'Shocking' jump in STI rates among Indigenous people in Sask. is 'an emergency': Indigenous Services top doc
Published Tuesday, March 30, 2021 2:29PM CST Last Updated Tuesday, March 30, 2021 6:53PM CST
SASKATOON -- Cases of syphilis among Indigenous people in Saskatchewan have skyrocketed, according to Indigenous Services Canada medical health officer Dr. Ibrahim Khan.
While the disease is treatable, left untreated, syphilis can lead to serious complications, particularly in pregnant women.
“They're not normal numbers, they’re very shocking, very alarming, and quite an emergency in Saskatchewan,” he said. “We declared a syphilis outbreak in 2019, like summer 2019, and since then we have seen a constant escalation, but what we have seen in 2020 is something unbelievably high.”
Khan says 242 cases were found from January to December, representing a 110 per cent increase. Most of the cases were found in young people, which included many repeated infections, as well as pregnant women.
“We have seen in 2020, two stillbirths and one baby born with congenital syphilis, and more than a dozen babies are under investigations for congenital syphilis, so these are really alarming stats,” he said over Zoom on Tuesday.
Khan says congenital syphilis can lead to birth defects, partial or permanent impairment and disabilities, and in some cases death.
Saskatoon Sexual Health executive director Heather Hale has noticed the increase and attributes the rise to the COVID-19 pandemic.
“We know that despite lockdown advice around social or physical distancing, that doesn't necessarily inhibit behaviours, which may contribute to an STI,” she said. “But we do know from decades of experience and expertise in tons of public health or humanitarian crises, that sexual health or human reproductive health needs, they don't go down, they actually go up.”
“This is also compounded by the social stigma around STBBIs (sexually transmitted and blood-borne infections), so folks are less likely to seek care when it's challenging.”
According to Indigenous Services Canada, Saskatchewan has above average rates of chlamydia, gonorrhea, hepatitis C and HIV, and a person with syphilis is at an increased risk of contracting and spreading HIV.
As to the reason behind Saskatchewan’s higher numbers, Hale says the issue is quite complicated.
“It has to do with many complex systems related to health, colonization, many factors,” she said, with some in Saskatchewan lacking access to care, or facing stigma or discrimination when they try to access care.
Khan says rates of HIV and Hepatitis C are seeing an “artificial dip” during the pandemic and expects to see an immediate increase as the pandemic comes to an end.
These lockdowns, these restrictions had impacted access to care, and people weren't able to go through those screening processes or access to a physician or nurse,” he said. “Community health nurses were badly disrupted throughout this pandemic.”
“We already have some signs of increasing numbers of cases in just the last few months.”
Hale says while there has been an increase in sexually transmitted cases, HIV in Saskatchewan looks different than it does in many places in Canada.
“We know transmission for HIV is highest among folks who use intravenous drugs,” she said.
Executive director of Prairie Harm Reduction Jason Mercredi says because efforts within the medical community are focus on the pandemic, testing for HIV has suffered.
“We know there's a lot of undetected transmissions happening right now and undiagnosed transmissions that have happened,” he said.
“Once the testing gets back up and running in the HIV sector, at full capacity we're going to be seeing some pretty bad numbers coming up.”
Khan says the solution is more access to testing and healthcare, as well as education
“Particularly in a very early age group, in youth groups, having access to a nurse in the community, asking those questions, involving the knowledge keeper,” he said.
“Certainly it’s very important that you reach out to these people in very, very early stages, and provide that treatment, that care, and engaging with care.”
Hale says a positive of the pandemic will be greater health literacy in most people.
“Familiar with terms like contact tracing, which folks may not have known a year and a half ago,” she said. “There's really an opportunity to be able to leverage some of that increased health literacy to be able to make a greater impact on STI rates.”