Correctional Health Services work helps decrease syphilis rates among patients across Alberta’s jails & remand centres

The number of syphilis cases has dropped in Alberta — and that's thanks in part to the work being done by Recovery Alberta in provincial correctional facilities.

In 2022, there were 701 cases of syphilis detected and treated upon admission in Alberta's 10 provincially operated jails and remand centres. By 2024 that number was cut in half, to 356 cases.

"A significant factor driving the decrease in cases is our implementation of opt-out testing in 2019. We formalized that into policy this year, which is the first of its kind in Canada," explains Kayley Goralczyk, senior practice lead of Community Health-Nursing, with Recovery Alberta's Correctional Health Services (CHS).

Under the policy, individuals admitted or transferred to a corrections facility will be advised by Recovery Alberta nurses of the opt-out program and will be tested for sexually transmitted and blood-borne infections, unless the patient does not consent.

Members of Recovery Alberta’s Correctional Health Services team gather in an exam room at the Red Deer Remand Centre. Pictured left-right back row are Robin (Health Services Manager), Jennifer (Registered Nurse), Ceanna (Nurse Practitioner), Hope (Licensed Practical Nurse). Seated in front row are Alex (Clinical Nurse Educator) and Victoria (Registered Psychiatric Nurse).

The previous, opt-in method relied on individuals to self-identify and ask for testing, often based on symptoms.

"A full one-third of individuals agree to be tested — and considering individuals admitted to jail and remand are often dealing with a number of challenges including ill health, along with family and legal issues, it's a great result," Goralczyk says.

Nurses will review each patient's medical history and screen for those who have already tested positive for syphilis and other infections.

All patients who test positive will be offered treatment and connected to follow-up care.

"The opt-out policy has changed the game, and as a result, we are seeing those numbers go down and noting improvements in the health of our population," says Angela Draude, senior operating officer of CHS.

"We know that when individuals come to one of our facilities, many of them haven't had access to regular medical care in the community. This is a great opportunity to reach these individuals — and they are often more invested in addressing their health concerns while here."

Though cases in correctional facilities aren't the complete picture, they do make an impact, with 20 per cent of provincial syphilis cases identified in 2022 occurring in provincial jails and remand centres.

While not as dramatic a reduction, total case numbers among Alberta's general population are part of the trend. There were 3,316 reported syphilis cases across the province in 2022, dropping by a third to 2,146 by 2024.

For CHS, a department comprising staff and physicians who provide a range of healthcare services, there is opportunity to make a significant difference for people at a low point in their lives.

In addition to delivering addiction and mental health care, CHS provides immunizations, medication management, emergency response, routine check-ups and medical care, and other health programs and services.

"We are really proud of the work and innovation of Correctional Health Services teams. They're making a difference in the health of our facility populations — and by extension, they're contributing to the wellness of all communities," Draude adds.