Joanna Alphonso:

“Diseases of the past” re-emerged vigorously over the past decade, leaving doctors astounded.

Cases of sexually transmitted infections (STI) are rising to rates never before seen in Canada by practicing physicians.


The CBC recently reported that the infection rates of the bacterial STI trio of chlamydia, gonorrhea, and syphilis were steadily rising before the COVID-19 lockdowns. While the two former decreased slightly at the beginning of the lockdowns, the latter continued its upward trend.

According to Stanford Medicine, chlamydia is a bacterium that can pass infectiously through all forms of sexual contact and congenitally from mother to child during pregnancy. Infectious and congenital chlamydia are cured by antibiotic treatment in its early stages of infection. If it remains untreated or incompletely treated, it can spread beyond the initial infection site, resulting in infertility, ectopic pregnancy, pharyngitis, and chronic pelvic pain. Women statistically suffer most with the complications of chlamydia, whereas complications for men are rare. Congenital chlamydia can result in early delivery during pregnancy according to the Centers for Disease Control, and these children can develop eye and respiratory tract infections.

As of 2021, about 274 in every 100,000 people in Canada had chlamydia according to Canada Public Health (CPH), or about a quarter of one per cent. The highest rates per 100,000 people were seen in Nunavut (3126), Northwest Territories (1351), and Yukon (493). The highest rates were seen in females (35 per cent) and males (28 per cent) ages 20-24 years old.


According to the Mayo Clinic, gonorrhea is a bacterium that passes infectiously through sexual contact and congenitally during pregnancy. Traditionally treated with antibiotics, a drug-resistant strain is rapidly emerging and is treated with ceftriaxone, a stronger antibiotic injection. Complications include infertility, inflammation that spreads across the body and into the joints, and an increased risk of HIV. Babies with congenital gonorrhea can develop sores on the scalp, blindness, and other infections.

The CPH reported that in 2021, 85 in 100,000 people in Canada had gonorrhea, double the rate of 2012. Attributed to Covid-19 lockdowns, there was a 14 per cent decrease in 2020 compared to 2019. The highest rates per 100,000 people were seen in Nunavut (1421), Northwest Territories (720), and Saskatchewan (272). There was a 191 per cent increase in male and 96 per cent increase in female rates of gonorrhea from 2012-2018. There was a similar increase from 2020-2021 among male and female cases.


According to the Mayo Clinic, syphilis is a bacterium that spreads infectiously through sexual contact directly with sores and congenitally during pregnancy. The disease is often painless and can lay dormant within the body and become active again later. It is typically treated with a penicillin injection. Untreated or incompletely treated syphilis can cause heart, brain, and other organ damage and become life-threatening. Babies with congenital syphilis are treated with penicillin.

The CPH reported that 31 in 100,000 people in Canada had syphilis. The highest rates per 100,000 people were seen in Northwest Territories (215), Saskatchewan (165), and Nunavut (114). Between 2012-2019, there was a 218 per cent increase in male cases and 2182 per cent increase in female cases. The highest cases were in 34 per cent of males and 32 per cent of females ages 30-39 years old.

Medical view

In a CBC interview, nurse practitioner Patrick O’Byrne said that syphilis cases would be seen every couple of months when he first started his practice 20 years ago; now he sees cases daily.

The WHO claims that congenital syphilis is the second most common cause of stillbirths and is completely preventable if a pregnant woman with syphilis seeks treatment during pregnancy. These rates are rising faster in the U.S. and Europe and can be attributed to methamphetamine use and inadequate access to health resources, particularly for Indigenous communities, according to a Thomson Reuters article. According to Canadian census data, five per cent of the population is Indigenous, yet about 45 per cent of pregnant women with syphilis identified as Indigenous. Data from CPH shows a 1271 per cent increase in congenital syphilis from 2017-2021.

Health Canada has approved rapid test kits for HIV and syphilis with the urging of researchers who sound the alarm of this health crisis.

Political Response

Mark Holland, the federal Minister of Health, announced a 2024-2030 action plan on sexually transmitted and bloodborne infections (STBBI) on Feb. 27, 2024. A total of $2.45 million will be allotted over the course of this plan to improve access to STBBI testing for vulnerable populations such as Indigenous, LGBT, sex workers, and drug users; support harm-reduction programs; address “stigma and discrimination” relating to STBBIs; and improve research and treatment of STBBIs.

International epidemic

Over the past five years, the U.S. Centers for Disease Control reports a 6.2 decrease in chlamydia cases, an 11.1 per cent increase in gonorrhea cases, a 78.9 per cent increase in syphilis cases, and a 183.4 per cent increase in congenital syphilis cases.

In Europe, the European Centre for Disease Control reports a surpassed increase in gonorrhea and chlamydia cases compared to pre-pandemic levels. On March 7, it reported: “In 2022, the number of reported cases saw a significant increase compared to the previous year, with gonorrhoea cases rising by 48 per cent, syphilis cases by 34 per cent, and chlamydia cases by 16 per cent.” ECDC reported that there were 17.9 gonorrhoea cases per 100 000 population, a 59 per cent increase since 2018. There were 8.5 syphilis cases per 100 000 population, representing a 41 per cent increase compared to 2018. There were 88 reported chlamydia cases per 100 000 population, a 15 per cent increase compared to 2018.

If anything, these figures underestimate the number of cases. According to IrsiCaixa (the AIDS Research Institute in Barcelona), Northern and Western European countries have better data collection and show higher STI rates per 100,000 people.

Why the alarming increase?

O’Byrne proposes that shifting sexual practices and ignorance played a role in the explosion of STI rates. With increased use of pre-exposure prophylaxis (PrEP), a medicine that is highly effective in preventing HIV infection, people have decreased or stopped use of condoms and other prevention measures. A shift towards oral sex may have also played a role as people assume that they will not catch HIV; but this is a common way to transmit syphilis. These STI rates had dropped to lower rates for a long time, to the point where physicians believed that they were no longer threats and had no need to screen for them.

Inadequate access and insufficient healthcare play a role in the rise of STIs. According to a 2023 article published in the Canadian Medical Association Journal, the number of Ontarians alone without a primary care provider from 2018-2022 rose from 1.8 million to 2.2 million, while about three per cent of family physicians stopped working within the first six months of the lockdowns; about twice as many compared to previous years. The Angus Reid Institute published a study in 2022 concluding that Canadians have “less confidence and more difficulty accessing health care than Americans,” in spite of universal healthcare coverage. In the six months prior to the publication, about two in five Canadians had a difficult time accessing healthcare or were wholly unable to do so. The five examined categories were appointments with specialists, emergency care, surgery, non-emergency treatment, and diagnostic testing. Access to emergency care and diagnostic testing experienced the worst access. Females overall have a more difficult time accessing required medical care in comparison to males.

In spite of Canadians having access to universal healthcare, the chart below shows that the percentages of ease of access are almost completely flipped between the US and Canada.

Poverty rates seem to play a role in the rise of STIs as well. According to the National Advisory Council on Poverty, an estimated 3.6 per cent of Canadians from 2015-2021 were living below 75 per cent of Canada’s official poverty line. 10.1 per cent of Canadians had unmet housing needs, and there was a three per cent increase in Canadians experiencing chronic homelessness. There was a 7.9 per cent increase in Canadians with unmet health needs and a 12.9 per cent increase in Canadians experiencing food insecurity.

Disadvantaged groups like Indigenous communities experience some of the lowest access to adequate healthcare, housing, and other basic necessities. There is a well-established strong correlation between the increase in STI rates and the deplorable situations of these communities.

How can STI rates be curbed?

According to the U.S. Office of Disease Prevention and Health Promotion, the only listed ways to prevent STIs are the use of condoms and increased testing and screening for STIs. Alarmingly, they do not promote the best and most obvious way to prevent STIs: abstinence.

The CDC does promote abstinence and mutual monogamy as the most reliable ways to prevent STIs. Other recommended ways are vaccination, reduction in the number of sexual partners, and the correct use of condoms, though they caution that these ways are not perfectly preventative and simply reduce the chances of transmission.

In an ironic turn of events, we have found ourselves as a society returning to God’s intention for sex, even if it is for a medical benefit: that it is to remain between one man and one woman within a marriage. This way, STIs are no longer able to make their way through the population, couples remain committed to each other and their families, and innocent children are not the victims of their parents’ poor sexual choices.