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Having the talk...with your senior citizen parents

When sixtysomethings come into his Toronto sex shop, Cory Silverberg says, they are normally giddy. And they want to know about condoms.

"They come in joking how it's silly that at this age they don't know anything about this stuff, but they don't, so they want to learn about it," said Mr. Silverberg, who runs Come as You Are.

And on some occasions, they come in with their adult children.

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"In the condom section, there will be the conversation where the parent will say, 'I don't need those,' and the kid will say, 'Well, you might.' "

As their mothers and fathers divorce or are widowed, and take up Viagra and online dating, it has sometimes fallen to adult children to re-educate their parents on the hazards of the modern dating world.

Canada's aging population remains ignored by traditional sexual health education campaigns, with the result being a spike in HIV infections and other sexually transmitted diseases.

HIV infections among Canada's 50-plus have almost doubled from 7.6 per cent in 1998 to 13.8 per cent in 2006, according to the Public Health Agency of Canada.

And since 1997, the number of 60-and-overs who report having chlamydia, gonorrhea and syphilis has risen consistently, although it still remains at less than 5 per cent.

"There seems to be a perception among older people that age gives them some kind of vaccine, some kind of protection against these diseases, and it doesn't," said Jane Fowler, a 73-year-old from Kansas City, Mo., who calls herself the "original 1950s good girl."

Ms. Fowler was a virgin on her wedding night and monogamous for all 23 years of her marriage. After divorcing from her husband, she had a handful of sexual partners, all of whom she knew well.

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In 1991, after undergoing routine blood tests for medical insurance, the retired journalist learned she was HIV-positive and that she had gone undiagnosed for five years.

"I was just overwhelmed. It wasn't, 'Why me?' but it was more, 'How could this have happened to me?' " Ms. Fowler recalled.

The man, who was also divorced, did not know he was HIV-positive when he infected Ms. Fowler and did not notify her when he found out.

Ms. Fowler now runs HIV Wisdom for Older Women, a program intended to help prevent older women from contracting the virus. On Monday, she spoke to caregivers in Toronto.

"These diseases that typically strike an older person, so many of them can't be prevented. This can be prevented," she said.

According to the U.S. Centers for Disease Control and Prevention, the number of adults in the United States aged 50 and older with HIV-AIDS rose from 16,300 in 1995 to 114,000 in 2006.

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Part of that number represents those who were infected years ago and have lived to be older thanks to antiretroviral therapy and other treatment options. Still, 8,000 people over the age of 50 are newly infected every year, a number that makes up about 10 per cent of all new infections. About 2,000 of the newly infected are over 60.

The National Association on HIV Over Fifty estimates that 17 per cent of new infections in Massachusetts were among those over 50 in 2006. That figure reaches 22 per cent in both New York and Miami. In Florida, women over 60 are one of the fastest-growing risk groups, according to the Senior HIV Intervention Project in Fort Lauderdale.

That's because Florida is a snowbird destination, as are cruises, said Joan Price, the California-based author of Better Than I Ever Expected: Straight Talk about Sex After Sixty.

"A lot of people will go to recover from a divorce or a death by taking a cruise, and meet some dashing stranger. They spend the cruise with the person, feel they know each other really well, have wild and wonderful sex and then start sedately dating," Ms. Price said.

Her website is littered with posts from elderly bloggers who, despite the risk, view protection as a nuisance at their age.

"When we grew up in the fifties and sixties, the worst that could happen was herpes," Ms. Price said. "By the time HIV broke out, most of the people in my generation were married or were in committed relationships. It's likely that most of my generation totally missed that era. Then, because of divorce or death of a spouse, many of us are again in the dating world, but it is not the dating world we left decades ago."

"Men complain to me that condoms make sex less pleasurable, especially when erections are less reliable. Women insist that they're not at risk and that they would be embarrassed to insist on condoms. Haven't we heard variations on these objections from youth?"

Ms. Price said that although it may be up to children to flip the roles and educate their parents, many are too embarrassed to acknowledge their elders' sexuality, let alone head to a clinic together.

But that is precisely the situation at Vermont CARES: In the past six months, the AIDS service organization has seen an increase in older divorced Americans getting pre-emptively tested before they re-enter the dating scene - on the advice of their kids.

"Folks in their 20s and 30s are bringing in their parents, who may be a little too anxious to get tested on their own. It's a really lovely teachable moment," executive director Peter Jacobsen said.

"Children tend to come in for the one-on-one discussion that we do with all HIV tests ... and sort of hold their parents' hands and be with them."

Experts believe HIV infection rates may be even higher than reported. Because they often fail to recognize the risk, seniors are not being tested and doctors may be misdiagnosing them. Essentially, Ms. Price says, "people who don't know they have it are passing it along."

Ms. Fowler was infected at New Year's, 1986. She visited her family doctor five times, but the physician mistook her symptoms for the flu.

"Who knew in 1986 to even look for HIV in an older heterosexual female?" Ms. Fowler said.

Sylvia Davidson, an occupational therapist, said ageism is at the core of the problem. She works with geriatric patients at the Toronto Rehabilitation Institute, and regularly travels across the province to educate health-care professionals about speaking with seniors about unprotected sex.

"A lot of us believe that we're a very open-minded society, but when it comes to aging adults I find that there's still a lot of ageism out there," Ms. Davidson said. "Elderly people themselves end up falling into the trap of believing the myth that exists around them."

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