Nova Scotia's sexual health centres have mostly closed their doors for walk-in service, shifting to telehealth and social media due to COVID-19 concerns.

At the same time, they're dealing with the challenge of increasing demand for their services as people struggle to access good health information.

"We did see a bit of a drop off at the very beginning, and I think that was, you know, people's focus was really on COVID, what's the province telling us to do," said Leigh Heide, the provincial co-ordinator of Sexual Health Nova Scotia. "But that didn't last long before people still have their same needs around their sexual health services."

Heide said the demand has since come back up to a regular level and then escalated even higher than the six member centres had seen before.

"In the last couple of months it's gone quite up because people are really struggling to find the services that they were already struggling to find in a lot of rural communities, STI testing being a huge one," they said (Heide uses the pronouns they/them).

The Halifax Sexual Health Centre has faced an additional challenge because it is the only one of the six centres that also provides medical clinic services and testing for sexually transmitted infections. With the STI clinic at Halifax's QEII Health Sciences Centre closed, the independent clinic has faced extra demand.

Rene Ross is the executive director of the Sexual Health Centre for Cumberland County and a sexual health educator in classrooms. Although she hasn't been working in a school since March, she's rarely been busier.

"The demand is very high, and in many respects the demand is higher. I've never received as many questions from youth, online and in social media, as I have in the past few months," Ross said. "I used to get questions from youth about sexual health and education just once a week or so, and now sometimes it's almost daily."

She has turned to social media such as TikTok to connect with students and get her message out.

She said she's hearing from young people who face stigma when trying to buy supplies like condoms in pharmacies, as people may feel the pandemic has made sexual activity inappropriate.

"The reality is, people are still having sex and hooking up," she said. Ross also points out that sexual health is about healthy relationships and violence reduction as much as it is about contraception.

"I've also been getting an increased number of youth asking for support around being in isolation with homophobic families, about youth who are dealing with anxiety and mental health issues," she said.

"More youth are communicating online now than ever before. They need to know there are laws and legal responsibilities around sexting, around intimate images."

Ross says although the province's plan for the coming school year has been rolled out, she's uncertain whether she will be entering classrooms to offer sex education.

Leigh Heide said services at the various centres are gradually returning to normal, though all centres are at slightly different points in reopening their physical doors.

"They're all gradually getting there," they said. "It's really quite amazing how they've all adapted."

But Heide added sexual health services have always been difficult to access, particularly in rural Nova Scotia, and it's an even greater challenge right now.

"It's a big picture of what sexual health looks like in our province. COVID doesn't necessarily change people's sexual practices," they said.