B, herpes, gonorrhea, HIV, and trichomoniasis. Addressing this issue tends to create awareness o its magnitude to the general human sexual health in the world. The rise of STIs among older women in North America has caused an uproar that requires immediate study to identify its magnitude, suggest possible responses, analyze and discuss the issue and interventions, specify the challenges faced, and finally indicate the way forward.
STIs as a Health Problem
Sexually transmitted infections like gonorrhea, syphilis, herpes and chlamydia are rising fast among older women in North America. The World Health Organization 2021 conducted research that indicated over one million new sexually transmitted infection cases are acquired each day, of which 25 percent consist of older women above 55 years (WHO, 2021). In a year, the number is above 374 million, with a majority of the cases being within four infections; gonorrhea, syphilis, trichomoniasis, and chlamydia (WHO, 2021). The sudden rise portrays it as a severe health concern requiring attention. STIs lead to severe health complications like a pelvic inflammatory disease if left untreated and cervical cancer among women. The HPV infection caused over 311 000 deaths due to cervical cancer out of the reported 570 000 cases in 2018 (CDC, 2019). An STI National Strategic Plan got developed by the Office of Infectious Disease and HIV/AIDS Policy (OIDP) and other federal partners to help mitigate this sudden increase in infections. The plan provides a clear direction for preventing, diagnosing, and treating infections to reduce and reverse the sudden increase of ailments, thus improving the nationals’ health.
Older women are primarily affected by the sudden rise of sexually transmitted infections in America. Several factors enhance the acquisition of STIs among older adults; they include risky sexual behaviors, psychosocial changes, and sexual changes associated with aging (Silverberg et al., 2022). The fundamental debate here is determining how these infections are transmitted quickly, causing a high increase in reported cases. The number of sexually transmitted infections among older women in North America rose at an alarming rate in less than ten years. In their 2019 STI surveillance report, the Centers for Disease Control and Prevention (CDC) indicated that from 2014 to 2018, the number of gonorrhea cases in American women aged above 55 years increased by 164 percent (CDC, 2019). Issues related to chlamydia rose by 86 percent, and those of syphilis rose by 120 percent in this same population (CDC, 2019). In the 2021 report by the WHO, over 14,867 cases involved women aged over 55 (WHO, 2021). The number of infections among older women recorded an increase from the previous years, indicating infections were rising rapidly, even though most of the cases were reported among young adults and the youth.
In Canada, the USA, and Mexico, STIs are rampant, posing challenges to the national health of the respective governments. The number of STIs increased in the early 2000s among seniors with syphilis and gonorrhea, increasing significantly (Alabi, 2021). STIs have more than doubled in women older than 55 years in the last ten years in this region (Mushtaq & Kazi, 2021). Each infection has recorded an increase in the number of conditions compared to ten years before. According to the WHO, in a 2021 report, primary and secondary syphilis rates increased to over 356 in 2019 from 95 in 2012 (WHO, 2021). The rates for gonorrhea rose from 707 in 2012 to 2,123 cases in 2019 (WHO, 2021). In the same year, the rates for chlamydia increased from 967 in 2012 to over 2,345 in 2019 (WHO, 2021). There is an increase in STIs among older individuals within society, with a higher percentage constituting women who are the primary victims.
Syphilis and chlamydia infections among older women in North America increase rapidly in a single day. Over three hundred thousand sexually transmitted diseases related to the two are estimated to be acquired by older women in North America (CDC, 2019). Over 10 million women older than 45 got diagnosed with genital herpes. In the 2019 report, the CDC indicated that 5 million out of the recorded 26 million new cases of STIs involved senior women in the United States (CDC, 2019). Causes of this high increase in STIs among older American women include bacteria, viruses, and parasites. Bacteria cause infections like syphilis, gonorrhea, and chlamydia, while parasites and viruses cause trichomoniasis, HIV, and herpes.
Innovations
Technological innovations can be used in addressing sexually transmitted diseases. These innovations include social media, mobile apps and traditional forms of media such as television, radio and print media. The technological interventions significantly help the general public, public health departments, and the Centers for Disease Control and Prevention in addressing sexually transmitted infections by learning how to use technological tools, their challenges, and their benefits (Vermund et al., 2021). This is because these tools are very efficient in enhancing identification, targeting and changing sexual behavior in individuals.
First, social media platforms such as WhatsApp, Instagram, LinkedIn, Reddit, Snapchat, Facebook, and Twitter enable users to develop and share content online, including knowledge on Sexually Transmitted Infections. This is because individuals utilize these social media sites for various reasons, such as sharing health information and connecting with peers, which allows them to easily share information (Burgess et al., 2017). The use of these sites among older women has increased in various parts of the world, including the United States of America, with Facebook and YouTube being prominent among older women compared to Instagram, Snapchat and Twitter. According to Perrin and Anderson (2019), 46% of the United States’ older individuals use Facebook, 38% use YouTube, 8% use Instagram, 3% use Snapchat and 7% use Twitter. As a result, the way and frequency individuals share and acquire health information have increased significantly because of these social media sites. As a result, individuals will help educate each other on the risk factors of acquiring these infections, how they can be prevented, and how to identify and treat them, hence increasing the quality of life.
Second, mobile apps are software created to enable tablets, computers, laptops and smartphones to run effectively on different websites with regard to different required features. The mobile apps vary in activities, functionality, features, and purpose, such as education. Mobile apps have significantly increased, with approximately 48,000 health apps available in the Apple App Store and over 47,000 health apps in Google Play (Statista, 2021). Therefore these apps help promote awareness, prevention, and treatment options for Sexually Transmitted Infections awareness across the world (Jakob et al., 2020). One of the mobile apps used includes Checkmate, a digital healthcare app that allows patients to do mobile STI testing. Mobile apps can also comprise social media sites that can help in promoting awareness, pass on relevant information, or educate people about STIs. As a result, apps linked with sexually transmitted infections or diseases significantly aid in preventing and early diagnosis of sexually transmitted infections. Additionally, mobile apps also help researchers easily acquire information on STIs that can be used to educate other individuals on the same.
Third, television, radio, and print provide outstanding communication channels for society. They help in mass media interventions that aim to decrease sexually transmitted infections by conveying formation to large populations on safe sex behaviors. This helps reduce risky sexual behavior, enhance or improve risk perception, increase STI mass testing, and increase STI knowledge or information. According to Madrigal (2018), the majority of the United States households have access to a television 2018 and watch it approximately nine hours a day. They also have access to radio and print, where they spend the greatest amount of their time listening to the radio and reading print media such as magazines. This kind of exposure increases the chances of older adults gaining information on the risk factors, prevention and methods of treatment of STIs. This is because television, radio, and print are some of the oldest forms of media with which older women are conversant and comfortable.
Exposure to these traditional forms of media also helps in enhancing change in sexual behavior among older women. Television, radio, and print media provide a means to conduct mass campaigns on a wide range of health topics that influence health behaviors and attitudes, including strategies for the prevention and treatment of STIs (Jeong & Bae, 2017). The conducted health campaigns also aid in encouraging and promoting STI awareness and interpersonal discussion, which determines the outcomes related to sexual health among older women. Additionally, television, radio and print media provide a means such as entertainment education to easily educate older adults with the aim of influencing health outcomes.
Analysis and Discussion
STIs problem is a critical issue that affects older women in the North American region. Governmental and non-governmental organizations have developed policies and interventions that help handle the problem. However, various challenges prevent addressing the STIs problem. These challenges include partner notification services, changing epidemiology of STIs, willingness to seek care, and shortage of out-patient antibiotics. First, the CDC recommended the patient notification service as an effective method of handling and reducing the transmission of STIs (Magaziner et al., 2018). This method collects information regarding the partners of individuals infected with STIs and provides them with notifications that encourage them to seek medical attention frequently. However, this method has faced a significant challenge in its operations. Most of the patients have refused to cooperate because of privacy issues. Most infected people fail to communicate after the first treatment, making it challenging to track their medical progress. Some patients provide anonymous partners that cannot be tracked. This promotes the transmission of STIs in many older women. Additionally, the program has inadequate staffing, making it challenging to manage the rising STI cases and tracking of the patients. This is due to the limited funding that the state and the federal governments allocated to the program.
Second, the changing epidemiology of STIs poses a significant threat when handling these infections. Some STIs have developed resistance to antimicrobials, which affects the available vaccines and medications. This affects managing the rising case of infections since they cannot be controlled and treated. Patients tend to spread the infections as they are unaware of their untreated condition, which increases the rate of infections (Foster et al., 2018). It also affects the budgeting area as funds that could have been allocated to treat and manage the infections are transferred to research and identifies new cures and vaccines, which may take a significant time (Muller & Kularatne, 2020). The changing epidemiology also creates new pathogens such as the herpes simplex virus type 2. This virus increases morbidity among older women and promotes the transfer of HIV.
Neisseria gonorrhea has also been identified as a global problem because of its resistance to antimicrobials. This infection has developed resistance to the antibiotics used for its treatment, such as cotrimoxazole and penicillin. This has resulted in the rise of infection in most developing countries as they lack surveillance programs to handle the disease. The pattern of herpes simplex virus type 2 has affected the development of genital ulcer disease (GUD) (Foster et al., 2018). Initially, it was thought to be insignificant as an aetiological agent. However, this is not the case in the current studies, as it has been significantly associated with the GUD. This has increased the transmission of the disease, thereby promoting its morbidity.
Third, willingness to seek medical attention regarding the effects of STIs significantly affects the fight against STIs among older women. Many people have challenges when it comes to speaking and seeking medical attention on issues that affect their reproductive healthcare (Xu et al., 2017). It is impossible to identify the infected individuals when they have not sought medical attention. Most feel shy about the issue, and this increases their vulnerability. As individuals hide their reproductive health status, they usually seek other alternatives, such as traditional medical solutions that have not been approved by health organizations, which may negatively affect their health condition. Despite vast awareness of the issue, most older women still find it difficult to communicate about STI problems, thus increasing its spread and morbidity.
Lastly, the shortage of out-patient antibiotics in handling certain STIs negatively affects the handling of these diseases among older women. For example, in 2017, there was a notable shortage of Benzathine penicillin G (BPG), the primary treatment for syphilis (Vries, 2019). This shortage significantly impacted women’s healthcare as it is usually considered the safest treatment prescription. The antibiotic shortage was because of the high costs associated with the production of the drug. Its impact was heavily noted as the syphilis cases increased significantly.
Technological innovation has provided a critical impact in handling the STIs problems among older women. However, various challenges are associated with this innovation, such as privacy issues, knowledge of technology, and misinformation associated with social media. First, privacy is a crucial problem during this technological period, as many organizations and people tend to retrieve user data, which helps them analyze and manage demand (Vermund et al., 2021). The apps used to provide information and awareness regarding STIs are prone to privacy issues that affect the user’s response to these apps. Through big data analysis and generation, third parties use personal information to serve the organization’s needs, which may lead to the leakage of personal information on older women infected with STIs.
Second, most older women are not used to technological changes, making it difficult to use these strategies. This lowers the effect of the innovation in providing information regarding STIs. They find it challenging and easily quit their usage (Vermund et al., 2021). Lastly, misinformation is prevalent in social media as it is not easy for them to differentiate fake information from the original one. This leads to misguided attention that may promote the spread of STIs. Creating awareness is important in handling the innovation challenge as it will help the older women understand the effective use of this strategy. Furthermore, creating social forums that guide them is also significant in emphasizing the importance of technological tools.
Conclusion
In conclusion, the rise of STIs among older women in North America is a significant health problem. Most of these cases are gonorrhea, syphilis, trichomoniasis, and chlamydia. This issue primarily affects them because of risky sexual behaviors, psychosocial changes, and sexual changes associated with aging. Various technological innovations help manage and reduce the spread of STIs. The first innovation includes using social media platforms such as WhatsApp, Instagram, LinkedIn, Reddit, Snapchat, Facebook, and Twitter. The second innovation is mobile apps, and the third is the use of television, radio, and print. Various challenges have resulted in the handling and management of STIs. For example, partner notification services, changing epidemiology of STIs, willingness to seek care, and shortage of out-patient antibiotics. Technological innovation also faces critical challenges such as privacy issues, knowledge of technology, and misinformation by social media. However, awareness programs and social forums can effectively provide relevant information regarding these tools.
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