Questions+Answers | NWT’s Chief Public Health Officer on high STI rates and the need for testing

A makeshift sexually transmitted disease testing clinic opened in Yellowknife this month.

In a news release, the territory’s Department of Health and Human Services said the clinic was in response to an NWT-wide syphilis outbreak that has been ongoing since 2019, “and increased rates of other sexually transmitted infections.”

Health officials said the clinic will remain open for at least a year.

The clinic is located at 487 Range Lake Rd, Unit 103 and both appointments and walk-ins are available.

Dr. Kami Kandola, the territory’s chief medical officer of health, spoke to CBC Trail’s End Host Lawrence Nayally explains why this clinic was necessary.

This interview has been edited for clarity and length.

Why did the territory open this makeshift clinic in Yellowknife?

When we look at our rates of sexually transmitted infections, we are relatively high compared to the rest of Canada. We have the second highest rate of chlamydia and gonorrhea nationally. Compared to other provinces and territories, we have the highest rate of syphilis in 2022. That’s why it’s important that we do things differently.

I reported a syphilis outbreak in 2019, but we are still in an outbreak situation. As I sat back and looked ahead to the post-COVID and evacuation period, I noticed that access to some laboratory and primary care services was limited. Because this clinic is open evenings and weekends with online booking, I hope this will ensure access and privacy, allow us to get people tested and treated, and reduce these prices.

What services are offered at this clinic?

These services are specifically aimed at sexually transmitted infections. So some of them [infections] B. Chlamydia and gonorrhea, which you can detect through swabs or urine samples. Others require a blood test and these would be syphilis, HIV and hepatitis B.

We know it’s important for people to get tested and receive all of these services at once. Therefore, it is important that patients make an appointment so that their urine can be processed and sent to the laboratory immediately, so that their blood can be drawn and sent to the laboratory immediately and they do not have to go somewhere else.

We also know that people work; For some people it is very difficult to take time off and get an appointment for a test. By making these clinics available both evenings and Saturdays, we hope to improve access. You can book online, so you don’t have to call someone and state that you want to be tested for an STI. And if you get tested, that record will remain at Range Lake Clinic as its own separate record system and will not be part of your regional medical electronic medical record.

STDs have long been a problem in the NWT. Why wasn’t there a clinic like this in the past?

So this clinic was initiated by my practice. Typically, the Office of the Chief Public Health Officer does not operate programs and services, so we do not operate clinics. But in this scenario, I was able to use federal funding to run a year-long clinic.

We know that technology has also improved, which is why we have point-of-care testing that can test for syphilis and HIV on-site. We have urine samples that can also be used to test for gonorrhea and chlamydia. Gone are the days when you had to insert a swab in a very private place. This makes it much easier for people to get tested.

Even this year, I have noticed a decline in the number of test subjects visiting clinics and also availing laboratory services. If you were to be tested for syphilis and HIV, you would receive a lab request but would have to have blood drawn. We need to accelerate this as we deal with sexually transmitted infections. For these specific diseases, it is very important that you get tested immediately so that you can get your diagnosis and not spread it further.

What factors contribute to STI rates across the area?

What we see are vulnerable people who have multiple partners. There are more anonymous encounters, so people don’t necessarily know their contacts. It is very difficult to know that you have been exposed to a sexually transmitted disease if you do not know who your partner was. Basically, we see STDs in the throat, STDs in the anus, and not just transmission from the vagina to the penis.

The best way to be safe is that you should get tested every three to six months if you are at risk and have multiple partners. However, we know that access to medical care and access to laboratory services has been difficult. We hope that with this clinic, where most of the cases are primarily in Yellowknife, people will have a much easier time getting tested and diagnosed. A valid health card is required for this clinic. If you come from another community and have a valid health insurance card, we’ll see you too.

You mentioned earlier that the NWT had one of the highest rates of syphilis in the country, at about 10 times the national average. Is this sentence still the same?

We had the highest rate in 2022. We were the highest in Canada. The rate in Yellowknife is lower, but we have also seen testing drop significantly. So if we don’t do tests, you won’t be able to detect syphilis because it requires a blood test. When you register at the STI clinic, your blood will be drawn at the same time and you will not have to go to a laboratory to have your blood test done. Hopefully more people will be tested and we can detect more syphilis.

There are already billboard campaigns in places like Yellowknife Airport, social media posts and more than 300 free condom dispensers throughout the area. What other plans do you have related to public health messaging?

It’s really important that people test themselves, not wait for someone to alert them that they’re exposed, rather than wait for them to show symptoms. If they are at risk and have multiple partners, anonymous partners or casual encounters, they must be tested regularly. If more people came and got tested regularly, we would be able to detect and treat infections and prevent ongoing transmission.