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Published on: 2/2/2026

Medicare and Sexual Health: How Often Seniors Should Request STI Screening

Screening needs vary, but many seniors should test at least once when starting a new relationship, annually if they have more than one partner, and right away after unprotected sex or if symptoms appear, with one-time hepatitis C screening and HIV testing at least once or annually if at risk. Medicare Part B often covers HIV and other STI screening and counseling for people at increased risk with little or no cost when ordered by a Medicare-approved provider, though coverage depends on medical necessity and your plan. There are several factors to consider; see below for specific test intervals, who is considered higher risk, and how to talk with your doctor so you can choose the right next steps.

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Explanation

Medicare and Sexual Health: How Often Seniors Should Request STI Screening

Sexual health does not end at retirement. Many adults over 65 remain sexually active, form new relationships, or re-enter dating after divorce or the loss of a partner. Yet conversations about sexual health and the frequency of STI testing in older adults are often overlooked. This can lead to delayed diagnosis and treatment of sexually transmitted infections (STIs), which may have more serious consequences with age.

This guide explains how often seniors should consider STI screening, what Medicare typically covers, and how to talk with a doctor about sexual health in a practical, calm, and informed way.


Why STI Screening Matters for Seniors

STIs are not limited to younger people. According to data from the U.S. Centers for Disease Control and Prevention (CDC), rates of several STIs—including syphilis, gonorrhea, and chlamydia—have increased among adults aged 55 and older over the past decade.

Several factors contribute to this trend:

  • Less concern about pregnancy, leading to lower condom use
  • New sexual partners later in life
  • Limited routine screening compared to younger adults
  • Symptoms that may be mistaken for normal aging or other conditions

STIs in older adults can be more difficult to detect and may worsen existing health problems such as heart disease, diabetes, or weakened immune function. This makes understanding the right frequency of STI testing especially important.


How Often Should Seniors Request STI Screening?

There is no one-size-fits-all schedule. The right frequency of STI testing depends on personal risk factors, sexual activity, and overall health. However, guidance from credible medical organizations such as the CDC and the U.S. Preventive Services Task Force (USPSTF) offers helpful direction.

General Guidelines for Older Adults

Seniors should consider STI screening:

  • At least once when entering a new sexual relationship
  • Annually, if sexually active with more than one partner
  • Immediately, if symptoms appear (such as pain, discharge, sores, or unexplained rashes)
  • After unprotected sex with a new or non-monogamous partner

For many older adults in long-term, mutually monogamous relationships, routine STI testing may not be necessary unless symptoms develop or a partner's status changes.


Recommended Frequency of STI Testing by Infection

Doctors typically recommend different screening intervals depending on the specific infection and risk level.

HIV

  • At least once for all adults, including seniors
  • Annually if there are ongoing risk factors such as new partners or unprotected sex

Early detection is critical. HIV can be managed effectively with treatment, even later in life, but delayed diagnosis increases complications.

Syphilis

  • Annually for seniors with new or multiple partners
  • More frequent testing if advised by a doctor due to higher risk

Syphilis can affect the brain, heart, and nervous system if untreated, and symptoms may be subtle in older adults.

Chlamydia and Gonorrhea

  • Testing is recommended for seniors with risk factors such as new partners or inconsistent condom use
  • Screening is not routine for all older adults but should be discussed openly with a doctor

These infections may cause few or no symptoms yet still lead to complications.

Hepatitis B and C

  • Hepatitis C: One-time screening is recommended for most adults, including seniors
  • Hepatitis B: Screening may be advised if there are sexual or medical risk factors

Medicare Coverage for STI Screening

Medicare recognizes the importance of preventive sexual health care and typically covers STI screening when certain conditions are met.

What Medicare Usually Covers

Medicare Part B may cover:

  • HIV screening (once per year for higher-risk individuals)
  • Screening for syphilis, gonorrhea, chlamydia, and hepatitis B for those at increased risk
  • Counseling to help reduce the risk of STIs

In many cases, these services are covered without cost-sharing when ordered by a healthcare provider and performed by a Medicare-approved provider.

Important Notes About Coverage

  • Coverage depends on medical necessity and risk assessment
  • Testing outside recommended guidelines may involve out-of-pocket costs
  • Always confirm coverage with your provider or Medicare plan

Talking to a Doctor About Sexual Health

Some seniors feel uncomfortable raising sexual health concerns. However, doctors are trained to discuss these topics professionally and without judgment. Being open helps ensure appropriate care.

When speaking with a doctor, consider discussing:

  • Any new or past sexual partners
  • Condom use or changes in sexual activity
  • Symptoms, even if they seem mild or embarrassing
  • Questions about the appropriate frequency of STI testing

If something feels serious, unusual, or life-threatening, speak to a doctor right away rather than waiting.


Symptoms Should Never Be Ignored

STIs in seniors may not cause obvious symptoms. When symptoms do appear, they can resemble other age-related conditions.

Possible warning signs include:

  • Burning or pain during urination
  • Genital sores, rashes, or itching
  • Unusual discharge
  • Pelvic or testicular pain
  • Fever or unexplained fatigue

Prompt testing and treatment can prevent long-term complications and reduce the risk of spreading infections to others.


Sexual Trauma and Emotional Health

Sexual health is not only physical. Past or recent experiences can affect how people experience intimacy, make decisions about protection, or seek care. This is true at any age.

If you're experiencing emotional or physical symptoms that may be connected to past experiences, Ubie's free AI-powered Sexual Trauma symptom checker can help you better understand what you're experiencing before speaking with a healthcare provider.

If trauma or distress is affecting your health or safety, speaking to a doctor or mental health professional is strongly recommended.


Practical Steps to Protect Sexual Health in Later Life

Maintaining sexual health does not require drastic changes—just informed choices.

Helpful steps include:

  • Using condoms with new or non-monogamous partners
  • Discussing STI testing openly with partners
  • Scheduling preventive care visits covered by Medicare
  • Asking direct questions about the frequency of STI testing that fits your situation

These steps support both physical health and peace of mind.


The Bottom Line

Sexual health remains an important part of overall well-being for seniors. Understanding the right frequency of STI testing, knowing what Medicare covers, and feeling comfortable talking with a doctor can make a meaningful difference.

There is no need for fear or embarrassment—but there is a real need for awareness and timely care. If you have symptoms, concerns, or potential exposure to an STI, speak to a doctor as soon as possible, especially if anything feels serious or life-threatening. Early action protects your health and helps ensure that aging does not mean neglecting an essential part of your well-being.

(References)

  • * Mader C, Gelfand S. Screening for sexually transmitted infections (STIs) in older adults: A review. *Sex Health*. 2021 May;18(3):213-220. doi: 10.1071/SH20146. PMID: 34001309.

  • * Scaramuzzino A, Rossettini G, Bonardi F, Barrese B. Sexually Transmitted Infections in Older Adults: A Narrative Review. *Geriatrics (Basel)*. 2023 Jul 19;8(4):81. doi: 10.3390/geriatrics8040081. PMID: 37489506; PMCID: PMC10368143.

  • * Khaddar S, Gelfand S, Miller LE. Understanding Sexually Transmitted Infections in Older Adults: Screening, Prevention, and Treatment. *Clin Geriatr Med*. 2020 Feb;36(1):41-52. doi: 10.1016/j.cger.2019.09.004. PMID: 31735400.

  • * Vance DE, Mugavero MJ, Kempf MC. HIV Infection in Older Adults: Implications for Practice. *Clin Geriatr Med*. 2020 Feb;36(1):15-28. doi: 10.1016/j.cger.2019.09.002. PMID: 31735398; PMCID: PMC6959827.

  • * Mader C, Gelfand S. Sexual Health Concerns in Older Adults: A Review of the Literature. *Sex Med Rev*. 2020 Apr;8(2):227-236. doi: 10.1016/j.sxmr.2019.05.003. PMID: 31315809.

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