2020-2022 Progress Report on Sexually Transmitted and Blood Borne Infections (STBBI)

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Organization: Public Health Agency of Canada

Published: May 25, 2023


Glossary of Acronyms

Two-Spirit, Lesbian, Gay, Bisexual, Trans, Queer. Intersex,
HIV and Hepatitis C Community Action Fund
Direct Acting Antiretroviral
Dried Blood Spot
Drug Resistance
Gay, Bisexual and Other Men who have sex with Men
Gay, Bisexual, Transgender, Two Spirit, Queer
Hepatitis C Virus
Human Papilloma Virus
Harm Reduction Fund
Interim Federal Health Program
Lymphogranuloma venereum Virus
National Advisory Committee on Sexually Transmitted and Blood-Borne Infections
Non-Insured Health Benefits
Northern, Remote and Isolated
Overdose Prevention Site
Post-exposure prophylaxis
Prison Needle Exchange Program
Pre-exposure prophylaxis
Sexually Transmitted and Blood-Borne Infections
Sustained Virologic Response
Truth and Reconciliation Commission
The Joint United Nations Programme on HIV/AIDS


The Government of Canada remains dedicated to improving the lives of people in Canada, achieving the strategic goals of the Pan-Canadian STBBI Framework for Action and accelerating efforts to meet global targets for STBBI laid out by the World Health Organization and the Joint United Nations Programme on HIV/AIDS. Our continued shared efforts will ensure progress is being made in addressing STBBI burdens in Canada.

Accelerating our response: Government of Canada five-year action plan on sexually transmitted and blood-borne infections (STBBI) is built from the vision, guiding principles and pillars of the Pan-Canadian STBBI Framework for Action, and articulates the Government of Canada's approach to addressing STBBI.

The Action Plan takes a whole-of-government approach to addressing STBBI, recognizing that overcoming barriers to STBBI prevention, testing, treatment and care intersects across many federal mandates that aim to improve the lives of Canadians. Nine federal departments are working together to build upon the Pan-Canadian STBBI Framework for Action that was jointly released in 2018 by federal, provincial and territorial ministers of health.

This Progress Report is the second in a series that will provide an overview of federal activities from 2019 to 2024 to address the Action Plan's priorities. Similar to the Action Plan, the Progress Report is organized by the seven priority areas:

  1. moving toward truth and reconciliation with First Nations, Inuit and Métis Peoples;
  2. stigma and discrimination;
  3. community innovation—putting a priority on prevention;
  4. reaching the undiagnosed—increasing access to STBBI testing;
  5. providing prevention, treatment and care to populations that receive health services or coverage of health care benefits from the federal government;
  6. leveraging existing knowledge and targeting future research; and
  7. measuring impact—monitoring and reporting on trends and results.

This current Progress Report details activities undertaken from April 1, 2020 to March 31, 2022 (fiscal years 2020-2022) to address STBBI in Canada. This includes activities carried out during, and in response to, the impacts of the COVID-19 pandemic on STBBI prevention, testing, care, treatment and support. The Government of Canada recognizes the health and social impacts of COVID-19 on STBBI and on key populations disproportionately affected by both. The Government of Canada is committed to working with community partners, key populations and other stakeholders to apply lessons learned and innovations from the pandemic to the STBBI response.

The nine federal partner departments:

  • Public Health Agency of Canada (PHAC)
  • Canadian Institutes of Health Research (CIHR)
  • Correctional Service Canada (CSC)
  • Department of Justice (DOJ)
  • Department of National Defence (DND)
  • Department for Women and Gender Equality (WAGE), including the 2SLGBTQI+ Secretariat
  • Health Canada (HC)
  • Immigration, Refugees and Citizenship Canada (IRCC)
  • Indigenous Services Canada (ISC)

Although this second iteration of the progress report highlights the 2020-2022 fiscal years, Canada has continued to accelerate its response to STBBI in the time since.  For example, important milestones such as the $17.9M in time-limited funding to improve access to HIV testing, supporting the International AIDS Society in hosting the 24th International AIDS Conference in Montreal and reconvening provincial and territorial governments to tackle increasing rates of infectious and congenital syphilis demonstrate Canada’s commitment to addressing this important public health issue. Since some of these initiatives are still ongoing, details on their implementation and the results they produce will be reported in the 2022-2023 edition of the STBBI Progress Report.

Through our recent milestones:

Priority #1: Moving toward truth and reconciliation with First Nations, Inuit and Métis Peoples

The Action Plan reiterated the Government of Canada’s commitment to taking a whole-of-government approach to ensure that efforts to address STBBI among First Nations, Inuit and Métis Peoples take into account underlying structural inequalities and social determinants of health.  To contribute to truth and reconciliation with First Nations, Inuit and Métis Peoples, the Government of Canada:

Priority #2: Stigma and discrimination

Stigma and discrimination have a direct and negative impact on the health of those affected by, and vulnerable to, STBBI. Stigma and discrimination increase vulnerability to STBBI by creating additional barriers to accessing STBBI testing and treatment. To reduce stigma and discrimination related to STBBI, the Government of Canada:

Priority #3: Community innovation – Putting a priority on prevention

Community programming and initiatives are essential in helping to reduce the burden of STBBI in Canada. Community partnerships help the Government of Canada advance the work of our Action Plan and achieve global STBBI targets by providing innovative, tailored approaches to address STBBI that are free of stigma and discrimination. To ensure that communities are supported, the Government of Canada:

Priority #4: Reaching the undiagnosed – increasing access to STBBI testing

Diagnosis is the gateway to STBBI treatment, care and support as it enables individuals to be directed to information or programming to prevent future infections or onward transmission. Reaching the undiagnosed and increasing access to STBBI prevention and treatment is key to achieving our global STBBI targets. To improve access to STBBI testing, the Government of Canada:

Reaching the Undiagnosed – The Northern, Remote and Isolated Initiative (NRI)

Early diagnosis and treatment of STBBI can help spread awareness and increase the quality of life for an individual. However, access to diagnosis, testing and treatment may be a challenge for priority populations and northern and isolated communities. Housed in PHAC’s National Microbiology Laboratory, the NRI initiative is a unique approach that will address barriers to accessing STBBI testing services and linkage to treatment for priority populations and Indigenous communities. Central to the initiative is the recognition of Indigenous communities’ rights of self determinations, and that it is community-led supporting priorities as identified by First Nations, Inuit and Métis Peoples.

Throughout 2020-2022, PHAC and Indigenous Services Canada (ISC) supported culturally appropriate community-based testing to over 400 Indigenous communities. Although purpose-build to support the Pandemic response in NRI communities, the initiative is well positioned to pivot to support testing and care for a variety of STBBI’s by:

  • Ensuring ongoing patient care and management, through community-based and community-led testing programs,
  • Expanding the capacity for testing through training community members on the collection of Dried Blood Spot (DBS) specimens for shipment and testing at laboratories,
  • Expanding DBS and community-based testing to new communities and,
  • Working directly with communities and with community-based organizations to develop and deliver training in both NRI sites and to underserved populations in urban settings.

Innovative testing options such as DBS and rapid community-based testing has transformed access to diagnosis and linkage to care. To ensure that individuals who are tested are linked to care and treatment, the NRI has:

  • Supported the development and implementation of community based STBBI testing during the pandemic response,
  • Worked towards implementing STBBI testing as decentralized point-of-care testing technologies are authorized for use in Canada and,
  • Used innovative options such as in-community collection of specimens (DBS) as well as in-community testing (i.e., using new and highly deployed molecular testing technology and point-of-care tests).
  • Supporting training for Indigenous peers (i.e., community members) on the collection and shipment of DBS for laboratory-based testing as well as extremely high-quality community-based testing.

Priority #5: Providing prevention, treatment and care to populations that receive health services or coverage of health care benefits from the federal government

The Government of Canada plays an important role in funding and providing a range of health services or coverage of health care benefits for several populations including registered First Nations and eligible Inuit people, serving members in the Canadian Armed Forces, individuals incarcerated in federal correctional facilities and certain immigrant populations. To ensure that each population receives adequate and culturally safe and accessible STBBI prevention, testing and treatment, the Government of Canada has provided the following to each population:

First Nations and eligible Inuit:

Individuals incarcerated in federal correctional facilities:

Canadian Armed Forces:

Immigrants and Refugees:

Priority #6: Leveraging existing knowledge and targeting future research

Investing in research can lead to innovative public health interventions, guidance, policy and programming. To support research and the use of existing knowledge, the Government of Canada has:

Priority #7: Measuring impact – monitoring and reporting on trends and results

Monitoring and reporting on new and emerging data is essential to assess progress against the priorities of the Government of Canada Five-Year Action Plan on STBBI. To support regular assessment and public reporting on progress and outcomes, the Government of Canada:


Despite the challenges that COVID-19 imposed, we have a renewed focus on populations disproportionately affected by STBBI and an unwavering commitment to achieving the three strategic objectives of the Pan-Canadian STBBI Framework for Action:

  1. to reduce the incidence of STBBI in Canada;
  2. to improve access to testing, treatment, and ongoing care and support; and,
  3. to reduce stigma and discrimination that create vulnerabilities to STBBI.

The Government of Canada is committed to continue working on improving the lives of people in Canada. Through the hard work, collaboration and dedication from nine federal departments and agencies, our provincial and territorial counterparts, Indigenous and community partners, people living with HIV and hepatitis C, public health and healthcare professionals, researchers and other stakeholders, we have a range of program innovations we can leverage to accelerate progress towards global targets.

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