August 25, 2011 — CMS officials are considering whether Medicare should begin covering testing for sexually transmitted infections, the Miami Herald reports. CMS is expected to announce a draft recommendation this week, though a final decision will not be made until November.
A summary of the proposed rule on the CMS website states that there is "adequate" evidence to conclude that screening for STIs -- including chlamydia, gonorrhea and syphilis -- is "reasonable and necessary for the prevention and early detection of an illness or disability." The testing would be available to beneficiaries engaging in high-risk behavior, including having multiple sex partners, not using protection or using it inconsistently, and men having sex with men. Advocates for the elderly say that STI screening for Medicare beneficiaries would be cost-effective because diseases that are caught early tend to be less costly to treat.
Naushira Pandya, chair of the department of geriatrics at Nova Southeastern University, said there is a "misconception" that seniors are not sexually active and therefore unlikely to contract an STI. Young individuals make up nearly half of all new cases in the U.S., according to data from CDC. But while STIs "may not be as common an issue in the elderly, ... it is a health issue," Pandya said, adding, "It can affect anyone who's having sex."
A 2007 survey from the University of Chicago found that contrary to prevailing stereotypes, many seniors have active sex lives. About 53% of respondents ages 65 through 74 and 26% of those ages 75 through 85 reported they were sexually active in the 12 months preceding the study. Further, of the sexually active respondents, 54% reported having sex at least two to three times per month and 23% reported having sex once a week or more.
Some geriatricians believe that STIs in seniors are underreported. Regina Marranzini, medical director of geriatrics for Memorial Regional Hospital South, said, "We're not catching [STIs] because we're not even asking about them." She added, "There are taboos on both ends -- on the doctor's side and on the patient's" (Veciana-Suarez, Miami Herald, 8/23).