Nairobi — Kenyan parents may soon find it difficult to lecture their children about safe sex - a new study shows that older adults are the biggest victims of sexually transmitted infections.

According to the study conducted by the British Health Protection Agency, and published two weeks ago, STDs among older people have more than doubled in the past decade. The most vulnerable group are people aged 45 and above.

The findings concur with an earlier study carried out in Nairobi in February and published in the American Journal of Men's Health. The Nairobi study mainly analysed characteristics of Kenyan men who had sex with prostitutes.

It said: "The prevalence of having had sex with prostitutes increased by age, from eight per cent among men aged 15 to 19 years to 25 per cent among men aged 45 to 49 years." Studies blame the trend on aggressive peddling of sex-enhancing drugs, pornography and falling family values.

"Actually this is the trend across the country," says Mr Moses Makokha, a long-serving medical officer who has run private clinics in Nairobi, Kiambu and some towns in Western province.

"Because of the country's largely youthful population, teenagers have for a long time provided the largest number of clients with venereal disease, but the over 40s seem to be in a hurry to catch up or even break the record," he told the Saturday Nation.

"The tide is surely changing," says Mr Samuel Mwangi, a clinical officer in private practice in Mombasa. "We are increasingly seeing more urethritis, gonorrhea, trichomonas, pelvic inflammatory disease and candida among family people and even in women past their prime," he said in a telephone interview.

A pharmacist in Dandora, Nairobi, who sought anonymity for fear of antagonising her clients, concurred, saying that most of the seniors opted to buy medicine over the counter.

"We see a lot of movement with antibiotics and we can easily make conclusions especially for some people who come back for more. We don't ask questions," she said.

Married couples

The first signs of the shift of sexually transmitted infections were raised two years ago by the National Aids Control Council which indicated that 50 per cent of new Aids infections were among married couples.

Soon after, researchers went out to investigate the possibility that an increase in HIV infections among the older population could also mean high levels of chlamydia, genital herpes, gonorrhea, syphilis and genital warts among other treatable sex diseases.

But Mr Makhoha says the most prevalent STI among the older generation especially in the middle class estates in Nairobi is still HIV.

A medical consultant with a leading hospital in Nairobi, Dr Kamau Kinyenje, whose patients include people in the high-income bracket, says this segment will rarely report cases of gonorrhea.

"However, people reporting for HIV treatment are not teenagers but people with families and possibly with children in secondary school," he told the Saturday Nation.

Visiting a doctor

Studies bear this out; they indicate that middle-aged and older people tend to delay visiting a doctor for treatment of an STD, or avoid it altogether, largely due to the stigma associated with sexually-transmitted infections.

A study done in Uganda two years ago revealed that 65 per cent of new HIV infections were among married couples, while divorcees accounted for 26 per cent and the never married nine per cent. This means that marriage is no insurance against sexually transmitted diseases.

A study carried out on behalf of Family Health International in 2000 reported high prevalence of trichomoniasis and bacterial STDs at several tea, coffee and flower plantation areas in Kenya.

The study, 'Baseline STD prevalence in a community intervention trial of the female condom in Kenya,' covered 1,929 respondents majority of whom were married.

About 80 per cent said they had never used a condom while about 10 per cent said they had had more than one sexual partner in the previous three months.

Of the study sample, almost a quarter were found to have a treatable infection, specifically cervical gonorrhoea, Chlamydia trachomatis and Trichomonas vaginalis.

In 2002 a study on the 'Changing patterns in sexually transmitted diseases in Kenya' for the National Aids and STD Control Programme, indicated that since 2000 there had been an increase in genital ulcers, urethral and vaginal discharge in both males and females. This discharge could be as a result of many conditions including gonorrhea.

According to Dr Lyndon Marani of Nascop, the issue of seniors increasingly been infected with treatable STIs is of great concern. "It is a real problem and we are thinking of long-term measures that will ensure this segment is catered for," said the researcher.

Another study by the universities of Nairobi, Ghent and the Nairobi City Council observed 471 patients attending a referral clinic for STDs in Nairobi and reported that 68 per cent of the men admitted having extramarital affairs and 30 per cent of paying for sex. They also admitted to have rarely used condoms.

But if it is of any consolation, Kenya's seniors are not the only ones needing a dose of sex education. A new study, published in the current issue of Sexually Transmitted Infections, found that in less than a decade, STD rates in Britain had more than doubled among people aged 45 and above.

Among other things, the rise in sex diseases is linked to the emergence of sex wonder drug Viagra. In the year of its introduction, 1998, the biggest story in the world was Bill Clinton and Monica Lewinsky, the second was Viagra, "The Pill that Thrills".

The Lewinsky story has since died but Viagra's is still getting hotter. Then, it made its manufacturers, Pfizer, one of the most profitable companies in the world.

Many men who heard of this wonder drug wanted to have a piece of action, but retailing at about Sh1,000 a tablet, it was way out of reach for many. Not until India started to churn out generics, and many cheaper pretenders now appear in the local market.

Some of these trade in names almost similar to Viagra such as African Viagra, Vigrx and Vigra. These and other drugs are now being hawked in bars and other entertainment spots.

Today they are rated as some of the fastest moving non-prescription medical products in the country and have made their share of new millionaires.

Researchers point to myriad factors contributing to the rise in STDs, among them a high mid-life divorce rate and the ease of finding dates online.

"What we have in this age group is a lot of people who are separated or divorced and seeking relationships. Sometimes they obtain them via the Internet, where they don't know the person and they don't know their sexual history," says one of the researchers.