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Specialist Advice — 14 minutes

True or False: Five statements about STBBIs

Raymond Lepage, PhD, Doctor in Biochemistry
Raymond Lepage, PhD, Doctor in Biochemistry
Science popularizer

Over the years, it has become clear that even the most well-informed patients carry certain assumptions about transmission, infection, testing, and treatment for STBBIs (sexually transmitted and blood-borne infections). We asked our specialists to break down five of the most common they encounter.

Many weeks after having unprotected sex, I have no signs or symptoms of being infected by an STBBI. Therefore, I don’t need to be tested.


Many people infected with an STBBI may show few or no symptoms or signs of being infected, even many weeks after having unprotected sex. Testing is therefore critical to make sure that you are not infected or have had a former infection effectively cured. Depending on the disease, testing can be done on urine, blood, or swabs (urethra, vaginal or anal discharge, throat, eyes, and ears).

There are numerous risk factors that indicate a need for testing even if you or your sexual partner(s) do not show signs or symptoms of a STBBI:

  • unprotected sex
  • sharing of equipment used to inject or inhale drugs
  • tattooing or piercing with non-sterile equipment
  • exposure to contaminated fluids including sex toys that are contaminated with semen or vaginal secretions
  • individuals in a steady relationship and not wanting to use condoms or sheets of latex
  • pregnancy
  • you or your partner had sex with a new partner, multiple partners, or someone who has a STBBI

According to the Public Health Agency of Canada, people in the following populations  disproportionately affected by STBBI should also be tested regularly [1]:

  • Multiple partners (simultaneously or over time)
  • Anonymous or casual sexual partners
  • Sexual relations without the use of barrier methods
  • Sexual relation with individuals who have an STBBI
  • History of STBBIs
  • Substance use (drugs, alcohol, or both)
  • Use of erectile dysfunction medications
  • History of intimate partner violence or sexual violence
  • Social environments (e.g., saunas, circuit parties, post-secondary education institutions )

Timing is an important part of STBBI screening. No test will be positive the day after being contaminated. Syphilis can be detected 10 days after exposure, while the window period for detecting gonorrhea is still not well understood. However, it is recommended to consider that it ends 14 days after exposure.. The delay will be 2 weeks for HIV and chlamydia. In case of a first negative result, many of these tests need to be repeated to make sure that an infection can be effectively ruled out. As technology evolves rapidly, these delays need to be revised regularly [2].

A PAP test is not a STBBI test. A PAP test only checks for the presence of lesions of the cervix due to the human papilloma virus (HPV).

I have been successfully treated for an STBBI. I acquired lifelong protection.

False, except in some cases

In an immune competent individual, lifelong protection is obtainable only for Hepatitis A or B, or for infections that can be prevented by successful vaccination (HPV, hepatitis A or B). Chlamydia, gonorrhea and syphilis do not produce a sufficient antibody response by the organism and people can therefore be repeatedly infected. Herpes infection is for life. In rare occasions, even people under an effective treatment for HIV can be infected by another strand of drug-resistant HIV.

Chlamydia and gonorrhea can be successfully treated


In the past, chlamydia and gonorrhea have been effectively treatable by the use of antibiotics. The situation, however, is continuously evolving, particularly for gonorrhea due to the development of strains of bacteria resistant to cephalosporins. These antibiotics are the last available for its treatment.

Read more: How to speak about sexuality with your teenagers

Syphilis is an old disease, now rarely observed in Canada


Syphilis is effectively a very old sexually transmitted disease. Rates observed in Canada were very low until 2001 when they began to climb, particularly among men and more recently among heterosexual women. From 2011 to 2020, the overall infection rate surged by almost 400% Increasing from 5.1 to 24.7 cases per 100,000 people. Between 2014 and 2018, there was also a significant increase in Canada, with the number of newborns affected by congenital syphilis increasing by more than tenfold [4].

In Canada, I can be held criminally responsible if I have sex without disclosing that I have an STBBI.


In Canada, it's a crime not to disclose HIV or another STBBI before having sex that poses a “significant risk of serious bodily harm.” The charge usually laid is aggravated sexual assault, one of the most serious offences in the Criminal Code, carrying a maximum penalty of life in prison and mandatory designation as a sex offender. [5]

Most criminal prosecutions to date have been strictly related to HIV, while hardly any have been related to herpes, syphilis, chlamydia or other STBBIs. You can, however, be sued in a civil court including small-claim courts for not declaring an STBBI other than HIV. [6]

Read more: What is an STBBI and how is it transmitted?

Learn more about sexually transmitted and blood-borne infections.

When you need professional support, we're here to help

We offer STBBI screening with results in 24 hours or less for chlamydia, gonorrhoea, syphilis, hepatitis B, and HIV.

  1. Agence de la santé publique du Canada. Guide de prévention des Infections Transmissibles Sexuellement et par le Sang.
  2. « Prélèvements et analyses recommandés chez une personne asymptomatique – Syphilis, hépatites B et C, VIH – Intervention préventive relative aux ITSS », Publications du ministère de la Santé et des Services sociaux,, consulté le 20 novembre 2019.
  3. « Antimicrobial-Resistant Gonorrhea – Basic >Information. Centers for Disease Control and Prevention. 28 décembre 2022. Consulté le 10 février 2024.
  4. Agence de la santé publique du Canada. La syphilis au Canada de 2011 à 2020.
  5. Campanella, Emanuela. « Have an STI? What You're Legally Obligated to Disclose », Global News, 16 octobre 2017. « Sexually Transmitted Diseases (STDs) and Lawsuits », Nolo, 26 décembre 2013.
Raymond Lepage, PhD, Doctor in Biochemistry
Raymond Lepage, PhD, Doctor in Biochemistry
Science popularizer
For about 50 years, Raymond Lepage worked as a clinical biochemist in charge of public and private laboratories. An associate clinical professor at the Faculty of Medicine of the Université de Montréal and an associate professor at the Université de Sherbrooke, he has also been a consultant, researcher, legal expert and conference speaker. He has authored or co-authored more than 100 publications for scientific conferences and journals, and now devotes part of his semi-retirement to popularizing science.