The truth about five common STBBI assumptions in Canada

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 [3]:

• People living with HIV or hepatitis C and related conditions
• Indigenous Peoples
• Gay and bisexual men
• People who use intravenous drugs
• Transgender persons
• People with experience in the prison environment
• People from countries where HIV, HBV, and HCV are endemic
• People engaged in the sale, or the purchase of sex

Timing is an important part of STBBI screening. No test will be positive the day after being contaminated. Gonorrhoea and syphilis can be tested as soon as 7–10 days after infection. 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 [4].

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).

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, gonorrhoea 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.

In the past, chlamydia and gonorrhoea have been effectively treatable by the use of antibiotics. The situation, however, is continuously evolving, particularly for gonorrhoea due to the development of strains of bacteria resistant to cephalosporin antibiotics, which are the foundation of recommended treatments [5].

There are few other antibiotic options available that are well-studied, well-tolerated and highly effective.

Read more: How to speak about sexuality with your teenagers

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. Infection rates amongst males have increased by 115% between 2005 and 2014. At the same time, in the US but not in Canada, there has been a significant increase in the number of newborns affected with neonatal syphilis [6].

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. [1]

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. [2]

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

We offer STBBI screening with results in 24 hours or less for chlamydia, gonorrhoea, syphilis, hepatitis B, and HIV. A doctor's prescription is required.

• Screening for STBBI

Do you have a medical prescription for this test? Book an appointment online or contact Biron Health Group’s customer service at 1 833 590-2712.