Sexually Transmitted and Bloodborne Pathogens Infection Rates in PEI
The Chief Public Health Office is mandated by the Public Health Act and the Notifiable Diseases and Conditions and Communicable Diseases Regulations to control certain communicable diseases in PEI. The Communicable Disease Program contributes to this mandate through policy development, disease surveillance, case follow-up, contact tracing, immunization, education and reporting on STBBI rates.
NOTE: The COVID-19 pandemic impacted both the provincial capacity to test for sexually transmitted and bloodborne infections (STBBI) as well as STBBI test-seeking behaviours of individuals.i Prince Edward Island’s Chief Public Health Office is currently looking into how the pandemic impacted testing numbers for STBBI in PEI. The Chief Public Health Office urges caution when interpreting trends of STBBI infection rates, especially during the years 2020 and 2021.
PEI – Rates of chlamydia infection in PEI began increasing in 2016 and peaked in 2018 with a rate of 270.5 cases per 100,000 population. In 2021, the rate of chlamydia infections in PEI was 202.0 cases per 100,000 population and this rate was not statistically different from the average rate in the most recent five years prior (i.e., from 2016 to 2020). Chlamydia is often under-diagnosed because the majority of infected individuals are asymptomatic.
Canada – Chlamydia rates have increased by 33.1% over the past decade in Canada. In 2019, a total of 139,386 cases of chlamydia were reported nationally, for a rate of 370.8 cases per 100,000 population.ii
PEI – The four Atlantic Provinces (NB, NL, NS, and PE) have held the lowest rates of reported gonorrhea cases in the country since 2013.ii In PEI, rates of gonorrhea began increasing in 2014 and have been stable over the past five years. In 2021, the rate of gonorrhea in PEI was 11.0 cases per 100,000 population and this rate was not statistically different from the average rate in the most recent five years prior (i.e., from 2016 to 2020).
Canada – In Canada, gonorrhea is the second most commonly reported STI after chlamydia. Of particular concern is the emergence of antibiotic resistant gonorrhea. In 2019, 35,443 cases of gonorrhea were reported nationally, corresponding to a rate of 94.3 cases per 100,000 population, 181.7% higher than the 2010 rate of 33.5 cases per 100,000 population. Starting in 2012, the number and rate of reported gonorrhea cases began increasing annually before stabilizing between 2018 and 2019 from 93.5 to 94.3 cases per 100,000.ii
PEI – In 2014, PEI embarked upon a progressive approach for eliminating hepatitis C virus (HCV) that includes encouraging testing for individuals at high risk and providing new treatments through the Hepatitis C Drug Program. In 2015, the HCV rate in PEI dropped 12% below the national averageiii and continued to decline in 2016. An increase in the rate of HCV infections in PEI was observed between 2017 and 2019. More recently in 2021, the rate of HCV infections in PEI was 17.0 cases per 100,000 population and this rate was not statistically different from the average rate in the most recent five years prior (i.e., from 2016 to 2020).
Canada - In 2019, there were 11,441 reported hepatitis C cases in Canada. From 2014 to 2018, national hepatitis C rates rose by 14.4% from 29.6 to 33.9 per 100,000 population. However, from 2018 to 2019, the national rate dropped by 10.2% to 30.4 per 100,000 population, the lowest rate in the last five years.iv
Hepatitis B virus (HBV) infections are classified as acute or chronic infections. National rates are influenced by variations in which each province distinguishes HBV cases by infection status. In 2019, there were 178 reported acute hepatitis B cases in Canada for a rate of 0.48 per 100,000 population. National acute hepatitis B rates are low and have plateaued since 2010, with annual case counts remaining under 200.iv Many provinces and territories implemented a universal HBV immunization strategy in the early 1990s aimed at infants and children, and this strategy is attributed with reducing acute HBV infections in this population. Additional decreases in rates may be achieved through improving immunization strategies for immigrants, refugees, and adopted children from countries without mass HBV vaccination programs.
PEI – In PEI, we typically see somewhere between 0 to 2 local HIV transmissions per year and many cases of HIV diagnosed in PEI resulted from an exposure that occurred outside of Canada and are not reflective of domestic transmission. In 2021, the rate of new HIV infection in PEI was 2.4 cases per 100,000 population and this rate was not statistically different from the average rate in the most recent five years prior (i.e., from 2016 to 2020).
Canada - In 2020, a total of 1,639 new diagnosed cases of HIV were reported, a decrease of 21% since 2019. It is expected that the COVID-19 pandemic has had an impact on observed new diagnosis rates for HIV in 2020.v From 2010 to 2019, the number and rate of reported HIV cases in Canada has remained relatively stable over the last decade, with minor year-to-year variations.vi
PEI – Rates of infectious syphilis in PEI have declined in recent years. In 2020 and 2021, the rate of infectious syphilis was the lowest since 2010 at 0.6 cases per 100,000 population. Outbreaks of infectious syphilis have occurred in different parts of the country, often in populations of men who have sex with men (MSM). However, many MSM also engage in sexual activity with women, so both sexes are at risk. In PEI, there have been cases of infectious syphilis in both men and women.
Canada - Infectious syphilis rates increased almost five-fold (393.1% increase) between 2010 and 2019, the highest increase in rates of all three bacterial STI under surveillance. In 2019, a total of 9,245 cases of infectious syphilis were reported, for a rate of 24.6 cases per 100,000 population, an increase from 2018 rate of 17.0 cases per 100,000 population.ii
What are we doing?
- STI and STBBI testing at physician and nurse practitioner offices and at Health PEI Sexual Health Clinic
- UPEI Health & Wellness Centre (link is external) is open for students 5 days / week and offers STI testing (link is external)
- Development of STI education material and collaborating with community groups for increasing public awareness, specifically for populations at higher risk for STBBIs
- Prevention is provided with coverage for HIV Pre exposure prophylaxis (PrEP) through the HIV program, and the needle exchange program provides clean supplies for drug use to help prevent transmission of Hepatitis C
- Medication for those diagnosed with an STBBI is covered under the STI Drug program, the Hepatitis C treatment program and the HIV program
- All people who are infected with a STBBI are provided confidential follow up with a Public Health Nurse. This follow up includes education and assessment for immunizations that the person may require.
i Public Health Agency of Canada. Survey of the impact of COVID-19 on the ability to provide STBBI prevention, testing and treatment including harm reduction services in Canada. PHAC. 2021.
ii Public Health Agency of Canada. Report on sexually transmitted infection surveillance in Canada, 2019. PHAC. 2021
iii Public Health Agency of Canada. Report on Hepatitis B and C in Canada: 2017. PHAC. 2019.
iv Public Health Agency of Canada. Report on Hepatitis B and C in Canada: 2019. PHAC. 2022.
v Public Health Agency of Canada. HIV in Canada: 2020 Surveillance Highlights. PHAC. 2021.
vi Haddad N, Weeks A, Robert A, Totten S. HIV in Canada—surveillance report, 2019. Can Commun Dis Rep 2021;47(1):77–86. https://doi.org/10.14745/ccdr.v47i01a11