HIV and STI international screening week starts Monday

FILE - An HIV testing kit. (John Raby / AP Photo)

Access to screening for HIV and other sexually transmitted and blood-borne infections (STBBIs) is still difficult in Quebec and elsewhere in the world. International Screening Week, which starts on Monday, advocates better access and encourages people at risk to go and get tested.

The international campaign promotes screening for HIV, hepatitis and STIs, and reaches some 50 countries. It was launched in 2020 due to delays in the number of tests carried out worldwide during the COVID-19 epidemic.

The Coalition des organismes communautaires québécois de lutte contre le sida (COCQ-SIDA) is taking part in this initiative for a fourth year. The goal is to raise awareness among Quebecers of the importance of screening.

“We don't pretend that in one week we'll find everyone with an undetected case of HIV, but we do want to show that it can be done,” said COCQ-SIDA Executive Director Ken Monteith. He wants to send out the message that it's easy to get tested, and that community organizations have an important role to play in the testing process.

COCQ-SIDA is calling for community workers to be able to administer rapid tests for HIV and other STBBIs. In this way, they would act as an alternative gateway to the healthcare network.

The number of HIV tests recorded in 2020 was 18 per cent lower than in 2019, which impacted the spread of the infection. According to the most recent Quebec statistics, which date from 2022, 78 per cent of new HIV cases found were during their first screening.

“Almost half the people for whom we have data were considered to be late screeners. That means they had contracted it several years ago and it started to affect their immune system,” explained Monteith.

He points out that some people have HIV without knowing it, so they can't control their viral load. They can spread the virus without knowing it.

“The key is screening,” he stressed.

Unequal access

Access to screening is unequal from one region to another, said sexologist Audrey Morabito.

“Given that it's a taboo subject, I think there are people who don't really know where to go to get tested,” she said.

At an annual medical appointment, patients are not immediately offered a screening test. “There's a barrier in that respect, because it's not something that's going to be done systematically … There's also a lack of knowledge about where to go,” said Morabito.

People can go to one of the screening clinics, which are mainly located in major centres, or they can go to a CLSC, some Family Medicine Groups (FMGs) or ask their family doctor for a test.

According to Morabito, access would be easier if screening was systematically offered during a visit to the family doctor.

The sexologist pointed out that syphilis has been on the increase in Quebec in recent years. Gonorrhoea is also on the increase, and along with chlamydia, these are the most widespread STIs in Quebec.

Morabito said it isn’t just young people who are concerned with screening. Over the last few years, seniors have become a growing population with an increasing number of STIs.

One tool that would help access to HIV testing is the self-test kit. In 2022, at the International AIDS Conference, Jean-Yves Duclos, then Canada's Minister of Health, announced the introduction of a program of free access to HIV self-testing through Canadian community-based organisations. But this initiative came to an end last March.

“We've made the new federal health minister aware of the fact that we'd like to see it reinstated,” said Monteith. For the moment, he says he has had no indication that the programme will be renewed.

People with HIV can live long and healthy lives if they receive adequate treatment and care.

Sexuality still taboo

STIs, HIV and sexuality in general are still sensitive subjects.

“I think that in our society, talking about sexuality is still taboo. Talking about drug use is still taboo. It's a shame,” said Monteith. “We need to get rid of the shame and reticence so that we can talk about it openly, so that we can reach everyone and stop the spread of HIV.”

Morabito agrees, saying that “everything that falls under the umbrella of sexuality remains taboo in 2024.”

In her opinion, it's a subject that's rarely discussed, and as a result, a feeling of shame can accompany a positive screening result. The sexologist also noted that false beliefs persist, like the idea that you can detect an STI in your partner.

“Most people don't know that the majority of STIs are asymptomatic, so there's no visual or physical way of finding out in many cases,” she said.

She sees International Screening Week as an initiative that has the potential to destigmatize STIs and encourage screening.

This report by The Canadian Press was first published in French on Nov. 17, 2024.