Sexually transmitted and blood-borne infections

Given the desire to harmonize medical and nursing practices in the field of sexually transmitted infections (STIs) and the need to provide better guidance on the intervention known as expedited partner therapy (EPT), the Institut national de santé publique du Québec received a request from the Collège des médecins du Québec and the Ministère de la Santé et des Services sociaux. The purpose of this request was to issue a scientific opinion, including recommendations, on the effectiveness, benefits and drawbacks of the EPT strategy for Chlamydia trachomatis (Ct) and Neisseria gonorrhoeae (Ng) infections, the best practice to endorse as well as the conditions required to promote its appropriate use.

In Québec, two STI preventive interventions targeted for infected people and their partner are recommended for people infected with a sexually transmitted infection and their partners, that is:

• the passive approach, whereby infected persons personally…

In Nunavik, the battle against bacterial sexually transmissible and blood-borne infections (STBBIs) has become increasingly urgent. In the wake of mass interventions in the 1990s, and despite more recent efforts, the region has been unable to lower its incidence curves, particularly for gonococcal infection, which has reached epidemic proportions since fall 2007. In this context, and spurred by the renewed interest of medical teams on the ground, the Direction de santé publique (department of public health: DSP) of the Régie régionale de la santé et des services sociaux du Nunavik / Nunavik Regional Board of Health and Social Services (NRBHSS) has asked the Institut national de santé publique (Québec's national public health institute: INSPQ) to support a group of experts in an attempt to optimize the regional program for clinical prevention of STBBIs. Accordingly, a meeting was held on October 2010. In attendance were representatives of the two CSSS organizations (physicians, a con…

Since 2000, the resurgence of syphilis in Québec has led to increased screening and resulted in a greater number of reported cases, particularly in the Montréal area. To meet the growing demand for laboratory testing, some medical diagnostic laboratories have introduced an enzyme immunoassay (EIA) test into their syphilis detection algorithm. This situation raised concerns among general practitioners, microbiologists and infectious disease specialists with regards to the interpretation of screening results and the diagnosis and confirmation of syphilis infections.

In response to these concerns, the Comité sur les infections transmissibles sexuellement et par le sang (CITSS) of the Institut national de santé publique du Québec (INSPQ) established the Sous-comité Épreuves de détection de la syphilis whose mandate was to make recommendations for optimizing syphilis diagnosis in Québec.

To fulfill its mandate, the subcommittee:

• conducted a literature review…

Given that certain questions have been raised regarding the results of studies on the effects of SISs, the Institut national de santé publique du Québec (INSPQ) has taken the initiative of carrying out a critical analysis of these studies.

The objective of this report is to evaluate the relevance of establishing supervised injection sites in the province of Québec. It is based on a critical analysis of the scientific research carried out to date on the effects of SISs and on a review of the literature on the related ethical and legal issues as well as on acceptability and operational factors related to such sites.

This paper describes the state of health of Nunavik Inuit women and the sexual health profile of men and women as reported during the Nunavik Inuit Health Survey 2004. The results focus on the preventive attitude among women such as screening techniques of cervical and breast cancer and also on women’s behaviour during pregnancy and their bone health status. It also concentrates on preventive sexual behaviours among men and women such as the number of sexual partners in the preceding year and the use of contraceptives.

More than four out of five Inuit adult women had a Pap test in the two years before the survey (82%), and 60% of them had one in the previous 12 months. The use of the Pap test is less frequent among adult women with lower levels of education. Among those who had never had a Pap test or had one two or more years before the survey, 41% of them claimed that this examination was not offered to them by their doctor. In terms of breast cancer examination, 43% of wo…

SurvUDI is a network for the epidemiological surveillance of human immunodeficiency virus infection among injection drug users. The network was established in 1995, and covers eight districts in Québec, and Ottawa. Individuals who participate report injecting drugs during the six preceding months and are recruited mainly through centres that provide access to sterile injection equipment. A two-part study on hepatitis C (HCV) was appended to the SurvUDI network. This report presents the results of the epidemiological component; the psychosocial component will be discussed in a subsequent report.