Nova Scotia expands at-home STI testing program to include HIV

Nova Scotia Health is expanding a program designed to make it easier for people across the province to be tested for sexually transmitted infections.

The STI Care Now program, first launched as a pilot last August, will now deliver free at-home STI tests for chlamydia, gonorrhea and HIV anywhere in the province.

According to Dr. Todd Hatchette, the medical director for the program, early data from the pilot — which only screened for chlamydia and gonorrhea — shows that at-home testing has been successful.

"To date we've had almost 3,000 kits mailed out to people … and there was 122 positives," he said in an interview Friday. "So we are reaching people, we are finding STIs and we are treating those individuals." 

The province says HIV self-testing kits can provide tentative results within one minute, while tests for chlamydia and gonorrhea are done in a lab once kits have been mailed back.

When the results are in, patients are contacted by a pharmacist to discuss next steps, or directed to a physician if additional care is needed. 

Nova Scotians can see if they qualify and request a test be mailed to them by visiting Nova Scotia Health's website.  

A consultation for pre-exposure prophylaxis (PrEP), medication that people take to prevent contracting HIV through sex or intravenous drug use, can also be completed at this point.

PrEP is covered by many private insurance plans and is listed as an exception drug in Nova Scotia's Pharmacare program, but many advocates say accessing the drug through Pharmacare remains prohibitively expensive for many of the people most at risk of contracting HIV.

"There's certainly lots of people who are advocating for broader coverage for this, but at this time it remains the same as it was prior to the pandemic," said Hatchette.

STI rates have been on the rise

In recent years, rates for chlamydia, gonorrhea and HIV have been increasing in Nova Scotia.

Though numbers are not yet available for 2024, there were 359 cases of gonorrhea reported in 2023 — the highest figure reported since 2018 and up from 200 cases in 2022.

For chlamydia, there were 2,730 cases in 2023, a significant increase from 2,281 cases in 2022.

Meanwhile, there were 33 new HIV cases in 2023, the highest number in seven years. 

By improving access to testing and treatment, the province hopes to reduce the transmission of STIs and give Nova Scotians the tools to stay on top of their sexual health. 

"This will allow anybody in the province to order a kit at their convenience. If they don't feel comfortable going to their primary care provider, or they're having difficulty accessing it for whatever reason, they can now be able to test for gonorrhea, chlamydia and HIV at their location of choice," said Hatchette. 

He said the province hopes to eventually offer an at-home test for syphilis, but more research needs to be conducted before that option is made available. 

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