Preventing sexually transmitted infections

In the face of continued outbreak levels of infectious syphilis and gonorrhea, Alberta Health and Alberta Health Services (AHS) are working together to raise awareness about the importance of safe-sex practices and regular STI testing. That includes continued universal syphilis screening for all pregnant women.

Six cases of congenital syphilis have been reported in Alberta in 2017. Three of the cases have been confirmed with laboratory tests and three cases are probable, where the mothers and babies were treated for syphilis even though infection in the babies could not be confirmed with laboratory tests.

“We are very concerned that syphilis and gonorrhea rates continue to be high in Alberta. We are hard at work helping people living with or at risk of contracting an STI. We also want to remind Albertans to protect themselves and know how to get free STI testing and treatment.”

“The ongoing collaboration between Alberta Health Services, the Government of Alberta and community stakeholders has been and will continue to be central to our management of this outbreak.  We are working together and we will not tire in our efforts.”

AHS has created a dedicated provincial prenatal syphilis nurse position. This nurse directly coordinates care and ensures followup of all prenatal clients with infectious syphilis, as well as infants born to these clients.

Alberta Health and AHS are also implementing a series of additional actions, some of which are already in place:

• Alberta Health is updating the Alberta Prenatal Screening Guidelines to recommend chlamydia and gonorrhea testing for all pregnant women in the first trimester, then repeat testing in the third trimester for those at high risk of STIs. All pregnant mothers are already tested for syphilis early in pregnancy and again before delivery.
• As of October 2017, AHS has expanded the type of STI testing available through its Test & Treat program, to include testing of the throat and rectum. Sexually transmitted infections can infect the throat and rectum and may require different treatment than infections in other sites in the body.
• In February 2018, Alberta Health will begin covering the cost for Human Papillomavirus immunization (HPV9) for men who have sex with men (MSM) and transgender women aged 17 to 26. People within the MSM population may have disproportionately high rates of complications from HPV infection compared to the general population. For example, they are about 20 times more likely than heterosexual men to develop anal cancer. The primary goal of the HPV immunization program is to prevent cancer.
• Alberta Health is providing $18.5 million over three years (2017-2020) to the Alberta Community Council on HIV, a non-profit group representing community organizations that support vulnerable populations, including those with STIs. The council, in turn, provides funding to community-based organizations for health-promotion activities, targeted communications to youth and increased equitable access to culturally relevant services.
• Alberta Health provided grants to two organizations over three years (2016-2018) to support innovative approaches aimed at decreasing STI rates and reducing stigma.
  • Calgary Sexual Health Centre is receiving $600,000 to support more comprehensive and non-stigmatizing sexual health education for junior high and high school students. Sexual health sessions will focus on healthy bodies, sexuality and relationships, and aim to build students’ capacity to make informed, healthy choices about their sexual and reproductive health.
  • Boyle Street Community Services is receiving $400,000 to support an STI Harm Reduction outreach team to raise STI awareness, reduce stigma and facilitate testing and treatment. The project will have a particular focus on Indigenous women and will be facilitated through the Streetworks program.
• AHS is working with a broad range of community stakeholders to develop an operational strategy and action plan.

Quick facts

• In April 2016, the Chief Medical Officer of Health announced that STI rates were rising in Alberta, with gonorrhea and infectious syphilis at outbreak levels.
  • In 2016, there were more than 3,700 cases of gonorrhea reported in Alberta, doubling the number of cases reported in 2014.
  • In 2016, there were more than 400 cases of infectious syphilis reported in Alberta, 2.5 times more cases than in 2014.
  • In 2016, the proportion of female infectious syphilis cases increased to 13 per cent, from five per cent in 2015.

• In 2017, based on the year-to-date numbers for infectious syphilis and gonorrhea, Alberta is projected to surpass last year’s numbers.

Disease	2016	2017 (to October 31)
Gonorrhea	3,707	3,869
Infectious syphilis	410	369
Chlamydia	16,357	13,959
HIV	282	212

• To be tested for STIs, visit your family doctor, a walk-in clinic or sexgerms.com for more clinic locations.
• For more information, call Health Link at 811, or the STI/HIV Information Line at 1-800-772-2437.