The morning light spills through the windows of the Halifax Sexual Health Centre as Kelsey Chapman slides the slender testing strip into its protective packaging. It’s her fourth “take-home” HIV test she’s helped distribute today—a small moment in what health advocates are calling a quiet revolution in sexual health accessibility across Nova Scotia.
“People need options that work with their lives,” Chapman tells me, adjusting her glasses as she prepares another kit. As a sexual health coordinator who has spent five years working with vulnerable populations, she’s witnessed firsthand how barriers to testing can keep people from knowing their status. “For some folks, especially in rural communities, walking into a clinic isn’t simple. There’s the question of who might see them, what assumptions might be made.”
Last month, Nova Scotia expanded its at-home HIV testing program across all health zones in the province, following a successful pilot project that began in 2022. The initiative allows residents to order free HIV self-testing kits online or pick them up at designated community organizations, with results available within minutes in the privacy of their homes.
The program represents a significant shift in public health strategy—one that recognizes how stigma, geography, and healthcare access intersect in deeply personal ways.
“When we launched the pilot, we weren’t sure how people would respond,” says Dr. Lisa Barrett, infectious disease specialist with Nova Scotia Health. “What we found was extraordinary demand, especially from communities we’ve historically struggled to reach with conventional testing.”
That demand speaks volumes in a province where approximately 20 percent of people living with HIV remain undiagnosed, according to data from the Public Health Agency of Canada. The national HIV testing guidelines now recommend universal screening for everyone aged 15-70 years at least once, but implementation has been inconsistent across provinces.
For Jesse Haverkamp, 27, who lives in a small community outside Yarmouth, the take-home option eliminated a two-hour round trip to the nearest sexual health clinic. “I put it off for years, honestly,” he admits during our phone conversation. “It’s not just the drive—everyone knows everyone’s business here. The day I took the test at home was the first time I felt completely comfortable with the process.”
The kits themselves are remarkably straightforward. Users receive a finger-prick blood test similar to what someone with diabetes might use to check glucose levels. A single drop of blood provides results within minutes. Each kit comes with detailed instructions and access to virtual support from healthcare providers if needed.
What makes the Nova Scotia initiative particularly noteworthy is its comprehensive approach to support. Unlike purely mail-order systems, the provincial program includes community partnership and follow-up pathways, ensuring that those who test positive can immediately access counseling and treatment.
When I visited Halifax’s North End Community Health Centre last week, outreach worker Darnell Thomas was preparing to distribute kits at a local community event. Having worked in HIV prevention for over a decade, he sees the at-home option as complementary to traditional services.
“This isn’t replacing clinic-based testing,” Thomas explains. “It’s creating multiple doors to the same house. Some people will always prefer face-to-face interactions, and that’s still available. Others need this privacy, this control over when and how they learn their status.”
The province’s approach aligns with evidence from the World Health Organization, which found that self-testing can increase testing uptake by up to 11 times among populations who might otherwise not get tested.
Dr. Sean Rourke, who leads the national REACH Nexus research group at St. Michael’s Hospital in Toronto, has been monitoring Nova Scotia’s implementation closely. “What’s happening in Nova Scotia represents the kind of innovative, low-barrier approach we need across Canada,” he explains. “Their program is addressing what we call the first 90 of the 90-90-90 targets—ensuring 90 percent of people living with
