Saskatchewan’s rates of HIV and syphilis saw significant increases in 2019 over the prior year.
Preliminary numbers from the Saskatchewan Health Authority (SHA) show 199 new cases of HIV, a 18 per cent increase over 2018.
A syphilis and HIV outbreak was declared for the North Battleford area in June, which remains in effect. The area saw 147 new syphilis infections last year, with only 24 in 2018 according to the regions medical health officer, Dr. Mandiangu Nsungu.
Twenty-four new cases of HIV were confirmed in the area last year. That’s five to six times higher than normal, Nsungu said.
Nsungu encourages people who are sexually active to be tested for HIV if they do not know their status.
“We know that approximately 26 per cent of people who have HIV are not aware that they have HIV, so that’s the reason for being tested,” Nsungu said.
Injection drug use is the most common risk factor among people diagnosed with HIV in Saskatchewan. In 2018, the SHA found 71 per cent of people diagnosed with HIV reported injection drug use.
Needles are a daily reality for the AIDS Program of Southern Saskatchewan (APSS), a non-profit based in Regina. In addition to offering education and support services for people with HIV/AIDS, they run a very busy needle exchange program.
“For example, last Tuesday it was a very busy day. We gave out 14,000 needles in on day,” Amanda Sauer, APSS education coordinator said.
The support agency runs a needle exchange program, which hands out 1.5 million needles annually, according to Sauer. Over 5,000 individuals are signed up in the APSS exchange program. They can only receive needles equal to what they bring in.
Saskatchewan has the highest HIV diagnosis rate in the country according to Health Canada – 14.9 cases per 100,000 population. The latest national study puts Canada’s average at 6.9 cases per 100,000 people.
In Sauer’s view, Saskatchewan needs to catch-up when it comes to prevention. She says APSS current resources only allow them to be open five days a week; closing on Sunday and Monday.
“On Sundays, in Regina there’s nothing offered in terms of harm reduction. So we’ve actually heard our clients come to refer to it as re-use Sundays. They’ll re-use the needles they have because they don’t have access to clean ones,” Sauer said.
While the HIV outbreak status remains in effect in the North Battleford area, Nsungu said there is positive news. The area has not recorded a new HIV infection since September. He said will have to monitor data for a few more months before the outbreak status could be lifted.
Syphilis
New syphilis infections leapt 172 per cent last year, with 381 cases in 2019 compared to 140 in 2018. The SHA has been tracking a “sustained increase” in syphilis rates since 2016 when there were 85 cases.
The disease’s symptoms go through several stages as it evolves. Nsungu said syphilis is infectious through contact during the early stage.
“At the beginning, the signs of primary syphilis are very obvious. You can have an ulcer on the genital parts, but then that ulcer can actually heal on its own even without treatment,” Nsungu explained.
“That doesn’t mean the disease has gone away. The disease will continue to evolve in silence.”
However, Nsungu can’t say for certain that this is contributing to the increase in cases.
The SHA has also found more cases of infectious syphilis are being found in women, increasing from seven per cent in 2017 to 44 per cent in the first half of 2019.
Nsungu said they are asking doctors in the outbreak area to test pregnant women for syphilis due to the risk of congenital syphilis being passed to an unborn baby. This can lead to miscarriage, stillbirths, or birth defects with lifelong health consequences.
Since the outbreak was declared, a task force has been meeting on a biweekly basis to examine the spread of syphilis in the North Battleford area. They have been coordinating a push for testing, public awareness campaigns and other mitigation efforts.
In the outbreak area, 147 cases were diagnosed last year, compared to 21 in 2018.
Nsungu is encouraged by the fact that 90 per cent of patients who have been diagnosed are currently undergoing treatment.
In Regina, Planned Parenthood executive director Jacqui Wasacase said she hasn’t seen any cases of syphilis in the area. She said HIV, gonorrhea, chlamydia, and other STIs seem to be bigger issues in the south.
Still, she said this emphasizes the importance of destigmatizing routine STI tests for anyone who’s sexually active, monogamous or not.
“We have worked very hard over the last couple of years to get that education out there that there shouldn’t be a stigma attached,” she said.
“This is something normal and natural in life, and if you’re going to have sex you need to look after your sexual parts.”
The SHA has five dedicated sexual health centres across the province. There are a handful of community-based organizations, like Planned Parenthood that also offer treatment and testing services.
Still, Wasacase said more should be done to increase their visibility to help ensure people get tested and know their STI status.
“I think it’s important to have pop-up clinics – like we do pop-up clinics where we’ll go to different organizations or different parts of the city and invite people to come and just get tested, and I think that needs to happen everywhere,” she said.
The SHA has also begun to notice increased gonorrhea rates in Saskatchewan. In 2016, the health agency tracked 118 cases per 100,000 people. That shot up to 217 cases per 100,000 people in 2018. Preliminary 2019 data shows an 11 per cent increase in gonorrhea.