A poster promoting condom use at the UPEI Student Health Centre. Public health officials are concerned that the message of condoms preventing the spread of STIs isn't being heard. (CBC)

Diseases such as gonorrhea and syphilis, which for years had disappeared from P.E.I., are being reported again on the Island, part of an increasing number of STIs being reported across Canada.

"Many, many Canadians underestimate the risk for sexually transmitted infection," said Alex McKay, researcher coordinator Sex Information and Education Council of Canada.

"So they're not taking the precautions that they need to in order to protect themselves."

Between 2000 and 2006 there were six reported cases of gonorrhea on P.E.I., all of them in 2004 and 2005. Since then there have been more than 26. The numbers for syphilis are not as dramatic, but there were no cases from 2000 to 2006 and it has been appearing since.

"It's come and is it going to stay and how much more are the rates going to increase?" wonders provincial epidemiologist Dr. Carolyn Sanford.

"It's definitely caused us quite a bit of concern."

The most common STI on the Island is chlamydia, and the infection rates have risen steadily since 2001, when they were about 100 per 100,000. In 2011 they were more than 150 per 100,000.

Public health officials worry that people are growing weary of hearing the message about protecting themselves, which for the most part comes down to wearing a condom.

Dr. Heather Morrison says HIV is not as scary for people as it once was. (CBC)

"People aren't as worried about HIV as much now as they were before," said Dr. Heather Morrison, P.E.I.'s chief health officer.

"Is there some kind of condom fatigue? People don't want to hear the message, or they don't want to listen to it in the same way."

Some experts argue that better and more testing is leading to an apparent increase in prevalence of the diseases. Dr. David Reid of UPEI's Student Health Centre sees other factors that could be the cause.

"There's more and more use of drugs recreationally," said Reid.

"Along with that behaviour you'll sometimes see more risky sexual behaviour."

Hidden problem

STIs can lead to a variety of problems: an increased risk of some cancers, infertility, or a lifetime of managing uncomfortable and sometimes painful symptoms. Some are easily cured with antibiotics, some never go away.

McKay said the problem is much bigger than suggested in the rate of detected infections.

"The number of cases that are reported represent just a fraction of the actual cases in the population," he said.

"Most cases, particularly among women, are asymptomatic."

The actual rate of young men and women carrying chlamydia, he said, is probably close to 10,000 per 100,000.

And it's not just a problem for young people, said McKay.

"Human papilomavirus, most sexually active Canadians will be exposed to some point in their life," he said.

"[The] general estimate is that approximately a fifth of Canadians will be infected with genital herpes by the time they're into their 40s or so."

Multiplying sexual partners

While condoms are the best protection against STIs, there are other risk factors to consider. Having more than one sexual partner increases a person's chances of picking up an STI, and using drugs or alcohol increases the chances of unsafe sexual behaviour.

Recreational drug use can increase risky sexual behaviour, says Dr. David Reid. (CBC)

"If there's an individual who has three contacts in one year, which isn't an outrageous number from my experience, and each of those people have had three contacts in one year, they may think 'Well, I've had two or three contacts, I probably don't have much risk'," said Reid.

"But really what that multiplies out to is three to the factor of three, potentially 27 contacts in one year. People don't think of those sorts of things. They don't realize that."

While there is an argument that improved testing has increased the rate of detected infections in Canada, some also suggest that argument does not apply to P.E.I. There is no sexual health clinic on the Island to help boost the number of people tested. That could mean reporting rates are actually lower in the province than they are in the rest of Canada.