STI screening in Quebec: everything you need to know without judgment

Screening for sexually transmitted and blood-borne infections (STBBIs) is a preventive health measure - just like a cholesterol test or blood pressure check-up. Yet many people in Quebec put off having this check-up for lack of information, because they're uncomfortable talking about it, or because they don't know how to access it without a family doctor. This article answers these questions directly, straightforwardly and without judgment: which STBBIs to test for, how often, how to get tests in Quebec and what you can do if a result comes back positive.

Who should be screened - and how often

There is no single profile of a person who should be screened. STI screening concerns anyone with an active sex life who wants to know their health status - whatever their age, sexual orientation, relationship status or lifestyle.

Routine screening - once a year as a starting point

For a sexually active person with no particular symptoms, an annual STBBI check-up is a reasonable starting point. This standard check-up generally includes a blood test for HIV, syphilis, hepatitis B and hepatitis C, as well as a swab for chlamydia and gonorrhea. The frequency may be increased depending on the context of exposure, the physician's recommendations or INSPQ guidelines applicable to certain populations.

Situations that may warrant more frequent screening

Certain clinical or contextual situations may justify more frequent screening than once a year. These include: a new partner with no known status, several partners over a given period, unused protection during a relationship, notification by a partner of a positive test result, a planned or ongoing pregnancy (screening systematically recommended in perinatal care), or percutaneous exposure to blood (healthcare professionals, accidents involving contaminated equipment). In these situations, the recommended approach is to consult a physician to assess the appropriate screening frequency.

Prenatal screening - systematic in Quebec

In Quebec, screening for certain STIs is systematically offered as part of pregnancy follow-up. Chlamydia, gonorrhea, syphilis, HIV and hepatitis B are part of the standard prenatal check-up recommended by the MSSS and CMQ. This screening can be carried out during a medical consultation at a clinic or, for certain tests, by prescription from a midwife.

The main STBBIs - what you need to know

Chlamydia and gonorrhea - the most common, often without symptoms

Chlamydia and gonorrhea are the two most frequently diagnosed bacterial STIs in Quebec, across all age groups. The majority of sufferers have no symptoms, which makes active screening essential - the absence of symptoms does not rule out infection. The test is simple: a urine sample or swab, depending on the site of exposure. Both infections can be treated with antibiotics. An untreated infection can lead to long-term complications - notably affecting fertility - which is why regular screening is so important.

Syphilis - on the rise in Quebec over the past few years

Syphilis has come under increased scrutiny in Quebec since INSPQ data documented a rise in cases in several regions, including Montérégie and Montreal. Syphilis is detected by blood test. It progresses through several stages, and is treatable with antibiotic therapy at all stages, the earlier the diagnosis, the more effective it is. Some stages may be asymptomatic, or present with non-specific symptoms that delay diagnosis without active screening.

HIV - detectable, treatable, and a manageable chronic condition by 2026

In 2026, HIV is a chronic medical condition that is manageable thanks to available antiretroviral treatments. A person living with HIV and under effective treatment can have a life expectancy comparable to that of the general population, and does not transmit the virus sexually when his or her viral load is undetectable. HIV testing is performed by taking a blood sample. Rapid tests are also available from certain community organizations in Quebec. Early detection means that treatment can be started quickly and partners protected. Knowing your status - positive or negative - is important medical information.

Hepatitis B and C - blood and sexual transmission

Hepatitis B is transmitted through sexual contact and blood. A preventive vaccine against hepatitis B is offered free of charge in the Quebec vaccination schedule - check your vaccination status if you have any doubts. Hepatitis C is transmitted mainly by blood (sharing injection equipment, unsterile tattoos, occupational exposure) and more rarely by sexual contact. Both can be detected by blood test. Effective treatments exist for both, with high cure rates for hepatitis C with currently available therapies.

HPV - the most common, a vaccine available to all

The human papillomavirus (HPV) is the most widespread STBBI in the general population. Most sexually active people will be exposed to it at some point in their lives. The vast majority of HPV infections resolve spontaneously without treatment. Some strains can cause genital warts or, in a minority of cases, precancerous lesions of the cervix, vagina, vulva, penis or anus. The HPV vaccine is offered free of charge in Quebec as part of the school vaccination program and is recommended up to a certain age - consult a physician to assess the suitability of the vaccine if you have not received it at school. HPV screening of the cervix is integrated with the Pap test (cervical cytology) recommended as part of regular gynecological follow-up.

Genital herpes - common, manageable, often undiagnosed

Genital herpes is caused by the herpes simplex virus (HSV). It manifests itself as recurrent skin lesions, but many people carrying the virus never show any obvious symptoms. Diagnosis is often clinical - based on examination of the lesions - but can be confirmed by sampling during active periods. Genital herpes is not included in the standard STBBI work-up in most protocols - screening is generally indicated in the presence of symptoms or at the patient's explicit request. Treatments are available to reduce the frequency and duration of episodes. Herpes is a manageable condition that does not define or limit the sexual lives of those who carry it.

How to get an STBBI check-up without a family doctor in Quebec

One of the most frequently asked questions is, «Can I get tested for STIs without a family doctor?» The answer is yes - and the options are many.

In a walk-in clinic - the most direct route

A consultation at a primary care medical clinic allows you to obtain a laboratory order for a complete STBBI work-up. The doctor evaluates you, discusses the appropriate tests for your situation and issues a laboratory requisition. You then go to the nearest laboratory - the majority of public and private laboratories in Quebec handle STI tests - and the results are forwarded to the prescribing physician for follow-up. This process is covered by the RAMQ for both medical consultation and laboratory analysis.

By telemedicine - for the prescription of the check-up

A teleconsulting physician can assess your situation and prescribe a complete STBBI work-up without you having to visit the clinic for the initial consultation. The lab order is transmitted electronically. You then go directly to the laboratory for the samples to be taken - blood and urine samples if indicated. This option is particularly useful for people whose schedule or location makes a clinic visit difficult, or for those who prefer to discuss the subject in the privacy of their own home.

In CLSCs - STBBI services available in most areas

Most CLSCs in Quebec offer STBBI screening services, sometimes on a walk-in basis and with a community-based approach. Some CLSCs also offer consultations with specialized nurse practitioners for STI screening and follow-up, including prescribing treatment for simple cases. CLSCs are also distribution points for prevention materials, and can provide referrals to community resources specializing in sexual health.

In specialized community organizations

In Quebec, several community organizations offer anonymous or confidential STBBI screening services, sometimes using rapid tests with results in just a few minutes. These organizations are particularly accessible to people who prefer to avoid the traditional medical circuit, or who need specialized support. They operate in many major cities, including Montreal and the South Shore regions. Your local CLSC or doctor can direct you to the resources available in your area.

RAMQ, confidentiality and results - what you need to know

What RAMQ covers for STBBI screening

Medical consultations for STBBI screening are covered by the RAMQ when carried out by a physician enrolled in the plan. Prescribed laboratory tests - blood tests, swabs - are covered by the RAMQ if performed in an accredited laboratory in the Quebec network. In some CLSCs and community organizations, screening may be offered free of charge, without billing RAMQ, in a public health context.

Confidentiality of results

The results of an STBBI test are as confidential as any other medical result. A doctor cannot share this information without your consent - not with your employer, not with your family, not with your partner, except in very specific circumstances governed by law.

Notification of partners - a voluntary and sustained process

In the event of a positive result for certain notifiable STIs (chlamydia, gonorrhea, syphilis, HIV, hepatitis), the Public Health Department is informed for statistical purposes - without identifying you by name in all cases. For notification of sexual partners, a voluntary approach is generally preferred, often with the support of a nurse or social worker who can facilitate the process on a confidential basis if you wish. You are not alone in this process, and there are resources available to support you.

Prevention - PrEP, PEP and vaccines available in Quebec

PrEP - HIV pre-exposure prophylaxis

PrEP (pre-exposure prophylaxis) is a preventive treatment that enables HIV-negative people to be protected against HIV when taken correctly according to medical recommendations. It is prescribed by a physician after a clinical evaluation and a basic check-up. In Quebec, PrEP is covered by the RAMQ's general drug insurance plan under certain conditions. It requires regular medical follow-up - consultations and periodic laboratory tests - to verify efficacy and tolerance. If you wish to discuss PrEP, a consultation with a doctor in a clinic or via telemedicine is the first step.

PEP - HIV post-exposure prophylaxis

PEP (post-exposure prophylaxis) is an emergency treatment for people who may have been exposed to HIV in the previous 72 hours. It should be initiated as soon as possible after exposure - ideally within the first 24 hours. After 72 hours, PEP is no longer indicated. If necessary, go directly to a hospital emergency department or call 811 for immediate referral. PEP is not a substitute for regular protection, and its repeated use should be discussed with a physician.

Hepatitis B vaccine

The hepatitis B vaccine is offered free of charge as part of the Quebec vaccination schedule - and is generally administered at an early age. If you have not been vaccinated, or if you don't know your vaccination status, a physician can check your immunity by taking a blood sample, and initiate or complete vaccination if necessary. This vaccine is recommended for non-immunized people of all ages.

The HPV vaccine

The HPV vaccine is offered free of charge in Quebec as part of the school program. For adults who were not vaccinated at school, the vaccine is available in pharmacies or clinics, usually at an out-of-pocket cost (check whether your private insurance covers it). The vaccine is most effective before exposure to the targeted strains - but a doctor can assess the suitability of vaccination for your specific situation, whatever your age.

FAQ - ITSS screening in Quebec

Q : How long after an exposure should I wait before getting tested?

A: The optimum screening period varies according to the STI. For chlamydia and gonorrhea, one to two weeks is generally sufficient. For syphilis and HIV, a window of four to six weeks is recommended for a reliable result, with a confirmatory test possible at three months. For hepatitis C, the window can be as long as twelve weeks. If you're in any doubt about the appropriate timeframe for your situation, a doctor can guide you during a clinic or telemedicine consultation.

Q : Can I request an STBBI screening without explaining the context to my doctor?

A: Yes. You can simply ask for a complete STBBI check-up without having to explain the context or circumstances. A doctor can prescribe a screening test at the patient's request - it's a legitimate preventive measure. That said, the more clinically relevant information the doctor has, the more he or she can tailor the test - for example, by including samples taken at specific sites according to exposure patterns - to maximize the relevance of the results.

Q: Do the results of my STBBI assessment appear in my shared medical record?

A: In Quebec, the Dossier Santé Québec (DSQ) centralizes certain medical information, including laboratory results. STI test results may be recorded in the DSQ and made available to authorized health professionals who treat you - for example, an emergency physician who accesses your file. You have the right to restrict access to certain information in your DSQ - see the Régie de l'assurance maladie du Québec website for applicable terms and conditions. This information is not accessible to unauthorized third parties (employers, insurers, relatives).

Q: What happens if a result is positive?

A: A positive result is first and foremost medical information - not a judgment. Depending on the STI concerned, the doctor will discuss with you the appropriate treatment, the necessary follow-up and the options available. For bacterial STIs (chlamydia, gonorrhea, syphilis), antibiotic treatment is generally prescribed promptly, with an excellent prognosis. For HIV and hepatitis, referral to a specialist is organized to begin appropriate treatment. In all cases, you won't be left without support after a positive test result.

Q: Can my employer find out that I've been tested for STIs?

A: No. The results of your STBBI assessment are strictly confidential and cannot be communicated to your employer without your explicit written consent. This confidentiality applies even if you have an employer in the health field or in a regulated sector. The only exception is certain mandatory declarations to the Direction de santé publique for epidemiological purposes - these declarations are anonymized and have no impact on your professional life.

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