Breaking the cycle of increasing STI rates

The Cree Health Board reports that the rates of chlamydia and gonorrhea among Cree youth aged 15-25 are seven and 11 times higher than that of the general population in the province

According to Patrice Larivée, a Nurse Counselor on Sexual Health for the Cree Board of Health and Social Services of James Bay (CBHSSJB), these sexually transmitted infections (STIs) have reached epidemic proportions.

“We know that syphilis has also been on the increase throughout the province and that we have had a few cases within the territory last year and so we are now keeping an eye out for it,” added Larivée.

As a result, when a patient tests positive for one STI, they are offered further screening for other infections.

Larivée said there are many reasons why the numbers in the communities are so much higher than the rest of Quebec. They include the fact that these diseases are hard to detect, the reluctance of youth to go to the clinic for check-ups and that many who do get treatment often get re-infected.

According to Larivée, the phenomena of re-infection usually occurs when a person has unprotected sex with their partner before they are treated or before the treatment has had time to fully cure the individual.

While those working at the clinic will tell the patients to come and get treated as soon as possible and to avoid sex for up to seven days after the treatment, this advice is often ignored.

Treatment and testing for both infections are quite simple. Chlamydia and gonorrhea require only a urine test at the clinic and treatment usually consists of one-time medication.

“It is just important that people understand that if they are told that they have been in contact with someone who just was just diagnosed with an STI, they should come to the clinic as soon as possible,” said Larivée.

However, the reluctance of young adults to visit clinics unless they are very sick compounds the problem. Both chlamydia and gonorrhea often don’t produce symptoms and so people can have these infections and never know unless they are tested.

As a result, the CBHSSJB has been looking at different means to fight the growing STI epidemic. One suggestion of the new Youth Friendly Health Care Services Initiative is to offer testing to all people aged 15 to 25 twice a year. This eliminates the stigma since testing is offered to everyone. As well, treatment would be easier to access.

“If not treated, these two STIs can lead to abnormal pregnancies in women and sterility in men and then there are more serious complications,” said Larivée. “We encourage people to get tested as often as possible, at least once or twice a year if they have multiple sex partners.”

The CBHSSJB is also informing youth how to best protect themselves. The best way to do that is through barrier protection, better known as condoms.

While condoms are readily available at various locations throughout the communities, there are still some issues when it comes to using them. Larivée said that not all boys, or teens in general, know how to properly use them. He said the condom must always be put on before any penetration occurs to prevent the transmission of an STI.

Availability can also be a problem. While condoms can be purchased discreetly at pharmacies throughout Quebec, this isn’t the case in Cree communities.

“I am pushing to have condoms everywhere. In all of the washrooms of the clinics, at the youth centres in the washrooms, there should also be a machine in the washroom of the mall and the nurses’ offices. They have to be easily available,” said Larivée.

But this is sometimes met with resistance from some in the community who fear the impact of their availability on children.

According to Larivée, prevailing myths discourage teens from practicing safe sex, especially the belief that condoms diminish sexual sensation. He insisted there are ways to get around this and to understand it better.

“Young teenagers (boys) learn to masturbate quickly because the act of masturbation is shrouded with moral barriers, stigma and guilt. As a result of quick masturbation, when they put a condom on they feel that they lose a lot of sensation but that is because of what we refer to as the ‘death-grip syndrome,’ which is a way to increase sensation to their penises to reach climax faster,” he explained.

“When I talk to teenagers I always tell them that they should try to slow down or reduce the pressure. I tell them to masturbate with a condom to get used to the sensation. This way they can practice putting it on and installing it properly.”

Another myth is that one must be sexually promiscuous to be at risk. Not true: a STI can be transmitted during a person’s first sexual encounter. As well, Larivée often sees youth who have serial monogamous relationships.

“Within six months an individual could have had three or four sexual partners and so if you haven’t been tested between these partners, you can be just as much at risk as someone who has multiple sex partners and is not in a committed relationship,” said Larivée.

Other myths include the idea that STIs cannot be transmitted during oral sex. Larivée stressed that oral sex is still sex and carries risk and that condoms are still necessary even in these cases.

The bottom line is that anyone can get an STI from an infected partner. The only way to know whether someone is infected is to get tested and use protection if you are not in a committed long-term relationship.

For more information, visit your local clinic.