As a well-known sexual health educator, it’s routine for Rene Ross to field questions about sexually transmitted infections.
But things have been a lot busier for the executive director of the Cumberland County Sexual Health Centre since the province officially declared a syphilis outbreak last week after the number of cases more than doubled in 2019 compared to 2017.
“I'd say over the past year in general, but even more so like we're noticing the change month to month," Ross said in a recent interview from the centre.
"We're going from, you know, a couple of calls a week to now I'd say every day or every other day. We're getting a lot of calls . . . most of them are around STIs, you know, wanting to know, ‘I think I have an STI, where do I go, what do I do’ and it's a huge challenge here.”
The challenge is that the centre doesn’t have the resources to do its own STI testing - the only sexual health centre in Nova Scotia that does is in Halifax, she said.
While there are collaborative care teams in Parrsboro, Pugwash and Springhill, many people in rural areas like Cumberland County don’t have a primary health-care provider. The sole walk-in clinic in the county in Springhill recently closed, according to a Nova Scotia Health Authority spokeswoman in an email Wednesday.
If a caller worried they have an STI is young, Ross might suggest they visit the nearest teen health centre, but the only alternative for an older person without a doctor or nurse practitioner is the nearest outpatients department. Ross said it’s always a good idea to call ahead to make sure it’s open and there’s a doctor on call.
“Or you go to what I call Springhill Facebook and you say (in a post on your timeline), does anybody know if there’s a doctor on call in town? Honest to goodness, this is how it rolls here!” she said with a laugh. “And a whole bunch of people comment.”
The rates of STIs such as syphilis, gonorrhoea, chlamydia and genital herpes have spiked across Canada, particularly in the west. The rates tend to be lower in Atlantic Canada, according to the latest Canada Communicable Disease Report.
So what’s going on with the across-the-board rise in STIs? Ross said one factor could be the “hook-up culture” driven by online dating apps.
“I think there’s so many things going on, it depends on your situation and it depends on your age,” she said. “So one of the highest spiking stats in STIs right now are amongst older folks.”
She referred to surveys that have been done on increasing STI rates among Canadian seniors who go down south for the winter.
“No 1, they come from the old school, they didn’t talk … they didn’t have comprehensive sexual health education. … Then also, 'I can’t get pregnant, why would I need that?' ”
The most powerful tool against the spread of STIs is education, Ross said. That could relate to basic information such as free condoms being available at sexual health centres across the province and the more complicated communication that’s needed to relieve the stigma around STIs.
“It’s not just about getting the STI testing, it’s also about working with folks around the anxiety, and how do you communicate, how do you talk to folks,” she said. “Like the absolute desperation I see in some folks when they have just been diagnosed. ‘I’ll never date again, I’ll never see anybody again.’ ”
Ross said her mantra is, “everything is manageable, we just need to know what we’re dealing with.” She reiterated that message in a recent YouTube video in response to the syphilis outbreak on the Sexual Health for Cumberland County channel.
“We’re trying to take the stigma off it, we’re trying to talk about it more, but I really think there needs to be some (provincial) strategy in place. If you’re going to declare an outbreak, help us and work with us and talk with us in the community about where some good places are … for folks to go.”
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