Doctor shortage forces Halifax clinic to cut STI testing despite growing need

A doctor shortage is being blamed for a significantdrop in testing forsexually transmitted infections at a Halifax clinic in a year that has seen a jump in newcases of HIVand gonorrhea in Nova Scotia.

The Halifax Sexual Health Clinic is the only place in mainland Nova Scotia that offers anonymous testing for STIs. Since February, the non-profit centre has lost five family doctors, four of whom left the province entirely and another who relocated within Nova Scotia.

Kate Calnan, the centre's executive director, said patients are squeezed in for timely treatment if an STI test comes back with positive results.

Butsheestimatedmore than 100 patients are left unseen everyweek because no doctor is available.

The service reduction is"hugely frustrating," said Calnan.

"That's been one of the most significant challenges we've been facing here at the centre."

Cuts to testing and longer wait times

The staffing crunch has alsohurt the facility's bottom line.

The centre charges physicians overhead on theirMSIbillings to help cover salaries for nurses and staff. That overhead accounts for approximately 60 per cent of the centre's$650,000 operating budget, said Calnan.

With fewer physicians working, the budget has taken a direct hit.

Back in April, the centre could afford to hire two full-time nurses and one part-time nurse, saidCalnan. Now it takes three weeks to see the clinic's sole nurse, up from one week.

Nurse-run tests for blood-borne infections such as HIV, syphilis, and hepatitis C and B arenow offered just one day a week instead of three.

A drop-inblood-testing clinic, a weekly service popular among people who get testedregularly, has been suspended.

And access to a doctor is limited for testing of bacterial STIs, such as gonorrhea or chlamydia.

It can take four weeks to be seen by a doctor at the centre, which, in any given year, usuallyprovides testing for blood-borne STIsfor 1,000 clients. Calnan said it's on track to provide testing to only one-third of its clients this year.

HIV,gonorrhea rates could be highest in 5 years

According to the Nova Scotia Health Authority, as of the end of August, there were16 confirmed cases of HIV in the provinceand two suspected cases. In the same period last year, there were just eight confirmed cases. By the year's end,there were 15.

Gonorrhea rates also rose faster this year. In the first eight months,there have been 224 cases, compared to 152 in the same period last year. For all of 2017, there were233 cases.

Dr. Trevor Arnason, the medical officer of health for the central region, said the spread of the two STIs"could be the highest level" in the past four or five years. He said they're both on track to post 25 to 50 per cent higher rates.

'Another barrier to proper testing'

While STI testing is available through primary care providers in settings other than the Halifax Sexual Health Clinic, some at-risk patients aren't willing to ask.

Matthew Numer, an assistant professor of health promotion at Dalhousie University, studies the sexual health of gay men. He said he's very worried about the loss of the drop-in blood-testing clinic, calling it "another barrier to proper testing."

He said "many gay men do not have family doctors and even if they do, they may not be willing to discuss their sexual practices or history of them."

Stress on hospital STIclinic

Clients who can't be seen by the Halifax Sexual Health Clinic are now being referred to the Nova Scotia Health Authority's STI clinic at the Victoria General site in Halifax.

The hospital's first-come, first-servedclinicis supposed to run twice a week from5 p.m. to 6:30 p.m. an end-of-dayshift for the nurses and doctors who work there. Instead, some nights, they're workinguntil 9 p.m.

The clinic's co-director,Dr. ToddHatchette, said there's a risk of burnoutamong clinic staffand they're now considering capping the number of patients that can be tested at 30.

Funding request for a nurse

Calnan said hercentre needs an extra $60,000 in funding to pay for a second sexual health nurse.

She said the centre does not receive fundsfrom the Nova Scotia Health Authority, but applied for funding for a nurse anyway earlier this year.

Health Minister Randy Deloreysaid Wednesday he was unaware of the centre's funding proposal and that nobodyin his office could track it down.

On Thursday, however, a department spokesperson confirmed in an email toCBCNews that staff received the proposal in March for an additional $32,000. Tracy Barron said the request came in too late to be considered for the 2018-19 budget.

"Staff are in contact with the centre to discuss its current situation and possible options," Barron wrote. She also noted the department provides $250,000 a year to six centres that fall under Sexual Health Nova Scotia, including the Halifax clinic.

Calnan said she's also putting work into fundraising. Last weekend, an event at Grafton Street Dinner Theatre raised between $3,000 to $4,000.

Calnan plans to use the money to reinstate the drop-in blood collection clinic, but instead of it being held weekly, it will likely be monthly to stretch the money as long as possible.