FR

STBBI self-screening at Prélib

Specific STBBIs

ChlamydiaGonorrheaSyphilisHepatitis BHepatitis CHIV
Vaccination

Hepatitis A and BHPV
Protection against HIV

Prophylaxie pré-exposition (PrEP) contre le VIHPost-exposure prophylaxis (PEP) against HIV
List of abbreviations

References

STBBI self-screening at Prélib

What is it?

Prélib is a testing centre that combines telecommunication technology with medical expertise in the field of sexually transmitted and blood-borne infections (STBBIs). Its objective is to improve the accessibility of STBBI screening and minimize the stigmas surrounding sexuality.

The service is fast and confidential.

In just a few clicks, an appointment is assigned and an electronic medical evaluation is completed. Personalized sexual health advice, as well as the list of screening tests to be completed, are provided online.

How does it work?

At the Prélib centre, a qualified nurse draws blood samples as needed and provides the recommended self-screening materials. The patient is then granted access to a private room where a screen with explanatory videos will assist them at each step of taking the different samples.

Once the screening is completed, the results are quickly posted online to the patient portal. In the event of an abnormal or inconclusive result, a Prélib centre professional will contact the patient with support and instructions.

STBBI self-screening at Prélib

STBBI self-screening at Prélib

What is it?

Prélib is a testing centre that combines telecommunication technology with medical expertise in the field of sexually transmitted and blood-borne infections (STBBIs). Its objective is to improve the accessibility of STBBI screening and minimize the stigmas surrounding sexuality.

The service is fast and confidential.

In just a few clicks, an appointment is assigned and an electronic medical evaluation is completed. Personalized sexual health advice, as well as the list of screening tests to be completed, are provided online.

How does it work?

At the Prélib centre, a qualified nurse draws blood samples as needed and provides the recommended self-screening materials. The patient is then granted access to a private room where a screen with explanatory videos will assist them at each step of taking the different samples.

Once the screening is completed, the results are quickly posted online to the patient portal. In the event of an abnormal or inconclusive result, a Prélib centre professional will contact the patient with support and instructions.

Specific STBBIs
Chlamydia

Chlamydia

Brief summary

  • The most common bacterial STBBI in Québec
  • Transmitted during unprotected sex
  • Often asymptomatic
  • Free access to antibiotic treatment

Causes

Chlamydia is an infection caused by the bacteria Chlamydia trachomatis. It is generally transmitted by secretions from the vagina, penis, mouth or anus. This is why unprotected sex is one of the main risk factors for chlamydia. It can also be transmitted from a pregnant mother to her baby during birth, risking serious complications for the baby.

Who is at risk of infection?

Chlamydia is the most widespread bacterial STBBI in Québec. Over the past several years, we have seen a growing number of chlamydia infections, most often affecting people aged 15 to 24 years who are sexually active. Chlamydia infection is also often accompanied by an infection with gonorrhea (see “Gonorrhea”).

Simply being sexually active puts a person at risk of this infection. Nevertheless, the following activities can increase your risk of infection:

  • having sex without a condom
  • having sex with multiple partners
  • sharing sex toys

Symptoms and complications

In the vast majority of cases, chlamydia passes undetected because it shows few or no symptoms. When symptoms are present, they may occur up to six weeks after the at-risk exposure, although two to three weeks later is average, and can vary depending on the site of the infection.

Possible symptoms, by site of infection, include:

  • Genital tracts: burning while urinating or after sex, urethral itching, unusual discharge or odour
    • For women: unusual vaginal bleeding. In more advanced cases, it is possible to have abdominal pain accompanied by fever and/or nausea.
    • For men: painful or swollen testicles
  • Throat: sore throat or throat discomfort
  • Rectum: abnormal secretions, pain or cramps, bleeding, ulcerations
  • Eye: pain, discharge, itching

Untreated, the infection can persist for many months and lead to complications even in the absence of symptoms. It may cure itself spontaneously. There are many potential long-term complications of untreated chlamydia. These include infertility, increased risk of ectopic pregnancy, chronic testicular infection, chronic abdominal pain and permanent scarring of the urinary tract. In rare cases, chlamydia can cause liver inflammation.

It is important to note that a chlamydia infection can increase your risk of being infected by or transmitting HIV.

Screening and treatment

How to test: The most common samples are swabs of sites exposed by sexual activity (such as the vagina, anus and throat) and urine samples.

When to test: The minimum delay before detection is unknown. The window period ends 14 days after exposure.

It is treated with the help of antibiotics, with the duration of treatment varying depending on the infected site. Treatment is free for those affected, as well as their partners, as part of a program for free medication to treat sexually transmitted infections.

When diagnosed, it is also recommended to inform and treat all sexual partners from the last 60 days.

Likewise, a period of abstinence following treatment for chlamydia is necessary because a person continues to be contagious for some time after starting medication. Once cured, there is no longer a risk of transmitting chlamydia to other sexual partners. However, even after treating the infection, it is possible to be re-infected.

Protection

There is no vaccine to protect against chlamydia. The best means of protection is to use condoms, regardless of the type of sex. Since it is possible to be infected and not have any symptoms, routine screening is recommended for anyone who is single and sexually active, especially when there have been new partners or unprotected sex.

Gonorrhea

Gonorrhea

Brief summary

  • The second most widespread bacterial STBBI in Québec
  • Transmitted during unprotected sex
  • Usually asymptomatic in the genitourinary system
  • Free access to antibiotic treatment

Causes

Gonorrhea is an infection caused by the bacteria Neisseria gonorrhoea. The bacteria is generally transmitted by secretions from the vagina, penis, mouth or anus. This is why unprotected sex is one of the main risk factors for gonorrhea. Gonorrhea can also be transmitted from a pregnant mother to her baby during birth, risking serious complications for the baby.

Who is at risk of infection?

Gonorrhea is the second most widespread bacterial STBBI in Québec. Over the past several years, we have seen a growing number of gonorrhea infections, most often affecting people aged 15 to 24 years who are sexually active. Also, between 10–20% of men and 20–30% of women who are diagnosed with a genitourinary gonorrheal infection are also infected by Chlamydia trachomatis (see “Chlamydia”).

Simply being sexually active puts a person at risk of this infection. Nevertheless, the following activities can increase your risk of infection:

  • having sex without a condom
  • having sex with multiple partners
  • sharing sex toys

Symptoms and complications

In men, urethral infection is usually symptomatic. In women, cervical infections may be symptomatic. Infections of other sites are generally asymptomatic. When symptoms do appear, they are typically observed two to seven days after the at-risk exposure, and can vary depending on the site of the infection.

Possible symptoms, by site of infection, include:

  • Genital tracts: burning while urinating or after sex, urethral itching, unusual discharge or odour
    • For women: unusual vaginal bleeding. In more advanced cases, it is possible to have abdominal pain accompanied by fever and/or nausea.
    • For men: painful or swollen testicles
  • Throat: sore throat or throat discomfort
  • Rectum: abnormal secretions, pain or cramps, bleeding, ulcerations
  • Eye: pain, discharge, itching

There are many potential long-term complications of untreated gonorrhea. These include infertility, increased risk of ectopic pregnancy, chronic testicular infection, chronic abdominal pain and permanent scarring of the urinary tract. Without treatment, gonorrhea can infect the circulatory system, cause damage to joints (septic arthritis) and even cause meningitis.

It is important to note that a gonorrhea infection can increase your risk of being infected by or transmitting HIV.

Screening and treatment

How to test: The most common samples are swabs of sites exposed during sexual activity (such as the vagina, anus and throat) and urine samples.

When to test: The minimum delay before detection is unknown. The delay is 48 hours when using a culture test. The window period ends seven days after exposure.

Gonorrhea is treated with antibiotics. Treatment will completely eradicate the infection unless there is resistance to antibiotics. Treatment is free for those affected, as well as their partners, as part of a program for free medication to treat sexually transmitted infections.

When diagnosed, it is also recommended to inform and treat all sexual partners from the last 60 days.

Likewise, a period of abstinence for seven days following treatment for gonorrhea is necessary because a person continues to be contagious for several days after starting medication. Once cured, there is no longer a risk of transmitting gonorrhea to other sexual partners. However, even after treating the infection, it is possible to be re-infected.

Since a treatment-resistance phenomenon is currently being observed, it is warranted to re-test two weeks following treatment to confirm that the infection has been eradicated.

Protection

TThere is no vaccine to protect against gonorrhea. The best means of protection is to use condoms, regardless of the type of sex. Since it is possible to be infected and not have any symptoms, routine screening is recommended for anyone who is single and sexually active, especially when there have been new partners or unprotected sex.

Syphilis

Syphilis

Brief summary

  • A bacterial STBBI on the rise among men who have sex with men since the 2000s
  • Transmitted through contact with lesions (typically during sex)
  • Clinical presentation varies (“the great imitator”)
  • Increases the risk of acquiring and transmitting HIV
  • Can take up to 12 weeks to detect after being exposed
  • Free access to antibiotic treatment

Causes

Syphilis is a bacterial infection caused by the bacteria Treponema pallidum. The bacteria is transmitted through contact with a syphilis lesion. Generally, syphilis is spread during sex, but also during contact with a lesion (for example, skin-to-skin contact or wet kissing). Syphilis can also be transmitted from a pregnant mother to her baby, risking serious complications for the baby.

Who is at risk of infection?

Syphilis is less widespread than chlamydia or gonorrhea. Currently, a resurgence of syphilis is being observed in Québec, particularly affecting men who have sex with men, a group who are especially at risk.

The following activities are associated with a higher risk of infection:

  • vaginal, anal or oral-genital contact, with or without penetration
  • having sex with multiple partners
  • sharing sex toys
  • sharing injection materials

Symptoms and complications

Syphilis is sometimes nicknamed “the great imitator” because its clinical presentation can often be confused with other diseases. Classically, untreated syphilis evolves through three main clinical stages: primary, secondary and tertiary.

The most frequently observed symptoms, by stage:

  • Primary stage (appears between approximately 3 to 90 days after infection):
    • Painless sores or lesions (may disappear after several weeks)
  • Secondary stage (appears between approximately 2 to 12 weeks, sometimes several months, after the disappearance of lesions):
    • Skin rash (most often on the chest, stomach, hands, feet and genitals)
    • Flu-like symptoms (such as fever, headache, fatigue)
  • Tertiary stage (observed on average 5 to 30 years after the disappearance of lesions):
    • Cardiovascular complications, such as aortic aneurysm
    • Lesions that can damage many different parts of the body, including the skin and bones
    • Neurological complications, such as dizziness and dementia

In the long term, the consequences of syphilis are serious and can be life-threatening.

It is important to note that a syphilis infection can increase your risk of being infected by or transmitting HIV (if you are HIV positive).

Screening and treatment

How to test: Testing is performed using a blood sample.

When to test: The minimum delay before detection is approximately 10 days. The window period ends 12 weeks after exposure.

Treatment consists of antibiotics, which are administered by injection in the majority of cases. Often, one dose is enough, but a longer treatment period is sometimes necessary. Treatment is free for those affected, as well as their partners, as part of a program for free medication to treat sexually transmitted infections. Response to treatment is evaluated with the help of medical follow-up and additional blood tests.

It is also recommended to inform and treat all sexual partners from the last 90 days preceding the diagnosis. Screening is also recommended for recent sexual partners of up to one year prior to diagnosis.

Protection

There is no vaccine to protect against syphilis. The best means of protection is to use condoms, regardless of the type of sex. Since it is possible to be infected and not have any symptoms, routine screening is recommended for anyone who is single and sexually active, especially when there have been new partners or unprotected sex.

Hepatitis B

Hepatitis B

Brief summary

  • A viral STBBI transmitted mainly through unprotected sex and injectable drug use
  • Symptoms such as fatigue, loss of appetite, abdominal pain and jaundice (yellowing of the skin or eyes)
  • Can take up to 12 weeks to detect following exposure
  • Can be prevented with vaccination

Causes

Hepatitis B is an infection caused by a virus that is transmitted via bodily fluids, including blood. Transmission takes place mainly during unprotected sex or through sharing injection materials among those who consume drugs. Hepatitis B can also be transmitted from a mother to her fetus during pregnancy.

Who is at risk of infection?

In Québec, the majority of new infections are linked to unprotected sex and the use of injectable drugs. Certain other populations are also at higher risk, notably immigrants and Indigenous people. There is also an increased risk of transmission during non-sterile medical procedures (transfusions, tattooing), especially in the context of travel.

The following suggest a higher risk of infection:

  • having sex without a condom
  • having sex with multiple partners
  • sharing injection materials
  • being tattooed or pierced with non-sterile material
  • working as a healthcare professional

People infected with HIV have a higher risk of contracting hepatitis B because these infections have similar risk factors.

Symptoms and complications

People infected with hepatitis B do not always show symptoms. If they are observed, symptoms can appear months after the initial infection. Hepatitis can appear as:

  • intense fatigue
  • loss of appetite, nausea or vomiting
  • abdominal pain and diarrhea
  • pale stools and dark urine
  • fever
  • jaundice (yellowing of the skin or eyes)

In most cases, hepatitis B infection resolves itself spontaneously within six months. Following the infection, the production of antibodies protects against hepatitis B. In certain cases, the infection does not resolve itself and becomes chronic, with a risk of being transmitted. Chronic hepatitis B increases the risk of serious liver disease, notably cirrhosis and liver cancer.

Screening and treatment

How to test: Testing is performed using a blood sample.

When to test: The minimum delay before detection is one week. The window period for detection ends 12 weeks after exposure.

Antiviral treatments exist to stop the replication of the virus and slow the progression of chronic hepatitis B.

Protection

There is a vaccine that can protect you against hepatitis B. For more information, see “Vaccination against hepatitis A and B”). Another way to protect yourself is by using condoms every time you have sex. In the case of consuming intravenous drugs, it is recommended to use sterile materials and never share. Since it is possible to be infected and not have any symptoms, routine screening may be recommended depending on your risk factors and vaccination status.

Hepatitis C

Hepatitis C

Brief summary

  • A viral STBBI transmitted mainly through injectable drug use
  • Tends to cause chronic infection, without obvious symptoms
  • Almost half of those infected don’t know their status
  • Can damage the liver in the absence of treatment
  • Can take up to 12 weeks to detect following exposure
  • High cure rates due to the availability of new antiviral medications

Causes

Hepatitis C is an infection caused by a virus that is transmitted via bodily fluids, including blood. Sexual and mother-to-fetus transmission are possible but very rare.

Who is at risk of infection?

In Québec, most new infections are linked to injectable drug use. More rarely, transmission can occur during sex or from a mother to her fetus. Hepatitis C is more widespread in certain regions outside of Canada where transmission also occurs during non-sterile medical procedures.

The following can increase your risk of exposure to infection:

  • sharing non-sterile materials for injection or inhalation (e.g., intranasal cocaine)
  • tattooing, piercing or transfusion with non-sterile materials
  • having unprotected sex when there is a high risk of bleeding
  • being incarcerated

Public health authorities have also observed high rates of hepatitis C in people born between 1950 and 1969 (baby boomers). It is therefore recommended for people in this age group to be screened once in their life.

Symptoms and complications

Hepatitis C has a tendency to become a chronic infection. Affected people often have no symptoms and transmit the virus without realizing. If symptoms do appear, often many years after the initial infection, they can include:

  • intense fatigue
  • loss of appetite, nausea or vomiting
  • abdominal pain and diarrhea
  • pale stools and dark urine
  • fever
  • jaundice (yellowing of the skin or eyes)

Chronic hepatitis C increases the risk of serious liver disease, notably cirrhosis and liver cancer.

Screening and treatment

How to test: Testing is performed using a blood sample.

When to test: The minimum delay before detection is six weeks. The window period for detection ends 12 weeks after exposure.

Advances in hepatitis C research have made treatment more accessible. Currently, hepatitis C is essentially curable in the majority of cases after several weeks of treatment.

Protection

There is no vaccine to protect against hepatitis C. In the case of consuming intravenous drugs, it is recommended to use sterile materials and never share. Since it is possible to be infected and not have any symptoms, routine screening may be recommended depending on your risk factors. Also, hepatitis C is a disease that can be contracted more than once, meaning that maintaining safe behaviours remains important even after being cured.

HIV

HIV

Brief summary

  • A viral STBBI transmitted mainly through unprotected sex and injectable drug use
  • Especially affects men who have sex with men (an estimated 1 in 7 are infected)
  • Can pass undetected
  • Now considered a chronic illness when adequately detected and treated
  • Once undetectable and with adequate treatment, no transmission is possible (undetectable = untransmissible)
  • Can take up to 6–8 weeks to detect after exposure

Causes

The human immunodeficiency virus (HIV) is transmitted through unprotected sexual contact and blood. Without treatment and over the course of several years, HIV can develop into acquired immune deficiency syndrome (AIDS). A person can therefore be a carrier of HIV, but not have AIDS.

Who is at risk of infection?

HIV infection is relatively rare, but certain groups are more likely to be affected, particularly men who have sex with men. In fact, an estimated 1 in every 7 men who have sex with men could be infected with HIV in Québec.

The following activities are associated with an increased risk of infection:

  • having sex without protection (a condom or pre-exposure prophylaxis [PrEP])
  • sharing injection materials
  • being tattooed or pierced with non-sterile materials

HIV is not transmitted through casual, everyday contact such as shaking hands, sneezing, kissing, sharing a meal, using the same toilet or drinking from the same glass.

Symptoms and complications

People infected by HIV do not always have symptoms, and when they do appear, they can pass by unnoticed. Because someone can be infected without knowing, it is especially important to practice safe sex and to get tested regularly.

The following symptoms of HIV infection can appear between two to four weeks after the infection and last one to three weeks:

  • flu-like symptoms (fever, muscle pains, headache, sore throat)
  • swollen lymph nodes
  • sores in the mouth
  • rashes on the torso or face
  • nausea, vomiting or diarrhea
  • significant weight loss

It is very important to understand that even if there are no symptoms, the virus will remain in the body and can still be transmitted to another person.

HIV attacks the system that defends us from infections: the immune system. By doing so, HIV can weaken those defenses and make you more vulnerable to other diseases and infections. Without treatment, there is a risk of developing potentially life-threatening infections once the infection progresses to the AIDS stage.

Screening and treatment

How to test: Testing is performed using a blood sample.

When to test: The minimum delay before detection is 14 days after exposure with fourthgeneration tests and 21 days after exposure with third-generation tests. With some exceptions, the window period for detection ends eight weeks after exposure.

There is no cure for HIV.

Adequate medication and medical follow-up can provide excellent control of the infection, helping to limit its transmission and prevent progression of the disease.

The term “undetectable” is used when the amount of virus present in the blood (the viral load) is not detected. Based on the latest studies, an undetectable viral load indicates that the virus is no longer transmissible.

Today, seropositive people, when treated, have a quality of life and life expectancy comparable to that of the general population.

Protection

Currently, there is no vaccine to protect against HIV.

Condoms and/or pre-exposure prophylaxis (PrEP) are the most effective and commonly used methods to protect against HIV. For more information, see “Pre-exposure prophylaxis (PrEP) against HIV.”

In cases of at-risk exposures and activities, post-exposure prophylaxis (PEP) also exists. PEP can be taken within 72 hours following an at-risk event to significantly reduce the risk of HIV infection.

Since it is possible to be infected and not have any symptoms, routine screening may be recommended depending on your risk factors.

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Vaccination

Vaccination

Vaccination is a fundamental part of optimizing your sexual health. It helps to prevent the transmission of certain infections and complements other preventative measures. An easy way to learn your vaccination status is to consult your vaccination booklet.

Hepatitis A and B

Hepatitis A and B

It is possible to be protected against hepatitis A and B with vaccination (separate or combined vaccines for the two viruses). The vaccines available against hepatitis A and B are very effective (90–99%) at preventing infection.

In Québec, students in the fourth year of primary school receive the combined vaccine for free. Certain at-risk groups, notably men who have sex with men and people who use injectable drugs, also benefit from free vaccination.

Currently, there is no vaccine against hepatitis C.

For more information on vaccines against hepatitis A and B, consult a healthcare professional or call Info-Santé (811 in Québec).

HPV

HPV

For those with an active sex life, it is very common to contract a strain of human papillomavirus (HPV) at some point in your life.

HPV strains are divided into two classes: those with a low risk of cancer and those with a high risk of cancer. Low-risk strains can appear as small flesh-coloured bumps (warts) in the genital area, mouth or throat. High-risk strains generally do not produce symptoms, but can sometimes cause lesions (e.g., on the cervix) that can increase the risk of certain cancers.

Vaccination is the best way to be protected against HPV. The vaccine offers protection against the nine most common HPV strains, including:

  • those causing the majority of general warts
  • those (strains 16 and 18) that cause the majority of HPV-associated cancers (e.g., cancers of the cervix, vagina, vulva, penis, anus and head/neck)

In Québec, vaccination against HPV is a part of the regular vaccination schedule and is offered free to students in the fourth year of primary school. The vaccination program is also offered for free to girls aged 9 to 17 years and to people aged 26 years or younger who have risk factors (e.g., weakened immune system, HIV infection, men who have sex with men). Vaccination does not replace cervical cancer screening, which is recommended for all women aged 21 to 65 years.

For more information on vaccination against HPV, contact a healthcare professional or call InfoSanté (811 in Québec).

Protection against HIV
Prophylaxie pré-exposition (PrEP) contre le VIH

Pre-exposure prophylaxis (PrEP) against HIV

What is it?

PrEP is a medication used to prevent HIV infection as a complement to other safe sex practices. It is used before a potential at-risk exposure.

It consists of a combination of two antiviral medications (tenofovir and emtricitabine) in a single oral pill (Truvada). PrEP works by preventing the virus from replicating in your system before it can cause a permanent infection.

There are two ways of taking PrEP: either taken continuously (every day) or intermittently (two pills between 2 to 24 hours before at-risk sexual contact, plus one pill every 24 hours, up to 48 hours after the last sexual contact). Taking PrEP continuously is the most common, although both options are effective for men who have sex with men, according to the most recent studies.

How well does it work?

Studies show that continuous (daily) PrEP, when properly used, reduces the risk of contracting HIV by up to 97% among men who have sex with men.

Warning!

PrEP can only prevent HIV infection. It does not offer any protection against other STBBIs, such as herpes, chlamydia, gonorrhea, hepatitis or syphilis. Safe sex practices, such as wearing condoms, remain central to STBBI prevention for this reason.

Is it for me?

PrEP is aimed at people without HIV who have an elevated risk of becoming infected. For example:

  • A person who has a seropositive partner who is untreated or has a detectable viral load
  • Men who have sex with men or sex workers who have vaginal or anal sex without a condom
  • Especially when one of the following risk factors applies:
    • Received a recent STBBI diagnosis
    • Has taken post-exposure prophylaxis (PEP) in the past
    • Has sex under the influence of psychoactive substances

A consultation with a professional is needed to determine whether this prevention method is indicated and to prescribe it if needed.

How to obtain a prescription?

A prescription for PrEP is made following a consultation with a doctor that includes many recommendations, including how to properly take the medication and its potential side effects. Regular follow-ups every three months will be performed to monitor tolerance to the medication (and to screen for STBBIs).

In Québec, PrEP is covered by RAMQ. However, a maximum deductible of approximately $88 per month will be required unless you are exempt. For those with private insurance, medication coverage varies from one insurer to another. It is best to check with the specific insurer to find out what is covered.

Post-exposure prophylaxis (PEP) against HIV

Post-exposure prophylaxis (PEP) against HIV

What is it?

PEP is another means of preventing HIV. Unlike PrEP, PEP is designed to be used after a potential exposure to HIV, and should be started as soon as possible (within 72 hours).

PEP consists of a triple therapy containing the three antiretroviral medications that are also used for HIV. Following an at-risk exposure, these medications block the replication of the virus and prevent permanent infection.

How well does it work?

The efficacy is very high (nearly 100%), but depends on whether the medication is taken correctly.

Is it for me?

All HIV-negative people who believe they may have been exposed to HIV should quickly consult a healthcare professional for a medical evaluation. Examples of at-risk exposures include unprotected sex, a puncture with a used syringe or a human bite. A medical evaluation will help to evaluate the at-risk exposure and decide whether PEP is recommended.

How to obtain a prescription?

You should consult a doctor as soon as possible to start the medicine quickly. The maximum delay between the at-risk exposure and starting treatment is 72 hours. Regardless, the earlier you are able to start the medication, the more likely it is to be effective. The duration of the treatment is 28 days.

Medical follow-ups and screening will be done at the start and end of treatment to cover the appropriate window period of infection.

List of abbreviations

List of abbreviations

STBBI – sexually transmitted and blood-borne infections

PPE – post-exposure prophylaxis (against HIV)

PrEP – pre-exposure prophylaxis (against HIV)

HIV – human immunodeficiency virus

HPV – human papillomavirus

References

References

CATIE. “Chlamydia.” https://www.catie.ca/en/fact-sheets/sti/chlamydia

Ministère de la santé et des services sociaux du Québec. “Guide québécois de dépistage des infections transmissibles sexuellement et par le sang.” June 2017.http://publications.msss.gouv.qc.ca/msss/document-000090/

CATIE. “Gonorrhea.”

CATIE. “Hepatitis B.” https://www.catie.ca/en/fact-sheets/sti/hepatitis-b

CATIE. “Hepatitis C.” https://www.catie.ca/en/hepatitis-c

CATIE. “HIV Basics.” https://www.catie.ca/en/basics/hiv-and-aids

CATIE. “Oral PrEP.” https://www.catie.ca/fact-sheets/prevention/pre-exposure-prophylaxis-prep

CATIE. “PEP.” https://www.catie.ca/fact-sheets/prevention/post-exposure-prophylaxis-pep

CATIE. “Syphilis.” https://www.catie.ca/fact-sheets/infections/syphilis

Coffin CS, Fung SK, and Ma MM. “La prise en charge de l’hépatite B chronique : les lignes directrices consensuelles de l’Association canadienne pour l’étude du foie.” Canadian Journal of Gastroenterology (Volume 26-12). December 2012.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551569/

Gouvernement du Québec. “Vaccins contre les infections par les VPH.” https://www.quebec.ca/sante/conseils-et-prevention/vaccination/vaccin-infections-par-vph/

Gouvernement du Québec. “Vaccin contre l’hépatite A et l’hépatite B.” https://www.quebec.ca/sante/conseils-et-prevention/vaccination/vaccin-hepatite-a-et-hepatite-b/

Institut national de santé publique du Québec. “Avis sur la pertinence d’un dépistage du VHC chez les baby-boomers au Québec.” March 2018. h https://www.inspq.qc.ca/publications/2333

Ministère de la santé et des services sociaux du Québec. “Guide québécois de dépistage des infections transmissibles sexuellement et par le sang.” June 2017. http://publications.msss.gouv.qc.ca/msss/document-000090/

Ministère de la santé et des services sociaux du Québec. “Guide québécois de dépistage des infections transmissibles sexuellement et par le sang.” October 2017. http://publications.msss.gouv.qc.ca/msss/document-000090/

Ministère de la santé et des services sociaux du Québec. “La prophylaxie préexposition au virus de l’immunodéficience humaine : Guide pour les professionnels de la santé du Québec.” November 2017 http://publications.msss.gouv.qc.ca/msss/document-000313/

Portail VIH/sida du Québec. “La PrEP FAQ.” https://pvsq.org/ppe

Portail VIH/sida du Québec. “La PPE FAQ.” https://pvsq.org/ppe

Public Health Agency of Canada. “Canadian Immunization Guide.”

Hepatitis A – https://www.canada.ca/fr/sante-publique/services/publications/viesaine/guide-canadien-immunisation-partie-4-agents-immunisation-active/page-6-vaccin-contrehepatite-a.html

Hepatitis B – https://www.canada.ca/fr/sante-publique/services/publications/viesaine/guide-canadien-immunisation-partie-4-agents-immunisation-active/page-7-vaccin-contrehepatite-b.html

Vaccin contre le virus du papillome humain – https://www.canada.ca/fr/santepublique/services/publications/vie-saine/guide-canadien-immunisation-partie-4-agentsimmunisation-active/page-9-vaccin-contre-virus-papillome-humain.html

Public Health Agency of Canada and Health Canada. “Hepatitis C.” https://www.canada.ca/fr/sante-publique/services/maladies/hepatite-c.html

Public Health Agency of Canada. “Human immunodeficiency virus – Guide for screening and diagnosis of HIV infection.” https://www.canada.ca/fr/sante-publique/services/vih-sida/guide-depistage-diagnostic-infectionvih.html

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