Nova Scotia launches take-home STI testing kit, a first in Atlantic Canada

Nova Scotia's decision to offer free at-home tests for sexually transmitted infections is an important step toward reducing some barriers to vital sexual health care, says the head of the provincial AIDS coalition.

Dr. Todd Hatchette, an infectious disease specialist who is the clinical director of Halifax's STI clinic, said the province is seeing an increase in rates of gonorrhea, chlamydia and syphilis, and that the best line of attack is to make it easier for people to get tested.

"I take a seek and destroy kind of attitude toward STIs, because many people may not even know they have an infection. And getting tested and treated is the way to stop the spread," Hatchette said in an interview Monday.

That's the idea behind a new program launched last month in the Halifax and Truro areas that involves an online form people can complete to see if they qualify for an at-home STI test kit. The test is sent in the mail and comes with instructions for collecting a specimen, which is sent to a lab. If a test is positive, an appointment is made with a medical professional.

According to statistics from Nova Scotia Health, 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. 

Nova Scotia Health data also indicates that in 2023 there were 49 cases of infectious syphilis and 52 cases that were non-infectious or unable to be staged, for an overall increase of 14 compared to the previous year.

Chris Aucoin is the executive director of the Health Equity Alliance of Nova Scotia, formerly known as the AIDS Coalition of Nova Scotia. The group advocates for ramped-up testing of all sexually transmitted infections.

Aucoin said the home-based testing model comes with advantages that may encourage testing among people who find it challenging or uncomfortable to visit a sexual health clinic or ask a primary care provider for an STI test.

"This helps sidestep a lot of psychological obstacles that exist for people getting access to sexual health testing. Lots of people aren't comfortable having that [STI] conversation with their general practitioner — if they have one," he said in an interview Tuesday.

Helpful for residents in rural communities

Aucoin said the option could also be helpful for people who live rurally or far from the province's two main STI clinics in Halifax and Truro.

"Nova Scotia has had grossly inadequate STI testing infrastructure for forever, so a new expansion of a test option is always welcomed," he said, adding that more should be done to increase access to comprehensive sexual health care provincewide.

Over the past three weeks, 277 kits have been sent out to patients who qualified for tests, and 77 specimens have been tested in a lab. Of those, there were eight positive lab results for chlamydia or gonorrhea. Provincial health officials are working on expanding the program to the rest of the province.

Gap exists for people who are homeless

Hatchette said that while a similar program exists in Ontario, Nova Scotia's is the first of its kind in Atlantic Canada.

Aucoin said there is still a gap in ensuring that people who are homeless or in precarious housing situations have access to testing. The new at-home test kit program, he said, requires that people have an address for the test to be sent to.

The local AIDS coalition makes free HIV self-tests available at many libraries in the province, as well as through the mail. Aucoin said offering more STI tests at libraries or in pharmacies could be a way for the province to further improve access for people without a permanent address.