STIRN Background

Research Team: Jacqueline Gahagan (Principal Investigator), Susan Kirkland, Nathaniel Lewis, Matthew Numer, Michelle Proctor-Simms (Co-Investigators), Brian Condran, John Gould (Associates), Maria Mac Intosh (Collaborator)

In the past decade, Nova Scotia has experienced an upswing in rates of sexually transmitted infections (STIs), including syphilis in men who have sex with men (MSM) and chlamydia in young women. Similarly, new cases of HIV have been reported, particularly in vulnerable populations (e.g., injection drug users, Aboriginal populations, MSM), despite an overall low prevalence rate in the province. Due to its location away from major urban STI epicentres, Nova Scotia has typically been categorized as a province with relatively low STI risk. Yet steady increases in STI cases  during the past 10 years and particularly the current outbreak of syphilis in the Halifax region suggest that there are gaps in sexual health education and upstream STI prevention and sexual health promotion efforts in the province.

The increasing prevalence of many STIs in the province indicates both the need for an overall improvement in sexual health promotion efforts, and more specifically, a need to target the groups most at risk for particular STIs. In general, interventions in this area have been largely top-down processes in which provincial health authorities provide certain services (e.g., syphilis testing), and potential clients choose to seek out that service usually after symptoms of infection have already presented. Community-based strategies to promote testing or other prevention strategies within particular populations, however, have been less common in Nova Scotia. In addition, HIV/AIDS remains largely separated from provincial efforts to prevent other STIs and blood-borne infections (BBIs) even though many of the risk behaviours (e.g. unprotected sex, injection drug use) and prevention strategies (e.g., screening) are similar.

The purpose of this research is to build an inter-sectoral network of researchers, doctors, public health authorities, and community-based organizations (CBOs) to identify the most pressing concerns for STI prevention in the province and develop appropriate interventions that involve collaboration between groups. The initial working group, called the Sexually Transmitted Infections Research Network (STIRN), would use the NSHRF funds to: 1: convene for a two-day meeting between September and December 2013, and 2: apply for a Canadian Institutes of Health Research (CIHR) Operating Grant in March, 2014. While the NSHRF Development Grant would fund the two- day meeting and report, the larger operating grant application would be used to fund the development of specific populations interventions, such as a province-wide survey of STI risk behaviours and testing rates at the province’s key clinical and CBO sites, and/or a pilot study of integrated STI screenings that promote testing for multiple STIs within single patient visits.

Funded by the Nova Scotia Health Research Foundation for $ 14,997 (September 2013 - August 2014).