UBC Reports | Vol. 52 | No. 12 | Dec. 7, 2006
Changes needed to education and treatment
By Hilary Thomson
When the oil and gas boom came to the northeastern town of Ft. St. John, an unwanted visitor came along with it.
Sexually transmitted infections (STIs) among youth 19-24 are spreading in this and other oil and gas communities at rates that far outstrip provincial averages. Chlamydia incidence in the region is 30 per cent higher, but youth seeking testing and treatment are encountering significant obstacles, according to UBC grad student Shira Goldenberg.
A master’s student in the Dept. of Health Care and Epidemiology, Goldenberg is looking at the socio-cultural and structural forces that limit youth’s ability to stay healthy. Her findings and recommendations will help tailor and target STI testing services for youth living in northeastern B.C.
“In addition to resources, there are real and complex concerns around trust, confidentiality, and gender dynamics,” says Goldenberg. “The gap between services and the needs of youth is large.”
In the only such study in Canada, Goldenberg is examining factors ranging from structural issues, such as testing clinic location and layout, to socio-cultural forces such as bar culture and how high wages influence sexual behaviours.
Since May, Goldenberg has spent time in Ft. St. John to recruit 25 youth, aged 15-24 years, and 15 service providers, including public health nurses, community outreach workers and other adults who work with youth.
“The rapid growth of the city as a result of the “boom” raises serious concerns about health and social service provision, including STI testing,” says Goldenberg.
She says many youth are unaware of the consequences of STIs, which for women can include pelvic inflammatory disease as well as risk for cervical cancer. Chlamydia, one of the most common STIs, is one of the primary health concerns because individuals can carry the infection but have no symptoms to alert them to seek treatment.
Ft. St. John has a population of 18-25,000 depending on time of year. A migrant community has developed consisting almost entirely of young men who work in high-paying jobs in remote areas with virtually no access to health services. The men come into town on days off, but testing services may not be available. Taking a day off to come into town for testing at the public health clinic would mean a significant loss of wages.
Additional practical barriers to getting tested include lack of awareness of the location of the public health centre, no public transit to get there and only four testing appointments offered each week, all during school or work hours. Also, anonymity is an issue for many youth who seek testing at local clinics because waiting rooms are busy with patients there for other services.
Physicians’ offices, walk-in clinics and the emergency room offer STI testing but often do not have time to provide important detailed educational information and counseling.
While an oil and gas boom is good for business, it has complex social and sexual impacts, says Goldenberg. Labels like “rig pig” and “gold digger” emerge to describe sexual behaviour, related to perceptions about wages and work schedules affecting sexual behaviour. Working away from home for weeks or months at a time can mean family breakdown and change in sexual habits.
The system is pushed beyond maximum capacity and is not well designed for youth, says Assoc. Prof. Jean Shoveller, Goldenberg’s thesis supervisor. “There needs to be an investment to respond quickly and responsibly.”
“The fast growing population in the city of Fort St. John has created some challenges and community dynamics that may have impacted sexual health and attitudes on testing and treatment,” says Penny Gagnon, Regional Manager of Preventive Public Health at Northern Health. “Next year will show some very concrete and appropriate changes to our sexual health services.”
Goldenberg recommends STI testing and treatment services be adapted to serve boom communities as well as specific risk groups such as youth. Strategies might include increasing hours and available appointments at the health clinic, drop-in testing services, advertisement of testing sites and services, and possibly even a traveling clinic to improve access to testing at rig sites.
The study is funded by the B.C. Medical Services Foundation. Results from the study will be linked with studies that are part of a five-year CIHR Interdisciplinary Capacity Enhancement Team led by Shoveller, which investigates how gender, place and culture affect youth sexual health disparities.
Other members of the research team are Asst. Prof. Mieke Koehoorn and Assoc. Prof. Aleck Ostry of the Dept. of Health Care and Epidemiology.