Fighting the good fight! from VD to HIV/AIDS
Historic fights against sexually transmitted infections (STIs) can tell us a lot about society and public health today.
Private Louis Dufour of The Essex Scottish Regiment standing beside a venereal disease warning poster, Netherlands (1945)
No one knows how long sexually transmitted infections have existed. Syphilis epidemics were recorded in Europe in the 1500s. In Canada, STIs used to be called venereal diseases (VD) and they first became a major public concern during the First World War (1914 to 1918).
Before then, VD was rarely discussed, even among the medical community. But when high rates of infection were found among the Allied soldiers -- especially the Canadians -- the silence was broken. An estimated 28% of the Canadian troops were infected with syphilis and/or gonorrhoea and public health officials worried about the results when the soldiers returned home.
The Government and VD
When the Dominion Department of Health was established in 1919, it included a VD division. Manitoba was the first province to enact legislation to prevent VD in 1910 but every province except Prince Edward Island had followed suit by the 1920s. These laws, which called for the mandatory treatment of VD through free public clinics, were not always enforced.
The two most common types of VD at this time, syphilis and gonorrhoea, were hard to diagnose and the treatment available was long and painful. Most patients stopped treatment before they were cured. The clinics were overcrowded and the staff often lacked expertise.
Eventually, public education was adopted as the best approach. VD prevention became part of a "social hygiene" movement, which preached early marriage, heterosexuality, monogamy, decency and conformity. Illicit sex and immorality were seen as national threats, while good, normal sex took place only within marriage, for the purposes of reproduction.
According to the Health League of Canada, VD could not be contracted innocently: "If we abstain from free and easy intercourse, we need not fear that we shall contract the disease."
World War II
By the end of the 1920s, it was time to know if any progress had been made to prevent VD and the Great Depression led to a fading interest in venereal diseases. The federal government disbanded its VD control division and cancelled VD health grants to the provinces in 1932, but the outbreak of World War II in 1939 renewed national interest in the fight against VD.
The federal Venereal Disease Control Division was set up in 1943. The military provided health education and treatment, and gave condoms and prophylactic packages to soldiers prior to leaves. This and the use of penicillin starting in 1943 for overseas personnel resulted in a 50% reduction in the incidence of VD among Canadian military personnel compared to rates during the First World War.
p>After the Second World War, public education about venereal diseases declined dramatically because the effectiveness of antibiotics and changing social values led to widespread indifference about VD.
In the 1980s, two new STIs emerged that medical science could not cure -- genital herpes and HIV (the human immunodeficiency virus, which causes AIDS, or acquired immunodeficiency syndrome). HIV attacks the immune system and once the virus gets inside the body, the infected person may not feel or look sick for years, but he or she can still infect others. Without treatment, HIV can weaken the immune system and eventually cause life-threatening infections.
The global AIDS pandemic led to public information campaigns and the development of treatments that allow AIDS to be managed.
There has been a new surge in STI rates in Canada, which started in 1997. Chlamydia, gonorrhoea and syphilis are an increasing public health concern. All three diseases are preventable, treatable with antibiotics, and in their early stages, curable. But people can spread them without knowing they are infected.
As research and surveillance continue, the history of STIs reminds us that these diseases still carry a stigma and when an epidemic breaks out, there is a tendency to look for someone to blame.
History also reminds us that two fundamentals of public health are disease prevention and effective, non-judgemental public education.
For more information
Sexually Transmitted Infections (STI), Public Health Agency Canada
- Private Louis Dufour: Lieut. Michael M. Dean / Canada. Dept. of National Defence / Library and Archives Canada / PA-137657
- He "Picked Up" More Than a Girl: © Government of Canada, Library and Archives Canada, Acc. No. 1985-35-8
- Careful You Can't Tell: © Library and Archives Canada, Acc. No. 1985-111-4