STI cases are rising across Canada: Why experts say proactive testing is a necessity

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In Montreal, an all-too-familiar scene is emerging as talk of contagious infections makes headlines — though it's not exactly the catchable virus you might be assuming.

Rising case numbers, increased testing and concerns for public health is on the up, but we're not talking about COVID-19. Rather, it's sexually transmitted infections (STIs) making waves, as they continue to increase in the region.

It's part of what Dr. Julian Gitelman, the lead physician of sexually transmitted and bloodborne infections at Montreal Public Health, describes as a "global and a Canadian rise in the number of sexually transmitted infections."

"Montreal is no different: Pretty much across the board, syphilis, chlamydia and gonorrhea are all increasing," he tells Yahoo Canada. "Over the past 10 years, we've seen almost triple the number of gonorrhea cases, and a third of an increase in the amount of chlamydia."

Many bacterial STIs are often symptomless, Gitelman says. This means testing is vital, and he recommends asking your doctor for testing any time you get a new sexual partner.

If you're included in the estimated one in five Canadians without a family doctor, requesting a test at your nearest sexual health clinic is the most straightforward move. People in British Columbia can use the free web portal GetCheckedOnline, while the City of Toronto is still working to return to pre-pandemic levels of operation at drop-in clinics.

A Canada-wide issue

"There's a lack of awareness on the magnitude of the problem," Gitelman says. "People aren't getting tested because they don't feel at risk, because it's uncomfortable to talk to your doctor about sex, because doctors aren't offering the test to their patients."

Troy Grennan, the head of the HIV/STI program at the B.C. Centre for Disease Control, is quick to agree with Gitelman's claim that this is a nationwide issue.

"Montreal is unique in many ways, but this is not one way," he says, adding that B.C. has "seen a 400 per cent increase in a decade" of syphilis, with "steadily increasing year over year" numbers of the other major, recordable bacterial STIs, chlamydia and gonorrhea.

Grennan highlights that part of the rise — particularly for congenital syphilis, which is passed on to the fetus during pregnancy — can be tied to systemic issues.

"Mental health, housing, all these things that alone are challenges but together just multiply each other and make it impossible for people to access health care," he says.

Gitelman agrees that equity issues play a factor in the rise of STIs, though he and Grennan agree that's only one part of the puzzle. Gitelman says 700 cases of syphilis have been reported in Montreal in the past year, along with a rise in congenital syphilis after it had a decade-long absence in the city.

Both doctors say while a slight hike in numbers has occurred post-pandemic, the rising presence of these infections predates COVID-19. Some of the increase is due to more testing, and some to an increase in testing after the pandemic—points highlighted in an email from a spokesperson at Toronto Public Health as well.

"Sexual health services were disrupted by the pandemic and are slowly returning to pre-pandemic levels," reads an email from a Toronto Public Health spokesperson. "The need for services is significant, particularly amongst equity deserving populations."

The swell is present, albeit slower, in New Brunswick. A statement from the province's department of health states "in 2023, from January to June, STIs in New Brunswick are either higher or comparable to the averages of the five previous years for the same period."

In Manitoba, congenital syphilis has almost doubled in 2022 compared to 2021, with chlamydia and gonorrhea also steadily climbing by hundreds of cases, according to a report from Manitoba Health. Growth in STIs in Nova Scotia could be due to various factors, like "sexual behaviour, access to testing or other social determinants," says Nova Scotia Health.

Staying proactive

Multiple factors behind the rise aside, both Gitelman and Grennan bring it back to one thing: Proactive testing.

"If you are sexually active, you can take care of your own sexual health by getting tested and treated if you have an infection because these are quite common infections," Gitelman says.

"Sexually transmitted infections are an infection like any other that touch us all, and that are often easy to take care of. But that can cause serious health consequences if left untreated."

Grennan adds that it's important to increase awareness and education surrounding sex and sexual health. Moreover, people simply need to get STI tests.

"We can't shame people for having sex," he says. "It's normal, fun and people enjoy doing it, and we need to do whatever we can to make people's sexual health and sexual lives positive and healthy.

"The intention really is to reduce stigma and shame and, as a result of that, increase awareness and increase testing, and make sure people are being proactive around their health."

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