Chapter 31: Sexually Transmitted & Blood-Borne Infections

Sexually Transmitted & Blood-Borne Infections traces the historical shift in terminology from venereal disease to the modern, inclusive STBBI label, which encompasses asymptomatic infections and those primarily transmitted through blood or intimate skin contact. The discussion highlights common bacterial infections like chlamydia—the most prevalent reportable condition in Canada—alongside gonorrhea and syphilis, noting the emerging challenge of antimicrobial resistance. Viral conditions such as genital herpes and the human papillomavirus (HPV) are detailed, with a focus on the revolutionary impact of vaccination programs in reducing cancer risks. The text delves into blood-borne pathogens including HIV, where the "Undetectable equals Untransmittable" (U=U) campaign and global diagnostic targets are reshaping treatment optimism and long-term care. It also covers hepatitis B and C, emphasizing the high cure rates now possible for chronic infections. A significant portion of the analysis is dedicated to the social determinants of health and the concept of syndemics, which explains how political, social, and economic factors exacerbate infection rates among marginalized groups, including street-involved youth, Indigenous peoples, and incarcerated populations. CHNs are encouraged to utilize the population health promotion model to implement innovative interventions ranging from needle exchange programs and supervised consumption sites to digital health platforms like online testing services. By addressing systemic barriers such as stigma, discrimination, and safer sex fatigue, the chapter underscores the necessity of culturally safe, inclusive care—particularly for LGBTQ2S communities—and the importance of harm reduction strategies in effectively curbing the spread of these infections while promoting health equity across diverse regions.