Lack of access to sexual health services is a problem for many people in rural Nova Scotia.
Rural isolation creates barriers to essential sexual health services, from affordable contraceptives to relationship counselling, says Jean Ketterling, executive director of the Lunenburg County Sexual Health Centre.
“Sexual health and reproductive rights are fundamental human rights," she said in a recent interview. "When folks don’t have access to quality sexual health information … the health and the well-being of the community suffer."
Located in Bridgewater, Nova Scotia, the centre is one of seven such centres across the province, including the Sheet Harbour Sexual Health Centre ; Pictou County Centre for Sexual Health; Sexual Health Centre for Cumberland County ; Cape Breton Centre for Sexual Health ; and the Yarmouth County Centre for Sexual Health.
Each centre, funded by the Nova Scotia Association for Sexual Health — an organization affiliated with the Canadian Federation for Sexual Health— provides people with educational resources, counselling, as well as free condoms and pregnancy tests.
However, the Halifax Sexual Health Centre, is the only one to offer medical services, such as birth control prescriptions, STI testing and anonymous HIV testing.
“There’s a real need for those clinical services in rural areas,” Ketterling says, and cites how the small-town mentality of ‘everyone knows everything’ makes it harder for clients to trust that doctors uphold their promise of confidentiality.
“Even if there is confidentiality people don’t necessarily want to talk to their doctors about sexual health issues —which is fair,” she continues.
She believes that overall rural residents face more stigma and less access to sexual health supports compared to people who live in Halifax.
Sarah Yantzi, executive director of the Pictou County Centre for Sexual Health, agrees. She explains that oftentimes people feel uncomfortable when purchasing condoms or pregnancy tests from local drugstores because the staff know who they are, and there is a lack of privacy.
Both both women believe that having a second option to access sexual health resources in a more anonymous trusted way is key.
But Yantzi says that transportation is always a concern— especially for young people in rural communities who have no other option than to rely on their parents for a vehicle.
“Geography is certainly our biggest barrier,” she says.
Without having the means to drive long distances, Yantzi describes that many of the youth in the outskirts of county are simply unable to visit the centre, located in New Glasgow.
The result is a delay in healthcare and the added emotional stress of having to wait to receive important information, such as the results of a pregnancy test, she says.
Things become more even more complicated when a woman from a rural area chooses to terminate a pregnancy and must travel to either Truro or Halifax to have an abortion, Yantzi adds.
Her hope is to one day have enough funding to create a mobile health unit that would travel the county to offer clinical services, such a pap smear tests, on a regular basis.
In the meantime, she says the centre tries to overcome the barriers of rural isolation by partnering with the public health department and as many high schools as possible to build capacity for better sexual health support.
Every year, both she and Ketterling host a number of different educational workshops with students and community groups to provide their counties with comprehensive information and resources on sexual health.
Last year Ketterling says she handed out nearly 7,000 free condoms to students during class talks.
But that is not enough.
Each of the province's centres are staffed with one sexual health educator who also acts as the only full-time employee.
“The fact of the matter is one person cannot reach all of the students,” Ketterling says. “We don’t have enough resources. We don’t have enough people doing this work.”
“It comes down to funding,” Yantzi explains. “If we had the money we would absolutely hire more people."
