Social media, major events and the hook-up culture contribute to STI rise in Alberta

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It seems counterintuitive that sexually transmitted infection (STI) rates are increasing even though talk of “safe sex” has been part of our culture for some time.

Yet, that is what’s happening in Alberta and partly, experts say, because people aren’t getting tested regularly and don’t talk prior to having sex, or hooking up.

According to Alberta Health Services’ (AHS) 2015 report, incidences of gonorrhoea have increased by 80 per cent and cases of infectious syphilis doubled from 2014 to 2015.

“STI rates in the province are the highest they’ve been in decades and show no sign of levelling off,” said Dr. Gerry Predy, senior medical officer of health at AHS during a news conference in April.

Dr. Predy shed light on a possible reason: “A lot of the infections are non-genital sites, so, the rectum, the pharynx of the throat … that’s the part of the challenge I think we have in getting the message out.”

According to statistics and experts, several factors surround sexual health issues, although communication, or lack thereof, seems to be the biggest issue.

Roseline Carter, executive director of programs at the Calgary Sexual Health Centre (CSHC), said one reason people don’t educate themselves or get tested is because “we have a culture of shame around sexuality. People aren’t going to ask questions about STIs … because we shame people about their sexuality.”

The tricky part is without regular testing, STIs may be difficult to detect. “The most common symptom [of an STI] is no symptom at all,” Carter said in an interview.

Highlights from the Alberta Health Services 2015 Report: STIs in Alberta

• More than 3,400 cases reported in Alberta in 2015 (an 80 per cent increase from 2014).
• This rate (82 cases/100,000 population) is the highest reported since the late 1980s.
• The overall female rate in 2015 has increased 93 per cent from 2014.
• Nearly half of all cases among females reported
Indigenous ethnicity.
• The estimated rates among men having sex with men (MSM) are 11 times higher than the provincial rate for all males.

• More than 350 cases of infectious syphilis in Alberta in 2015, doubling case counts from 2014 case counts, and surpassing recent historic highs last seen in 2009.
• Majority of cases (86 per cent) were MSM. One-quarter of all cases were also infected with HIV.
• STIs are a significant health issue for Albertans, resulting in health, social, emotional, and economic costs. Some of these issues can be long-term.

She is referring to a sexually active person who may think she or he is healthy because they have no overt signs of infection, such as a rash, lumps or bumps on the genitals, yet they could in fact be carrying an STI.

STIs can also cause various long-term health issues if not treated.

“For example, chlamydia can result in infertility if left untreated,” Dr. Predy said during the conference. “Left untreated, syphilis can result in damage to the central nervous system.”

Although it doesn’t seem romantic to talk about sexual health before hooking up, Carter says that shouldn’t be the case.

“I think that’s part of the problem. We need to shift it to say it’s actually really sexy to know who the person you’re with is actually taking care of their health.”

Role of social media

The Public Health Agency of Canada (PHAC) conducted a network analyses in partnership with AHS for the 2015 report which identified core transmitters — people transmitting infections to a large number of other people — who are using social media sites like Tinder and Grindr to meet sexual partners.

Kelly Ernst, interim executive director of Calgary Outlink: Centre for Gender and Sexual Diversity, says social media makes hooking up much easier. Ernst — also the president of Rocky Mountain Civil Liberties Association — says a popular app for gay men is Grindr.

“Twenty years ago you didn’t have hook-ups happen so easily and readily online. I mean now, if you want to have sex, its really easy to hook-up with somebody online and go meet somewhere,” Ernst says.

Social media sites are one of two factors that Ernst says have ripened the environment for an increase in STIs. The second factor, he says, is a culture where people assume that by taking a pill a problem will simply go away.

Although social media has made it easier to meet partners, it is more difficult to track health concerns and the possible spread of infections.

Targeting support

The 2015 report, available on the Government of Alberta website, says a majority of syphilis cases — 86 per cent — result from men having sex with men. HIV is also found in one-quarter of those cases and although science has made great strides in treating HIV patients, “there is no cure for HIV or AIDS at this time,” Dr. Predy concluded.

Kelly Body copyCalgary Outlink’s interim executive director Kelly Ernst has only been at the organization since Feb. 2016, but he has hit the ground running by completing local survey’s of the LGBTQ+ community needs and new peer support groups. Ernst says education is an important key to stop the transmission of STIs. Photo by Deanna TuckerAccording to the Government of Canada’s Healthy Canadians website, HIV, the human immunodeficiency virus, attacks the body’s immune system making it unable to fight certain illnesses. If left untreated, HIV could lead to acquired immune deficiency syndrome, or AIDS, through the development of serious illnesses like pneumonia.

If infected with HIV, people need to be even more vigilant. “When someone has an immune disease like HIV, it makes them far more susceptible to all sorts of infections, STIs being one of them,” Carter says.

Ernst says after completing a local survey for Calgary Outlink, it was clear to him that people in the LGBTQ+ community were thirsty for more information regarding sexuality and health support.

He says more than half of the 300 respondents “wanted more information on STD (sexually transmitted diseases) testing, medical assistance, and HIV information (and) a huge number wanted LGBTQ-friendly doctors.”

He says people are asking for more awareness with regard to a healthy sex life, and he believes Alberta Health Services could do more to fill the information gap.

Public Health Agency of Canada epidemiologists also established in their research for AHS that one group has been overlooked regarding awareness of STIs: “urban Aboriginal females or indigenous females were a population that we weren’t reaching well enough.”

Dr. Predy says AHS will continue working with First Nations after learning half of all gonorrhoea cases among females reported indigenous ethnicity.

AHS has work to do while at-risk groups such as indigenous women and men having sex with men await support that shows inclusivity.

“There are some populations who don’t have access to testing or don’t feel accepted in the testing establishments that we have,” says Carter from the Calgary Sexual Health Centre.

She says making sure Alberta-wide measures are adopted to ensure services are culturally appropriate, and that follow-up procedures with people in non-urban areas is readily available, would be the first steps in creating better sexual health services for all Albertans.

All about condoms

(according to
• There are male condoms, female condoms and dental dams (for oral sex) available for protection against STIs.
• Spermicide can be used, though users should be aware it is an effective birth control and does not protect from STIs. To protect from infections, combine with a condom.
• Condoms only offer partial protection against STIs that can be passed through skin-to-skin contact, and do not cover the entire genital area. That means you are still at risk for STIs like herpes, syphilis, HPV and more.
• Latex condoms are the best defense against STIs.

In response to the outbreak, Dr. Predy says Fort McMurray, Calgary and Edmonton should expect to see an increase in access treatment hours, clinic locations and nursing resources.

“I encourage all Albertans who are sexually active to get protection and to be tested as necessary,” Dr. Predy said as he concluded his April press conference.

Big events, good times

The Calgary Stampede’s 2015 Report to the Community boasts that more than 1.2 million people made their way through the gates of the self-styled Greatest Outdoor Show on Earth in 2015. Those numbers are down from previous years, though the annual 10-day event in July, and the multitude of parties it sparks, is a big tourist draw and a popular event for Calgarians.

“Anytime there is a big event or there is a party atmosphere … then it’s a really good time for sexual health campaigning,” says Carter, outlining the CSHC’s beliefs. Although there are no studies or statistics to prove major events have a negative impact on sexual health, Carter says anecdotal evidence was enough to move their team to action.

CSHC started a campaign in 2015 to encourage positive behaviour around the Stampede called #safestampede. The website and Twitter account has especially targeted women to ensure their experience is safe and fun.


“We have a mutual responsibility to make it safe for each other,” Carter says of the Calgary Stampede and other large events where hook-ups are likely to happen.

AHS launched a campaign in 2012 — called “Put a condom on your cowboy” — targeting the Stampede, but there will be no campaign like this in 2016.

However, according to Shannon Evans, communications team lead for Alberta Health Services, the department launched a new campaign in June which refers to their website, with bold slogans like “Go balls deep without losing sleep”, and, “Keep your vajayjay yay-yay”. Evans said in an email this campaign is the third wave of STI marketing they will have started since September 2015.

Ernst says part of the problem with awareness campaigns is the traditionally conservative nature of Calgary’s culture.

“Those awareness campaigns have to be fairly broad but respectful to be really picked up by people,” he says.

Issues of oral sex can be tough to discuss through detailed campaigns, but Ernst, from Calgary Outlink, believes targeted campaigns could help stop problems before they begin.

“Once a person’s gone to the doctors, especially talking about STDs, it’s too late.” Ernst says at that point, people are typically looking for testing or for medication to treat infections.

“There is absolutely no reason that Alberta Health Services couldn’t get posters in front of urinals. So, why not the Stampede?” Ernst suggests campaigns may not reach everyone but they do play a role in stopping some transmission of diseases.

Education is lacking

Ernst says society can’t cling to the myth that talking to young people about sex will only encourage them to have sex. He is confident that talking with youth is a major key in preventing unwanted pregnancies and STIs.

“It’s not enough to just fund a program, but you have to actually get it out to culture and media as well,” he says.

 Calgary Outlink has changed its strategic direction, creating a one-stop community hub both online and at its Calgary office for information and support for the LGBTQ+ community. The organization is pursuing peer support for new Canadians and youth as well as strengthening existing peer support groups.Roseline BodyRoseline Carter has worked with CSHC for the last four years as the director of programs. She says regular testing for non-committed sexual partners is every three months, and once a year for those in monogomous or non-monogomous long-term relationships. Photo by Deanna Tucker

 The CSHC is very vocal about the lack of education standards in Alberta. Carter says, “there is no comprehensive sexual education in this province.” As a result, she says it becomes even more difficult to do more than tell people they need to use condoms.

“It’s really easy to say to someone, ‘Make sure you use condoms’ … way more difficult to say, ‘How are you going to communicate to your partner the importance of using a condom?’” Carter says.

People who are having oral sex may not think they are putting themselves at risk and aren’t getting tested as a result.

“If you had unprotected oral sex, it’s probably a good idea as well (to get tested),” she says.

Carter explains that using Google to research STIs is one thing, but learning the skills to communicate about sex is something entirely different. That is why CSHC is dedicated to serving Calgarians in as many ways as possible, including support groups, information on healthy sex, counselling and training programs for youth. The group even has one staffer responsible for answering questions about healthy sex directly through social media apps like Grindr.

For Carter, STI clinic wait times and a lack of location options are part of the bigger problem. “Social marketing campaigns are good if you have the resources to back them up,” she says.

While CSHC would never tell someone to not have sex with a new partner, Carter says, they do encourage people to take time to reflect first and ask important questions.

“Understand your own values. Is this a decision you would make under any other circumstance?”

Findr app design by Jodi Brak, Deanna Tucker and Joe Viergutz

Thumbnail by Jodi Brak

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