Sexually transmitted and blood-borne infections - STBBIs - are a significant public health issue in Quebec. Chlamydia remains the most frequently reported bacterial infection in the province, with particularly high rates among young adults aged 15 to 24. Syphilis has been on the upswing for several years, affecting more diverse populations than ever before. HIV, although less frequent thanks to therapeutic and preventive advances, continues to circulate, and thousands of Quebecers are unknowingly living with the virus. Early detection is key: the vast majority of bacterial STIs are easily cured with appropriate antibiotics when diagnosed early, and viral STIs such as HIV and hepatitis are well managed with modern treatments that allow a normal, non-transmissible life.
Yet many people hesitate to undergo screening - out of embarrassment, fear of judgment, lack of knowledge about the process, or lack of easy access to a healthcare professional without a lengthy appointment. Clinique Omicron offers a confidential, non-judgmental, rapid and accessible STI screening service at several of its branches in Quebec - without the need for a family doctor, and covered by the RAMQ for people with a valid health insurance card. This guide outlines the main STIs screened, the indications for screening, the consultation process and how to manage the results.
What STIs can be detected and when should you seek medical advice?
The STI screening panel recommended by the Protocole d'immunisation du Québec and provincial clinical guidelines includes several infections according to individual risk profile. Chlamydia - Chlamydia trachomatis - and gonorrhea - Neisseria gonorrhoeae - are the two most common bacterial STIs, and most often asymptomatic, particularly in women. Screening is performed by first-draft urine sampling or by swabbing exposed sites according to sexual practices - cervix, rectum, throat - and results are available in two to five working days. Syphilis and HIV are screened by blood test, as are hepatitis B and C. Human papillomavirus (HPV) is screened indirectly using the Papanicolaou test for cervical infections in women.
There are many situations in which screening is warranted, and not only for people with high-risk sexual behavior. Screening is recommended for any sexually active person who changes partner, at the start of a new stable relationship before abandoning barrier contraception, after any unprotected relationship with a partner whose STBBI status is unknown, after a sexual assault, during pregnancy - systematic screening recommended - and for men who have sex with men, trans people and sex workers for whom regular screening - every three to six months depending on the level of exposure - is recommended. Injecting drug users must also be screened regularly for HIV, hepatitis C and hepatitis B.
Course of an STBBI screening consultation at Clinique Omicron
Clinique Omicron's STI screening consultation begins with a confidential medical interview with a physician or nurse practitioner trained in sexual health. This interview is not an interrogation but a clinical conversation designed to personalize the screening panel according to the individual's exposure profile - sexual practices, partners, use of barrier contraception, possible symptoms - so as not to over- or under-screen. The environment is non-judgmental and respectful of confidentiality: information shared is not disclosed without the patient's consent, barring legal exceptions under the Public Health Act where there is a risk of transmission to identifiable third parties.
The necessary samples are taken during the same consultation: blood samples for HIV, syphilis and hepatitis; urine samples for chlamydia and gonorrhea; and rectal and pharyngeal swabs if practices warrant. Samples are forwarded to the clinic's partner laboratory. Results are communicated according to patient preference - by telephone, secure portal or follow-up consultation - within two to five working days, depending on the test. In the event of a positive result, treatment is rapidly prescribed, and notification of partners - which can be done anonymously via public health - is discussed with the patient in a caring manner.
Prevention and protection: beyond screening
The screening consultation is also an opportunity to discuss STBBI prevention and the tools available to reduce risks. HIV pre-exposure prophylaxis - PrEP - is a remarkably effective antiretroviral preventive treatment - reducing the risk of HIV transmission by more than 99 % when taken correctly - for people at high risk of exposure. It is available in Quebec on medical prescription and covered by the general drug insurance plan for those eligible. Post-exposure prophylaxis (PEP) is an emergency treatment to be initiated within 72 hours of potential exposure to HIV.
Hepatitis B vaccination is recommended and available for non-immunized people - it confers lifelong protection after a full course of three doses. HPV vaccination - Gardasil 9 - is recommended for people up to the age of 45 who have not yet been vaccinated, protecting against the strains responsible for the majority of cervical cancers, anal cancers and genital warts. Clinique Omicron's physicians discuss relevant vaccine options during the screening consultation, based on the patient's profile, and can prescribe or administer these vaccines at many of their branches in Quebec.
Frequently asked questions about STBBI testing in Quebec
Is SSTI screening really confidential? Will my family doctor be informed?
Confidentiality is a fundamental principle of STI screening. Information shared during a screening consultation is not disclosed to your family doctor, friends or employer without your explicit consent. The results are kept in your Clinique Omicron medical file, which is accessible to the physicians who care for you as part of your follow-up. Notifiable STIs - chlamydia, gonorrhea, syphilis, HIV, hepatitis - must be reported to the Public Health Department by the prescribing physician, in accordance with the Public Health Act. However, this report is made by name only in certain cases and is intended exclusively for epidemiological and public health purposes - it does not imply any disclosure to your entourage or to non-medical third parties.
How long do you have to wait after a risk exposure before getting tested?
Serological window times - the period between exposure and detectability of infection - vary according to the STBBI concerned. For HIV, 4th generation combined antigen-antibody tests detect infection in 99 % of cases after 45 days of exposure - a negative result at 45 days is highly reassuring. For chlamydia and gonorrhea, 7 to 14 days after exposure is generally sufficient. For syphilis, the window is 21 days for most tests. For hepatitis C, antibodies appear within 8 to 11 weeks in 97 % of cases. If you have had a recent high-risk exposure, your Clinique Omicron physician will advise you on the optimal timing of each test, to avoid false negatives resulting from testing too early.
What happens if my result is positive?
A positive test result is not a catastrophe - it's the start of treatment. For bacterial STIs - chlamydia, gonorrhea, syphilis - appropriate antibiotic treatment leads to complete cure in the vast majority of cases. Treatment is prescribed during the results consultation and can usually be initiated the same day. For viral STIs - HIV, hepatitis B and hepatitis C - highly effective antiviral treatments make it possible to control infection, preserve quality of life and, in the case of treated HIV, achieve an undetectable viral load synonymous with non-transmission. The doctor will discuss with you how to notify partners - a process that can be facilitated anonymously via public health - and what preventive measures to adopt for the future. The Clinique Omicron team will accompany you through this process in a caring and non-judgmental way.
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