By Alleah Boisvert
Healthcare workers in Alberta are concerned that stigma, poverty, and lack of awareness surrounding sexually transmitted infections play key roles in the surge in cases in the province.
Natalie Dumaine is a licensed practical nurse (LPN) with StreetWorks, a local organization that collaborates with Boyle Street Community Services, AHS, EPS, and other Edmonton agencies to provide harm reduction resources for communities in the city.
“A lot of people have a stigma about if you are a substance user. If you already feel like nobody cares about you and then you start feeling like you don’t care about you, why the hell are you going to care what the effects of syphilis or any other STI do to you?” said Dumaine.
In July 2019, Alberta declared a province-wide outbreak of infectious syphilis, with the Edmonton zone carrying the most cases. The Edmonton zone also held the most cases of an active gonorrhea outbreak declared in 2016.
Dumaine and her coworker, Rebecca Boonstra, work closely with vulnerable populations at higher risk of contracting STIs. Boonstra, an LPN, says that this can fall back on social and economic influences on health.
“If you don’t have a house, you don’t care [about your health] as much. Or if you’re worried about where you’re going to get your next meal, you don’t care as much about, like, ‘I have this little rash, maybe I should get it checked out.’ If you can’t address those multiple basic things, you’re not able to do higher-level helping,” said Boonstra.
Dumaine said it is difficult for anyone to talk to their healthcare providers about their sexual health, but marginalized people face more barriers.
“I feel like a lot of the clientele that we see have had a lot of distress with the health care system already, so to expect them to bring that conversation forwards on their own is just not likely. It’s scary for them, so a lot of [what we do] is building trust back up and bringing down the stigma,” said Dumaine.
The proportion of syphilis cases among women has grown from 5 per cent to 47 per cent from 2015 to 2019. It can lead to congenital syphilis, which can cause infant deaths.
There are many social challenges for marginalized women, such as substance use and unstable housing. Women also experience racism within the healthcare system and face difficulties advocating for their health.
“The report used as the rationale for our grant funding showed that the big majority of the moms that gave birth to babies with congenital syphilis were Indigenous,” said Boonstra.
Dumaine said there is still a lot more the government could do to help destigmatize and educate people about sexual health and that resources must be easily accessible.
“It needs to be more important for funders to pay attention and think that this is an important health issue. People should take pride in their sexual health, and when [the government] doesn’t put it in the forefront, it further stigmatizes it,” said Dumaine.
StreetWorks provides more information on what they do and how people can help on their website.