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Specialist Advice — 13 minutes

The truth about five common STBBI assumptions in Canada

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

Over the years, we’ve found that even the most well-informed patients carry certain assumptions about transmission, infection, testing, and treatment for STBBIs. 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 [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).

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

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.

Chlamydia and gonorrhoea can be successfully treated

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 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. 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, 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. [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?

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. A doctor's prescription is required.

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.

  1. Campanella, Emanuela. “Have an STI? What You're Legally Obligated to Disclose.” Global News. Global News, October 16, 2017.

  2. Nolo. “Sexually Transmitted Diseases (STDs) and Lawsuits.” Nolo, December 26, 2013.

  3. Public Health Agency of Canada. “Reducing the Health Impact of Sexually Transmitted and Blood-Borne Infections in Canada by 2030: A Pan-Canadian STBBI Framework for Action.” Public Health Agency of Canada, July 17, 2019.

  4. “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, November 20, 2019.

  5. “Antibiotic Resistant Gonorrhea - STD Information from CDC.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, October 24, 2019.

  6. Public Health Agency of Canada. “Report on Sexually Transmitted Infections in Canada: 2013-2014.” Government of Canada, July 20, 2017.

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.