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In recent years, a new at-risk group has been identified that has been relatively invisible until now: sexually active women aged 50 years or older.

The authors discuss the educational and primary care needs of these women so that their risk for developing STIs can be reduced.

The survey results reflected a trend toward more open attitudes about sex than in the two previous surveys of 19.

Of note, the proportion of adults aged 45 who believed that people should not have a sexual relationship if they are not married fell from 41% in 1999 to 34% in 2004 and to 22% in 2009.

If these women do not know what constitutes risky dating behavior (RDB)/ risky sexual behavior (RSB) or how to practice safer sex, they may be in danger of acquiring sexually transmitted infections (STIs).

In this article, the authors provide an update on STIs among women aged 50 , discuss sexual attitudes and beliefs among women in this age group that may lead to RDB/RSB, and issue a call to action for healthcare providers (HCPs) to address the sexual health of older women, particularly with regard to discussing safer sex practices.

Although some of these women came of age during the Sexual Revolution of the 1960s, their parents, from a more conservative generation, may not have discussed sex with them when they were children.

Thinner vaginal tissues and a reduced amount of vaginal lubrication may lead to abrasions or tears during sex that increase the chance that HIV will enter the bloodstream.In the United States, the overall incidence of STIs among adults aged 50 has risen in recent years.Statistics on STIs such as trichomoniasis, genital herpes, and human papillomavirus are generally lacking for this age group (the CDC does not recommend routine collection of surveillance data in these cases, although a few jurisdictions/states have initiated collection of such data). This extent is especially apparent with regard to syphilis, the incidence of which has tripled among adults aged 50 , from 2.1 cases per 100,000 individuals in 2001-2002 to 6.3 cases per 100,000 individuals in 2014.Romantic partner status was the most strongly associated factor with being sexually active, regardless of age.Similarly, in another cross-sectional study of 1,977 women aged 45-80, 60% reported being sexually active in the previous 3 months.These older adults are more likely to be diagnosed with HIV later in the course of their disease, usually because they are unaware of risk factors.For women, the major risk factor is having sex with a man infected with HIV, which accounted for 86% of new HIV cases in women in 2015.Intimacy and sexual expression are normal human needs.In the past, as men and women matured, they relied on spouses or long-term partners to satisfy these needs.In the 2015 nationally representative, cross-sectional Study of Midlife Development in the United States, 2,116 women age 28-84 years answered questions regarding their sexual activity.Although the proportion of women who were sexually active decreased with age, 59% of women aged 60 reported being sexually active in the previous 6 months.

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