Canadian Adult Performers say they can’t get tested for an antibiotic-resistant STI

British Columbia based sex work industry professionals “Sarah Moon” and “Alex Answers” are sounding the alarm on an antibiotic-resistent STI that Canadian doctor’s are unable to test for.

(Photo: CDC’s Division of STD Prevention)

The government of Canada website describes MGEN (Mycoplasma Genitalium) as “a sexually transmitted pathogen – a significant cause of genital tract infections.”
MGEN is proven to cause urethritis, cervicitis, miscarriages, affect fertility, and if left untreated can lead to pelvic inflammatory disease (a painful, life altering, and sometimes permanent condition). Despite this, the government of Canada website states that “screening is not routine and test availability is limited”.

Adult performer Sarah Moon first learned of MGEN after a trip to Australia, where testing and treatment of MGEN is available to anyone with symptoms or who may have been exposed. Though the infection was first discovered in 1980, Australian doctors were unable to properly screen for the STI until recently. In 2018, The Royal Women’s Hospital Centre for Infectious Diseases in Melbourne warned that an estimated 400,000 Australians were likely to be carrying MGEN. Since then, an Australian-made test has been made available across the continent – as well as Britain and the United States – for anyone who has been exposed to MGEN through sexual contact.

But what about Canada?
When Sarah Moon returned to Canada in April of 2023 she asked her family doctor about MGEN testing she was astonished to learn that not only was her doctor unable to test for the STI – they had actually never even heard of it.
Sarah’s doctor suggested she try an online service called “Get Checked Online” (available to all British Columbia residents). Unfortunately, this was the first of many dead ends for Sarah. Physicians at Aquarius Medical Clinic in Vancouver initially told Sarah that she would have to travel to Ontario (a four hour flight from Sarah’s home on the lower mainland) for testing. One week later, Aquarius Medical contacted Sarah to inform her that they were able to generate a lab requisition which she could bring to her local LifeLabs clinic. After a two hour wait to have her blood drawn, Sarah was informed that the requisition was invalid as MGEN testing is not available in Canada.
Sarah was sent in circles by each new doctor she saw, and eventually ended up at Granville Medical. There, Sarah was prescribed an antibiotic for MGEN, though the doctor she met with confessed they weren’t sure if it was even the right one. Sarah’s physician attempted to ‘make’ a test for her on August 15th – but never received the results.
Sarah eventually returned to Australia where she able to be screened for MGEN – but only because she had been “exposed” to someone with a positive test result.

Image of performer SarahMoon courtesy of Instagram

Adult performer and disability advocate GoAskAlex (“Alex Answers/Alex Verdant”) first heard mention of MGEN in a social media post by Australian adult performer Peggy Sue Winters. In a heartfelt video shared on her instagram account, Peggy Sue explained that she will need to undergo abdominal surgery to remove scar tissue caused by pelvic inflammatory disease (a common side effect of MGEN when left untreated).
Concerned for her health and the wellbeing of her community, Alex contacted a British Columbia physician to inquire after testing for MGEN. Alex’s experience mirrored that of her colleague Sarah, as Alex’s doctor was not familiar with MGEN and had to look it up on google while she waited.
The physician, who said they had seen the test performed in Russia but never in Canada, told Alex that they would “look into it” – but warned her that it was unlikely any testing would be available.

Alex then inquired with the nearby CDC office, who were also unable to provide testing. In a last ditch attempt, Alex was referred to a gynecologist in the hopes that they would be able to provide screening.
Alex was alarmed when the physician at her local Obstetrics and Gynecology clinic was unfamiliar with MGEN and needed to consult with a gynecological infectious disease specialist.
It came as a surprise when, despite the fact that the commonly drug-resistant MGEN is on the CDC’s 2019 watchlist for ‘highest threats’, the specialist informed Alex that positive MGEN test results are indistinguishable from those of Bacterial Vaginosis – and are treated in the same way.

Disheartened by this answer, Alex insisted that the physician make a note on her file stating that she requested to be tested for MGEN. Alex also used the voice note app on her cellphone to record her appointment so that it can be used as evidence of medical negligence in the event that she is eventually diagnosed with PID.

Image of performer GoAskAlex courtesy of Instagram

Canadian adult performers working with production studios are required to provide a recent (2-4 weeks depending on location) panel of negative STI results prior to performing.
In the USA, MGEN screening is now required as part of regular testing for on-set performers. Since MGEN testing is not yet available north of the border, Canadian performers are largely unable to shoot with those based in the United States as they no longer meet the USA studio testing requirements.

A frustrated Alex states that “sex workers have long been known as the ‘canaries in the coal mine’ for matters concerning public health and safety. Since we’re often the first ones impacted by these types of barriers, we’re also the first ones demanding policy change.”

Much like Peggy Sue in Australia, Sarah and Alex hope that by sharing their story with a Canadian audience they will inspire concerned Canadians to contact their doctors as well as politicians at all levels of government to demand widespread access to MGEN testing in Canada.