Population aging impacts the epidemiology of sexually transmitted infections (STIs). In Brazil, the increase in life expectancy and changes in sexual behavior among older adults, such as higher sexual activity and lower risk perception, have raised STI rates in this age group. Limited use of barrier methods, insufficient access to targeted information, and stigma hinder prevention and early diagnosis. Older adults are underrepresented in public health policies, and comorbidities and immunological alterations increase their vulnerability. This study analyzes the evolution of STI cases among individuals aged 60 years or older in Brazil (2011–2021), identifying epidemiological patterns and implications for public health.

Descriptive study using data from the National Disease Notification System (SINAN), selecting confirmed cases of acquired syphilis, HIV/AIDS, and viral hepatitis in individuals aged ≥ 60 years. Temporal trends and distributions by sex, region, and age group were analyzed.

Between 2011 and 2021, 75,208 syphilis cases were reported among older adults – a 152% increase, peaking in 2018. The 60–64-year age group, mainly men with low education, accounted for the majority of cases. The Southeast region, especially São Paulo, showed the highest number of notifications. HIV notifications quadrupled, from 360 to over 1,500 cases per year, reaching 1,951 cases in 2022, predominantly in men aged 60–64 years. AIDS-related mortality in this age group increased by 19.1% from 2011 to 2021. Hepatitis B prevalence was approximately 0.5% among older adults, while hepatitis C increased in some regions. Nationally, hepatitis incidence varied, rising 18.7% between 2014 and 2016 and declining thereafter.

The increase in STIs among older adults reflects social and behavioral changes, low risk perception, and stigma. Comorbidities and immunological alterations worsen clinical outcomes, demanding tailored prevention and care strategies. Expanding age-specific public health policies is essential to promote healthy aging, autonomy, and reduce the impact of STIs on public health, ensuring quality of life and dignity for this population.