Grant: Project Grant

In British Columbia (BC) and Canada, there have been dramatic increases in sexually transmitted infections (STIs), including chlamydia, gonorrhea and syphilis. STIs can lead to serious health complications and have significant costs on society. Testing for STIs is important to diagnose and treat STIs, which is needed to prevent complications and spread. For this reason, increasing access to STI testing is a national priority. However, very little is known about testing rates and patterns. Most of our data about STIs are based on diagnoses only and do not account for testing. This is a critical gap in our STI surveillance system because increasing testing will increase STI diagnoses, but STIs may not in fact be increasing. On the flip side, there may be people who are infected with a STI but are not diagnosed because they have not tested for STI, leading to a false sense that STIs are low. Accounting for testing is needed to interpret changes in STI trends and to guide where resources for testing and other preventative measures should be prioritized. Few surveillance systems worldwide are able to examine how STI trends are affected by testing. BC has recently invested in public health systems that link STI diagnosis and testing data, enabling us to address this challenge. Using these systems, we can calculate STI testing rates and patterns, assess how they relate to diagnosis rates, and identify populations that may benefit from additional testing and prevention efforts. By adjusting for the impact of testing, we can then have a better understanding of trends in STIs. Our results can be used to improve surveillance systems in other jurisdictions and improve BC and Canada's response to the current STI epidemic.