Support available for sexual and blood borne infections

Common STI symptoms include:

• Unusual genital discharge

• Pain during urination
• Pain during sex
• Abnormal vaginal bleeding
• Rash, sores or itching around the genitals or other parts of the body 

In many cases, STIs such as chlamydia, gonorrhea and HIV, don’t have any obvious symptoms. You can have an STI without knowing it. And, while you may feel perfectly fine, you can still pass an STI to someone else if you have vaginal, oral or anal sex without a condom.

Common BBI symptoms include:

• Jaundice (yellowing of the skin or whites of the eyes)
• Unusual fatigue
• Dark urine
• Abdominal discomfort 
• Loss of appetite

You may not experience obvious symptoms if you have a BBI and the infection may progress without detection. If you are at-risk of a BBI, it is important to learn your status by seeking testing and follow-up from a health care provider. 

Ways to protect yourself against STIs and BBIs include:

• Practice safer sex. Using latex or polyurethane condoms and/or oral dams for oral, anal or vaginal sex can reduce the risk of STIs
• Consider regular STI testing for yourself and your sexual partners
• Pre-Exposure Prophylaxis (PrEP) is a highly effective, safe treatment taken to prevent HIV transmission. For more information on how PrEP works, guidance on how to access PrEP, or to do a quick assessment to see if PrEP is right for you, visit ontarioprep.ca. You can also access PrEP through York Region Sexual Health Clinics 

Additional ways to protect against BBIs:

• Harm reduction, or the use of various tools and strategies to prevent infection when people inject or use drugs
• Avoid sharing any personal hygiene items (e.g., razors, toothbrushes, nail clippers)
• Seek personal services (e.g., tattoo, piercing, manicures, pedicures, cosmetic procedures) from facilities that use single-use needles, inks and/or follow proper sterilization procedures
• Get vaccinated for hepatitis B

Early detection of STIs and BBIs decreases the risk of long-term health complications from these infections. 

If you've had sex without a condom, including oral sex, see your health care provider or book an appointment at a York Region Sexual Health Clinic to get tested for both STIs and BBIs. To find out if you have an SBBI, you need to be tested. Otherwise, you could spread a SBBI to a sexual partner without knowing it.

If you are sexually active, you should get tested. You should consider getting tested every time you have sex with a new partner, prior to sexual contact, at your regular check-ups, and if you have symptoms such as pain during sex, sores, bleeding after sex, abnormal discharge, and/or abnormal vaginal bleeding. It is important to remember that many infections do not have any symptoms.

Testing for BBIs should be included if you have any one of the following risk factors:

• You have engaged in injection, intranasal or inhalation drug use with shared equipment (even once)
• You were born in a region where hepatitis B/C is more common
• One or both of your parents immigrated from a region where hepatitis B/C is more common
• You live in or travel to regions where hepatitis B/C is more common
• You’ve had exposure to non-sterile medical, dental or personal services equipment
• You received blood, blood products, or had an organ transplant before 1992 in Canada
• You had an invasive medical procedure(s) in a country or countries where infection prevention and control practices are not standardized
• You have a family history of liver disease or liver cancer
• You have been in prison
• You are pregnant
• You are a man who has sex with other men
• You receive dialysis

Once you know what you have, you can get the right treatment. It's also worth knowing so you don't pass along a sexually transmitted infection (STI) or blood borne infection (BBI) to someone else. Please review What to do if you were exposed to blood or body fluids resource for more information.

If you test positive for an STI or BBI, take action to prevent the spread. It's important to tell your partner(s) from the past and present, or even future ones, depending on the infection. A Public Health Nurse can provide guidance about which partner(s) require notification. If possible, those that are at-risk of exposure should be treated at the same time you are. That way they can avoid re-infecting you or others.

How do I tell my partner(s)?

If you have concerns about telling your partner(s), call us to speak with a nurse. They can suggest ways to handle the situation or will contact your partner(s) for you. Your name will be kept confidential. If you decide to talk to your partner(s) yourself, learn how to talk comfortably about it.

Treatment

STIs like chlamydia, gonorrhea and syphilis can be treated and cured by antibiotics. There are also highly effective anti-viral medications available to help people with HIV live longer and healthier lives. With consistent treatment and follow-up, it is possible to prevent sexual transmission of HIV.

While hepatitis B cannot be cured, there are treatments that help keep the infection under control and reduce its damaging effects. Advancements in hepatitis C treatment now make it possible to cure this infection. Getting linked early to a health care provider is important to managing these infections.

If you have had a recent exposure and would like to review recommendations for follow-up, including accessing Post Exposure Prophylaxis (PEP) (treatments to prevent acquisition of hepatitis B or HIV), contact a Public Health Nurse through Access York 1-877-464-9675, connect with a health care provider, or access emergency assessment at your local hospital.

• Chlamydia
• Gonorrhea
• Syphilis
• HIV
• Hepatitis B
• Hepatitis C

On receipt of a reportable SBBI for a client residing in York Region, surveillance letters are sent to testing health care providers. If you prefer to expedite this process, please complete the applicable case report on a lab confirmed SBBI and fax it back to 905-940-4541.  

• CTGC Case Report
• Syphilis Case Report
• Hepatitis B Case Report
• Hepatitis C Case Report
• HIV Case Report

Ensuring timely treatment of STIs is pivotal to preventing the spread of infections. The STI Medication Program supplies York Region HCPs with government-funded, first-line antibiotic treatment for reportable bacterial STIs. This enables clients and known contacts to access treatment without delay.  

Currently over 130 local HCPs are part of the STI stock medication program. To request more information on becoming a STI stock medication clinic or to order a one-time dose of antibiotics, including specialized syphilis treatment - please complete the ordering form and fax back to 905-940-4541, email [email protected] or call SBBI On Duty Line 1-877-464-9675 ext. 74214. 

To speak with a Public Health Nurse for SBBI infection management support, including review of STI guideline treatments, lab interpretation and community resources, please call the SBBI On Duty Line 1-877-464-9674 ext. 74214 or email @email.

Please review the Canadian STI Guidelines for additional information.

Post Exposure Prophylaxis PEP

HCPs can refer clients to a local hospital for baseline bloodwork, assessment, and initial access to PEP initiation. See St. Michael’s Pocket PEP guide.

Pre Exposure Prophylaxis PrEP 

PrEP is a highly effective HIV prevention strategy that can be used by HIV-negative individuals that are at-risk of HIV infection. When used in conjunction with risk reduction and adherence counselling programs, PrEP can prevent transmission of HIV. York Region Public Health is working towards increasing access to PrEP in York Region. To learn more on how to prescribe PrEP, or to access training, toolkits and resources, visit ontarioprep.ca.

Providing Inclusive Care

York Region health care providers play a pivotal role in addressing the health inequities experienced by individuals that identify as 2SLGBTQI+. It is important to foster an open and welcome environment where individuals can express their unique needs, in order to encourage them to seek much needed health services.

The Registered Nurses Association of Ontario (RNAO) has developed comprehensive best practice guidelines to provide helpful context and a framework that promotes health equity and improves the experiences and health outcomes of 2SLGBTQI+ individuals. 

The Canadian Public Health Agency of Canada provides core competency information on discussing SBBI health

York Region

• Updated dashboard of reportable infections in York Region, including STIs and BBIs:
• Access to historical reports and statistics for York Region