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Love Bugs · Healthier Together: Larimer County's Public Health Podcast

0:00
Welcome to Healthier Together, Larimer County's
0:03
public health podcast, where we come together
0:05
for healthier lives, connected communities, and
0:07
real conversations. From your local public health
0:09
team, I'm your host, Tom. And I'm Joanna. This
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is our monthly extended episode where we'll dive
0:14
deeper into public health topics and peek behind
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the scenes of the day -to -day work at the Larimer
0:19
County Health Department. Today, we'll discuss
0:22
how renters can respond to residential mold and
0:25
learn about STIs with our Sexual and Reproductive
0:27
Health Clinic team. But first, we're going to
0:30
talk about Larimer County's new child care sales
0:32
tax and how it relates to public health. Joining
0:35
us to discuss this is Liz Means, Chief Strategy
0:38
Officer at Northern Colorado Kids Thrive. Liz,
0:41
thanks so much for joining us. Thanks for having
0:43
me. I'm excited to be here. To start, can you
0:46
tell us a little bit about Northern Colorado
0:47
Kids Thrive and the work that you do? Yes. Northern
0:50
Colorado Kids Thrive is formerly known as the
0:53
Early Childhood Council of Larimer County. That's
0:55
probably how most listeners will know us. We
0:58
just rebranded in January, so we're excited to
1:01
roll out our new name. And we're calling it NoCo
1:03
Kids Thrive. That's on the streets what we call
1:06
it. And we're bringing together families, providers,
1:10
funders, and local leaders to improve affordability,
1:13
access, and quality of care, and to support the
1:16
workforce. Can you give us a brief overview of
1:18
what 1B is? Of course. So, ballot measure 1B
1:22
is a voter -approved county measure that created
1:26
a dedicated funding source for early childhood,
1:29
specifically for child care and education, through
1:32
a 0 .25 % sales and use tax. which is about 25
1:36
cents on a $100 purchase. And the goal is to
1:39
lower the cost of child care for families, stabilize
1:41
the workforce, and expand access to high -quality
1:44
care across the county. And that passed back
1:46
in November. Yes, it passed in November by a
1:50
pretty thin margin. So we're so excited. What
1:53
did the process of getting one B on the ballot
1:55
look like? Well, it was a lengthy process. It
1:59
took many years, upward of five years. And it
2:03
was very community driven. We started with a
2:05
local public information campaign called Larimer
2:07
Thrive by Five to build awareness and momentum
2:10
for why early childhood is important in our community
2:13
and what the gaps are. Our success was directly
2:16
tied to years of intentional relationship building
2:20
with the county commissioners and other county
2:23
staff. alongside strong data analysis, community
2:27
engagement, and careful policy design. We started
2:31
in the early years with a steering committee
2:32
that helped us design what the ballot initiative
2:35
would look like and what the priorities should
2:37
be. And then I assume that campaign process took...
2:41
quite a bit of time. What did the campaign look
2:43
like and what other groups did you work with?
2:46
Well, the campaign was deeply collaborative.
2:48
We partnered really closely with the United Way
2:51
of Larimer County locally, and we could not have
2:54
done it without critical support from our funders
2:57
at the Children Funding Project, the Buell Foundation,
3:00
and Gary Community Ventures, just to name a few.
3:03
And the strategy and messaging were really guided
3:06
over the years by our political consultants,
3:08
Cody Belsley and Lene Hansen. who have worked
3:11
with some of the most successful early childhood
3:13
initiatives across the state. They were responsible
3:16
for getting Proposition EE passed, which created
3:19
Universal Preschool. And we also worked with
3:21
very experienced pollsters that helped us craft
3:24
messaging that really resonated with people.
3:27
You mentioned it passed by a very tight margin.
3:30
I remember watching votes come in throughout
3:33
the week, two weeks after Election Day, and the
3:37
yes -no kind of going back and forth. What was
3:41
Election Day like for your organization and that
3:44
week afterwards? Yeah, it was intense. It was
3:49
exciting, but also nerve wracking because it
3:52
was so close. And for a while there, we were
3:54
lagging behind. Some news outlets reported that
3:59
we had lost it. And in fact, we did not. But
4:03
it was heartening because our... Policy consultants
4:07
were with us the entire time and they'd been
4:10
through this a time or two and knew that the
4:12
later votes would most likely fall in our favor.
4:16
And so they were just waiting to see the numbers
4:19
come in and kept us all calm. But it was really
4:23
exciting like that night and then the next couple
4:27
of days we were just on edge and waiting for
4:29
updates, refreshing. And when we finally realized
4:33
that the numbers were... closing in and there
4:36
was no opportunity for us to lose, that's when
4:39
we started to really take a sigh of relief and
4:43
then start to celebrate. So now that we know
4:46
it passed, 1B created a 0 .25 % sales tax that's
4:53
new for Larimer County for early childhood care
4:56
and education. When will that tax start being
4:59
collected? That's exactly right. So the tax collection
5:02
began January 1st, 2026. It's currently collecting
5:07
right now, but we are using 2026 as a planning
5:12
year and we're intentionally going slow so that
5:15
A, we can give the tax revenue time to collect
5:19
and then Also so that we can design a very impactful
5:24
and effective program. This first year, we'll
5:27
only be drawing down a fraction of the total
5:29
revenue. And so because of that, we are just
5:33
starting a couple of the pilot programs and some
5:36
early wins that we're planning. But we'll be
5:39
starting to draw down the full amount in subsequent
5:41
years. And do you know how much the tax is expected
5:45
to raise? Yes. Once it's fully implemented, the
5:49
tax will generate approximately $28 million per
5:52
year. Early childhood education is a big umbrella.
5:57
How will these tax dollars be used to support
6:00
that big system? Yeah, so these dollars are going
6:05
to be broken down into three to four buckets,
6:09
the two biggest of which are lowering the cost
6:13
of care for families. So we'll do that in the
6:15
form of tuition offsets. And the other huge bucket
6:19
is for educator wages. So we want to increase
6:22
educator wages, and that will help support recruitment
6:26
and retention, stabilize the workforce. The other
6:29
buckets that are also important but a little
6:31
bit smaller are going to be capital improvements,
6:35
so building new facilities, improving classrooms.
6:38
And then quality improvements kind of across
6:41
the board, which is a lot of what NoCo Kids Thrive
6:43
has been providing to the community to date.
6:46
It comes in the form of in -classroom quality
6:49
coaching, early childhood mental health consultation,
6:51
and other wraparound supports. You mentioned
6:54
support for tuition. Do we know yet what that
6:58
might look like, if that's supporting sliding
7:01
scale fees or tax incentives for parents, how
7:05
that might play out? Yeah, exactly. It is going
7:10
to be based on a model called targeted universalism.
7:13
So everybody will be eligible, but there will
7:15
be a sliding scale so that people with the greatest
7:17
need receive the greatest benefit. And we are
7:21
currently in the process of designing exactly
7:23
what that will look like. We have a program called
7:27
Larimer Child Care Fund or LCCF, which is a partnership
7:30
between NOCO Kids Thrive and United Way of Larimer
7:34
County that we will. likely be expanding. So
7:38
that is our existing model for getting money
7:41
into the community to offset the cost of care.
7:45
But right now we're dealing with a lot less money.
7:49
And then you also mentioned for teachers and
7:51
providers and people who work in early child
7:53
care education helping to increase wages and
7:57
improve retention. Do we know what that might
7:59
look like yet? That is probably the area of the
8:03
biggest lift. For me personally, I oversee the
8:06
workforce program. And so that's something that
8:09
we're really looking at because we don't necessarily
8:12
have an existing pilot that we're going to scale.
8:14
It's something that we're going to need to create
8:16
new structure for. The good news is there are
8:19
a lot of other communities who have come before
8:21
us and have done similar things with wage and
8:24
salary subsidies. So right now we are in the
8:27
research phase and examining case studies and
8:30
trying to design a system that's going to work
8:33
well in Larimer. So we've talked about the ways
8:36
that 1B will benefit our early childhood education
8:39
system and families in Larimer County. But from
8:43
a wider perspective, how does... quality early
8:46
childhood education benefit the wider community
8:49
in the long run? Well, quality early childhood
8:51
education supports working families, strengthens
8:54
the workforce, it boosts the local economy, leads
8:57
to better outcomes in health and education across
8:59
the board. And research shows that high quality
9:02
early childhood investments return $4 to $9 for
9:05
every $1 invested. So it's just... Huge returns
9:08
on investments, and that pays dividends in the
9:11
form of how healthy our community is over the
9:13
long term. If listeners would like to learn more
9:15
about 1B or NoCo Kids Thrive or get involved,
9:20
where should they go? You can check out northerncoloradokidsthrive
9:23
.org online. You can follow us on social media
9:26
and sign up for our newsletter in order to stay
9:29
up to date on the latest news on implementation
9:31
and some of these new programs that we'll be
9:34
rolling out in the coming years. Great. Thanks
9:36
so much for joining us. Thanks for having me.
9:39
Here at the Health Department, we often get questions
9:41
from runners about how to deal with mold in their
9:43
homes. Here to provide some guidance is Noelle
9:45
Udell, Environmental Health Team Lead. Noelle,
9:47
thanks so much for joining us. Yes, thanks for
9:50
having me. So if someone's apartment or home
9:52
does have mold, what should they do? Good question.
9:55
So if you find mold in your apartment or rental
9:58
unit, the very first step we recommend is documentation
10:01
and communication. Take clear photos or videos
10:04
of the mold and any visible leaks or moisture
10:07
and immediately contact your landlord in writing
10:10
to notify them of the problem, whether that's
10:13
by email, letter, or in some cases, a maintenance
10:16
portal. Under Colorado law, landlords generally
10:19
need to be given a notice and a chance to fix
10:22
the problem. You should also check your lease
10:24
agreement for any specific notification procedures
10:27
and other terms like maintenance responsibilities
10:30
for both the landlord and tenant. We often get
10:33
asked if a tenant should test for mold. However,
10:36
if mold is visible, testing is generally not
10:39
recommended as the first response. And that's
10:42
because the presence of mold growing indoors
10:44
already indicates that there's a moisture issue
10:46
that needs to be fixed. Gotcha. So it sounds
10:50
like it's kind of documentation first to kind
10:52
of provide that framework. And is there a way
10:54
that they can then also reach out to the health
10:56
department? Yes. So you can contact us by calling
10:59
our main office. You can also reach out to file
11:02
a complaint if you'd like, and we can contact
11:04
you that way. Gotcha. So it seems like this is
11:07
a public health issue. Do you know why the health
11:10
department might not take a more active role
11:12
in some of the mold issues and complaints that
11:14
we get? Yeah, so that's a common question. So
11:16
while mold can be a health concern, the health
11:19
department does not have an active mold inspection
11:21
or remediation program. In part, this is because
11:24
there are no local, state, or federal standards
11:27
that establish safe or unsafe levels of mold
11:30
or mold spores in private homes or buildings.
11:33
So if you think about it, mold spores are found
11:35
everywhere in the environment. That's indoors,
11:38
that's outdoors. And since mold spores grow where
11:41
there's surfaces that have sufficient moisture,
11:44
the presence of mold really indicates that there's
11:46
an underlying water damage or moisture problem.
11:49
So that can be from leaks, flooding, or maybe
11:52
a ventilation issue. And because the consensus
11:55
in general is that mold should be addressed by
11:57
fixing that moisture source. These issues are
12:01
primarily viewed more as a property maintenance
12:03
or landlord -tenant civil matter rather than
12:06
a reportable public health hazard. So that's
12:08
why in these situations we tend to see that it's
12:11
left to landlord -tenant law. Gotcha. Yeah, and
12:14
if there aren't any federal or state guidelines,
12:16
that makes it very difficult for, I'm sure, the
12:18
health department to follow up and have any kind
12:20
of enforcement. So after informing the health
12:23
department, you'd mentioned that there are documentations
12:27
and steps that... you encourage them to go to.
12:30
Is there anything else a renter should do to
12:32
encourage their landlords to correct any kind
12:34
of mold issues that they're concerned about?
12:36
Yeah. So like we mentioned, and if you haven't
12:38
already, that first step is really reporting
12:41
the issue to your landlord in writing. So it
12:43
can often be helpful to remind them that mold
12:45
is a symptom of a larger moisture problem that
12:48
could damage their property long -term. And if
12:51
you've already contacted them once and feel like
12:54
the issue isn't being addressed, you might want
12:56
to consider sending a second written notice.
12:58
The law requires landlords to maintain a general
13:01
habitable environment and visible mold can potentially
13:04
indicate a breach of that requirement. So reminding
13:07
of those requirements can be helpful as well.
13:09
Gotcha. And if that fails, then are there additional
13:12
legal channels a tenant could pursue to try and
13:15
get the mold issue fixed? Yes. So if you have
13:17
any legal questions about your rights as a tenant
13:20
or what legal steps to take if your landlord
13:22
is not addressing an issue. We recommend and
13:26
strongly encourage that you contact legal counsel.
13:29
They're likely free and low cost legal resources
13:32
available for you in your area if you qualify.
13:34
So it's definitely worth taking a look into.
13:37
And they can help you navigate the specific requirements
13:39
of the law to make sure your specific situation
13:42
and concerns are handled correctly. Gotcha. So
13:45
it sounds like there are still some options people
13:47
can pursue if they need to. Is there anything
13:49
else you'd like our listeners to know about mold
13:51
issues? Yes. I think a lot of the questions that
13:55
we get tend to be around, where can I find more
13:58
information or education on this? So the health
14:01
department focuses a lot more on the educational
14:03
side. So you can always start by contacting us
14:06
or searching for online resources like the Environmental
14:09
Protection Agency's website. They have great
14:11
information on mold and proper cleanup protocols.
14:15
And then if you need to take further action,
14:17
I'd suggest looking at maybe three main resource
14:19
areas. So the first is for structural or safety
14:23
issues. So if mold is caused by a leak or poor
14:26
ventilation, your local building authority or
14:29
code compliance might be able to assist if it's
14:32
within their scope. The second is information
14:35
for legal help and tenants' rights. So Colorado
14:38
has a warranty of habitability law that we alluded
14:41
to a little bit earlier, and that requires rentals
14:45
to be safe and fit for human habitation. So organizations
14:49
like Colorado Legal Services, Colorado Housing
14:52
Connects, or FixMyRental .org can be excellent
14:56
to reach out to because they can help you understand
14:58
your rights. And they might actually be able
15:00
to provide templates for more formal demand letters
15:03
to send to your landlord. That's good information
15:05
for our listeners to have. Noelle, thank you
15:08
so much for joining us. I really appreciate you
15:09
taking the time. Thank you. On the heels of Valentine's
15:13
Day, we are joined by Meg Vertigbeck, senior
15:16
nurse practitioner in our sexual and reproductive
15:18
health clinic, here to talk about love books,
15:20
a .k .a. STIs, and how to take care of your sexual
15:23
health. Meg, thank you for joining us. Thanks
15:25
so much. So what is an STI? Great question. So
15:29
STI stands for sexually transmitted infection.
15:32
So these comprise infections that are caused
15:35
by germs that can be bacteria, a virus, or even
15:40
a parasite that is spread typically by sexual
15:43
content. It can also be spread via blood or even
15:46
from parent to baby during birth. Gotcha. So
15:51
how common are STIs? STIs are surprisingly common.
15:54
So at any given time, the CDC purports that one
15:58
in five people in the U .S. have an STI, so 20
16:01
% of people. Wow. What are some factors that
16:04
increase the risks of contracting an STI? So
16:07
it's important to understand that anyone who
16:09
is sexually active is capable of acquiring an
16:11
STI. There's not like a specific type of person
16:14
who is more at risk. It really does come down
16:19
to risk factors. Youth are the folks that we
16:23
see most commonly coming in with STIs. Almost
16:27
50 % of new sexually transmitted infections are
16:30
among those 15 to 24 in the U .S. Also, the more
16:35
sexual partners you have, the more potential
16:37
exposures you have. And so that places you at
16:39
higher risk. So you think of other infections
16:42
that are spread differently, like the common
16:44
cold or COVID or flu. The more you're out and
16:47
about, the more you're going to be at risk. And
16:49
so similarly, the more... different partners
16:53
you have, the more exposures you have. So the
16:55
more opportunities you have to acquire an infection.
16:57
Yeah. Also, if you're not using barrier methods,
17:01
so those are things like condoms, dental dams,
17:04
that would increase your infection, kind of like
17:06
we saw in COVID if you weren't wearing a mask.
17:08
That's one way to protect yourself. Condoms kind
17:11
of function similarly, obviously, in a very different
17:14
form of transmission. And then also if you just
17:18
don't have regular access to health care, so
17:20
you don't have opportunities to get tested or
17:23
treated, you're going to be at higher risk as
17:25
well. What are the most common STIs that you
17:28
see? So the most common STIs that we see are
17:33
things like chlamydia, gonorrhea. herpes. But
17:37
we really do see a wide range here at the health
17:39
department. So things that people probably haven't
17:41
heard of as much like trichomoniasis, mycoplasma,
17:44
genitalium. We see a lot of a wide variety. We've
17:49
also noticed in Colorado over the past year,
17:52
there's been a significant increase in syphilis.
17:54
And so that has been something we're commonly
17:57
seeing in patients in our clinic, as well as
17:59
things like HIV. And what are some common symptoms
18:03
of STIs? What are some things that people can
18:05
be on the lookout for? That's a great question.
18:09
So one of the trickier things about STIs compared
18:12
to other infections is oftentimes people don't
18:15
have any symptoms. And so that can be unusual
18:19
or unexpected. People don't realize that these
18:22
infections can be living in your body and you
18:25
just have no way of knowing. So oftentimes people
18:28
have no symptoms at all. If folks are to have
18:30
symptoms, there can be a wide variety. Some symptoms
18:33
are more localized, so you would experience things
18:35
like pain when urinating, vaginal or penile discharge,
18:40
new rashes in the area. However, other infections
18:43
cause more systemic or full -body symptoms, so
18:46
we can see things like rashes across your whole
18:50
body. Some even cause things like fever and chills,
18:53
and so there can be a big variety in symptoms.
18:56
What steps can people take to prevent getting
18:58
an STI? Great question. So prevention is always
19:02
the best approach, right? We'd rather prevent
19:05
something than have to treat or manage it. So
19:08
some easy ways to prevent STIs are first just
19:12
having honest conversations with your partners.
19:15
And so checking in with folks you're going to
19:18
be sexually active with to see. Kind of understand
19:22
their health status, understand their risk factors,
19:24
the steps they take to prevent infections. Getting
19:27
tested regularly is always a great approach.
19:30
And so, you know, depending on how many partners
19:33
you have and how sexually active you have, that
19:35
can be every three months. Coming in, getting
19:37
tested, especially when you don't have symptoms,
19:40
because that's a great way to catch those asymptomatic
19:44
infections, infections not causing symptoms.
19:48
Also using barrier methods like I mentioned before.
19:50
So those are things like condoms or dental dams
19:52
can prevent infections as well. So what happens
19:57
when someone goes in for a test exactly? That's
20:00
really important to understand because I think
20:01
that's a point where people get really overwhelmed,
20:06
stressed, and then avoid, right? No one really
20:09
likes coming to any sort of clinic, especially
20:11
a sexual health clinic. We get that. as unintimidating
20:19
as possible. So when you come in, a lot of the
20:22
visit is just going to be talking about getting
20:24
to understand your risk factors, your history,
20:27
the things that we need to test for based on
20:31
what you tell us. And so a lot of it is conversational.
20:35
And then getting tested is not nearly as bad
20:38
as many people think. And so in recent years,
20:41
we've moved away from requiring exams, especially
20:46
in people who aren't having symptoms. And so
20:48
that means that oftentimes patients can collect
20:51
their own specimens for tests. They don't need
20:54
to have an intimidating pelvic or genital exam.
20:57
No one wants that. And so we want to make sure
21:01
that this is approachable and inviting. And so
21:03
folks can collect their specimens that can involve
21:07
like a urine sample that can involve for women
21:10
collecting their own vaginal swab. rectal swabs
21:14
depending on the different sexual activities
21:15
that folks practice sometimes we'll also get
21:17
an oral swab and then blood work is common not
21:22
all infections require blood testing to diagnose
21:26
an infection, but things like HIV and syphilis
21:28
can only be diagnosed or are typically diagnosed
21:31
via blood tests. And so a prick in your arm,
21:34
but usually it's done within a couple minutes.
21:37
And so it can be a lot of mental buildup for
21:40
a visit that really takes 10 to 15 minutes. Gotcha.
21:43
And how quickly do people typically get their
21:45
results back? Our lab turnaround is often within
21:49
48 hours. It's quicker than a lot of people think.
21:53
You know, some labs take longer to process, but
21:56
the most common infections that we're testing
21:59
for, we can get back within the week. Gotcha.
22:02
And how do people make an appointment to get
22:04
tested? Yeah. So if they're looking to come to
22:08
the health department at our clinic, they can
22:10
call the main health department phone number
22:12
or find us on Larimer .gov slash sexual health.
22:16
And we can often get people in within the week.
22:19
And so, you know, I know it can get it can be
22:21
really hard, especially if you aren't established
22:23
with a primary care provider somewhere to get
22:25
in as a new patient. But fortunately, we're able
22:28
to get people in quickly for these visits. And
22:31
so, you know, all that time. People often spend
22:34
stressed about, oh my gosh, should I do this?
22:36
I don't want to do this. When will I get the
22:37
results? I would encourage you just pick up the
22:40
phone and call and you can take that action,
22:43
take that step and have those results back within
22:45
a few days. Gotcha. So let's say somebody comes
22:48
in and they do get tested and the results are
22:50
not what they hoped for. What kind of STIs, or
22:55
I guess, what does treatment look like then?
22:56
I'm sure it's dependent on the STI, but in general,
22:59
what can somebody expect? Yeah, sure. And so
23:03
I think the fear of getting that bad news is
23:06
often the number one reason people don't want
23:08
to call, right? Besides being scared of what
23:10
will this visit look like? What kind of exam
23:11
do I need? How do I even get tested? And so I
23:15
like to ahead of time tell everyone nothing is
23:18
the end of the world. You know, worst case scenario,
23:21
you get a test result you don't want. There's
23:24
kind of two camps you can think of. Our infections
23:27
caused by bacteria can be treated and cured,
23:30
and so those can be managed, sometimes as simple
23:33
as two pills, two antibiotics to treat the bacteria.
23:37
Some require a longer course of medication, like
23:40
taking an antibiotic with breakfast and dinner
23:44
every day for a week. Sometimes things like gonorrhea,
23:49
syphilis require an injection, so a shot of medication.
23:55
The specific infection that can be once, that
23:57
can be multiple shots, but those can actually
23:59
be totally cured, which I think is really reassuring
24:03
to people. Are infections caused by viruses?
24:07
So that would be... primarily herpes or HIV,
24:11
we don't have a treatment for those infections.
24:14
That said, we do have medications that can manage
24:17
them. And especially with something like HIV,
24:21
which I think is still fairly misunderstood and
24:24
unfortunately quite stigmatized in our society,
24:26
the landscape has totally changed in the past.
24:31
you know, in more recent years. And so people
24:33
living with HIV can take one tablet once a day
24:37
for the rest of their life and really lead a
24:39
super normal, healthy, long life. They can have
24:43
families, they can have partners, they can have
24:45
children. And so I like to go through with that
24:48
with people ahead of time, just so, you know,
24:50
we can manage their expectations. Of course,
24:53
we want to avoid acquiring these infections in
24:55
the first place, but things happen. And knowing
24:57
that There are steps we can take either to cure
25:00
these infections completely or to manage them
25:03
and allow you to have a healthy, long, happy
25:06
life. I think it goes a long way towards making
25:09
people feel more comfortable even seeking out
25:11
the test in the first place. Absolutely. If you
25:14
do have an STI and don't get the recommended
25:16
treatment for it, are there any long -term impacts?
25:20
Yeah, so depending on the infection you have,
25:23
there certainly can be long -term effects. So
25:25
things like chronic pelvic pain, it can affect
25:29
fertility in both men and women potentially.
25:31
If you have an infection that you don't know
25:33
about or you don't get treated and you become
25:35
pregnant, that can cause complications. The more
25:39
serious infections like syphilis and HIV can
25:42
have long -term effects on multiple body symptoms,
25:45
whether that's your neurological system. your
25:48
immune system. And so it's definitely, like we
25:52
say, prevention is always better than treatment,
25:55
but early treatment is much better than delaying
25:58
that treatment. I know it's human nature to sometimes
26:02
know something's wrong, but want to avoid it,
26:05
kick that can down the road. But again... I really
26:08
encourage people to pick up the phone and call
26:10
if something doesn't feel right. The sooner we
26:12
can get you in, you'll feel better mentally and
26:15
emotionally because we're tackling the problem
26:16
head on. And then you'll also feel better physically
26:18
because we can get you the care you need, hopefully
26:21
to prevent those long -term issues. I think it's
26:24
also helpful for folks to know if you have a
26:27
known exposure, so that means a partner comes
26:30
to you and says, hey, I just tested positive
26:33
for this, or they have symptoms that are really
26:37
suspicious for an infection, come in. Sometimes
26:40
we can even treat you the same day you come in.
26:43
We call that empiric treatment or treating based
26:45
on your symptoms or based on your history where
26:48
it's compelling enough that we say, you know,
26:50
we'll get these results back in two days. Let's
26:53
just go ahead and give you the treatment. These
26:55
treatments are really safe, and we'd rather have
26:57
you get treated and then ultimately not need
27:00
it than to be potentially untreated. And so we
27:03
do provide both empiric treatment, so treatment
27:06
before getting those results back, or in the
27:08
case of... you know, someone coming in and we're
27:11
not as certain or they don't have symptoms at
27:13
all, we would call them back as soon as we get
27:16
those results and encourage them to come see
27:19
us for treatment or if they'd rather go elsewhere,
27:21
they could do that as well. And where can people
27:23
find more information about STIs? That's a great
27:26
question because I know, especially about these
27:28
topics that are a little bit more sensitive,
27:31
a little bit more, unfortunately, still stigmatized.
27:34
People are nervous to talk to you know, to come
27:39
into the clinic and have an appointment and often
27:41
will seek out that information on their own,
27:43
which I want people to feel empowered to, you
27:45
know, get that information and not wait until
27:50
they see a provider. That being said, it can
27:52
be hard to navigate what is good quality information
27:58
and what's, you know, lesser quality information.
28:01
So I would encourage people to You know, follow
28:05
up with your health care provider, a health care
28:07
provider, and they can help navigate you towards
28:10
sources that would be high quality, scientific,
28:13
evidence based. Because we do see just a lot
28:16
of like fear based information online that isn't
28:19
always accurate and can cause patients to come
28:22
in with a panic thinking that their life is over
28:24
or that, you know, they're going to be experiencing
28:27
specific symptoms or long term issues that really
28:30
aren't. valid. And so I would say, talk to a
28:34
healthcare provider and they can help you find
28:36
trusted resources that you can depend on in between
28:38
visits. I'm sure that's even getting worse with
28:41
like AI. Yes. I was just thinking that going
28:44
into a healthcare provider is always better than
28:47
relying on AI. You know, we did want to ask,
28:51
you know, what is the... the weirdest myth or
28:54
misconception that people have about STIs that
28:57
you've heard in your clinical experience? Yeah.
28:59
So I think there's a lot of myths. One is just
29:05
in general about how STIs spread. And so I think
29:09
that that has hopefully been dispelled more than
29:12
even when I was in eighth grade health class.
29:16
But there's still people who are really worried
29:19
that... you know, shaking hands, hugging, sitting
29:22
on a toilet seat can spread certain infections.
29:24
And that's just not how these infections spread.
29:28
And so knowing that I think is really important,
29:31
especially because that can lead to stigma, right?
29:34
We'll see a lot of people are so hesitant to
29:38
disclose, even if they've had a treated infection,
29:40
because there are so many misunderstandings out
29:43
there. And then that leads to this vicious cycle
29:46
where people are self -conscious to disclose.
29:49
And then, you know, these infections continue
29:52
to spread because people don't talk about it
29:54
or people are poorly educated. And so I think
29:57
one is just knowing how they spread and two,
30:00
that they are really common. And I think that
30:02
also helps normalize things, right? Like you're
30:04
not in this tiny minority if you've experienced
30:09
a sexually transmitted infection. Actually, many,
30:13
many, many people do. And by By kind of like
30:18
refusing to talk about it or closing it up in
30:22
a box and putting it in the closet, we're perpetuating
30:25
the problem. And so that's a big one. And then,
30:28
of course, crazy things on TikToks. You know,
30:30
I think nowadays people will come in and say
30:33
like, oh, well, I heard that if you eat strawberries,
30:37
you can't get an infection because of the acidity.
30:40
And so I always try to talk to patients about
30:43
those because I've yet to find. a crazy fact
30:47
like that that has been proven correct, but I'd
30:50
love for my patients to prove me correct. I'd
30:53
love if we found that lemons can cure chlamydia,
30:55
but not to my knowledge quite yet. Meg, you talked
30:59
about this a little bit in reference to HIV,
31:03
but how has STI testing, treatment, prevention
31:06
changed over the course of your career? I think
31:10
one of the big things is the push towards self
31:13
-swabbing. And so when I first started, that
31:16
wasn't really an option. Like if you needed to
31:19
collect a vaginal swab or a rectal swab on a
31:23
patient, the healthcare provider was always the
31:25
one to collect that specimen. And I'm so glad
31:29
that we're realizing that you don't need to go
31:31
to school for a bunch of years to do that. And
31:33
really, we're going to have a bigger impact if
31:37
people feel more comfortable coming to our clinics
31:39
to get these tests done. And a great first step
31:42
is allowing patients to have some of that bodily
31:44
autonomy and that you can provide in one minute
31:49
simple instructions and post them in the bathroom
31:51
how to collect these swabs. And people will feel
31:54
way more comfortable collecting those tests.
31:57
and coming in for a visit if they know they can
31:59
come in and within, you know, five minutes their
32:02
specimens can be collected, they can stay fully
32:05
clothed, you know, they don't need to have an
32:08
exam if they're not experiencing symptoms. And
32:10
so I think there's been a really positive movement
32:14
towards centering the patient and also trusting
32:17
the patient to be more of a partner in their
32:19
health care, which... Before, it was kind of
32:23
this paternalistic mentality where only the provider
32:26
had the skills to collect that swab. I think
32:31
that was really harmful and is a reason that
32:33
a lot of people don't want to access this type
32:35
of health care because it feels so sensitive
32:39
and delicate and allowing the patients to feel
32:43
empowered to be more of a partner. We are a team
32:46
navigating this together, figuring this out together.
32:49
I might know a lot about chlamydia, but you know
32:53
your body better than anyone. And so working
32:56
more as a team has been a really positive shift
32:58
that I've seen. I still remember like sitting
33:01
in my seventh grade health class and the way
33:03
that we were taught about STIs was so stigmatizing
33:06
and scary and fear based and really like put
33:12
a lot of blame on the individual. And I don't
33:15
think that's healthy or. helpful for any type
33:19
of infection, whether it's sexually transmitted
33:23
or a respiratory infection or other chronic conditions
33:27
from like diabetes or hypertension. And when
33:30
we put all of that blame on the individual, we're
33:33
really not taking the perspective of what can
33:36
we do as a society to help make our community
33:38
healthier. And really a lot comes down to, you
33:42
know, education, prevention, having healthcare
33:45
access so people, regardless of their insurance
33:48
status or identity or background, can access
33:50
the care they need to get testing, to get education,
33:53
to get preventative care methods. And so I think
33:57
I wish that the community knew that, you know,
34:03
we really at... our clinic treat STIs just like
34:06
we would treat if you're coming in with cold
34:08
symptoms or symptoms of any other infection and
34:11
normalizing it, that it's just another part of
34:15
your health and another part of your body. And
34:17
we should care for it just like we would if you're
34:22
experiencing, you know, respiratory infection
34:25
symptoms. And so normalizing it goes a long way
34:28
to removing the stigma. And I think that allows
34:31
us to provide higher quality education. better
34:34
healthcare access, and improve the health of
34:38
the community overall. I'm thinking that, you
34:41
know, you've mentioned the word stigma several
34:42
times and part of that's like, okay, you know,
34:44
this is a very personal, you know, subject for
34:47
somebody to share with a provider. I think that
34:50
there might also be the perception like, okay,
34:52
I tell my provider, then who else knows? Like,
34:55
so can you talk a little bit more about some
34:57
of like the privacy practices at the clinic or
34:59
just like any clinic in general? for best practices
35:02
should be using to, you know, protect that privacy?
35:05
You know, anything you tell your health care
35:08
provider, as long as we're not worried about
35:10
the safety of the community at large or, you
35:14
know, your immediate safety, that is confidential.
35:18
And so we want patients to feel comfortable disclosing
35:22
those things to us. And so that goes into their
35:27
medical record. That should only be accessed
35:31
by other people who are on a need -to -know basis.
35:34
And so really that information is confidential
35:36
and kept secure. So that kind of brings me to
35:40
another question that I had. In the current political
35:44
climate, it seems like there's things that are
35:46
changing with vaccine recommendations and things
35:48
like that. Have you guys seen anything in your
35:50
clinics that kind of reflect some of the changes
35:52
coming down? There are changes as far as the...
35:57
information you can find on certain federal websites
36:01
that used to be more readily available. And so
36:05
I think that is something that's shifting and
36:08
certainly like language on some of those documents
36:12
is shifting. And so I'm glad you brought that
36:15
up because I'd like to underscore that at our
36:17
clinic, you know, we continue to. care for patients
36:21
of all identities and backgrounds, and we respect
36:24
all identities and backgrounds of our patients.
36:26
And so I wouldn't want the fact that we are a
36:29
local government agency to lead folks to feel
36:33
like they wouldn't be safe seeking care at our
36:35
clinic. And another question that I had is, do
36:38
you have any tips for parents about how they
36:40
can talk to their kids about like STIs? Yeah.
36:44
I think the first step is knowing that you should
36:46
talk to them. I think this is probably still
36:49
a little bit of a holdover from older generations,
36:53
but some people still believe that talking about
36:57
things wills it into existence. And so we'll
36:59
see that with HPV vaccination. Parents are worried
37:04
that if they talk about what HPV is, human papillomavirus,
37:09
what the vaccine is protecting against. that
37:12
will somehow spontaneously cause their kids to
37:14
become sexually active at age 11. And that's
37:17
just not the case. And so I think talking to
37:22
your kids and your teens in developmentally appropriate
37:26
ways is huge because everyone benefits from having
37:31
a trusted adult. Like we talked about earlier,
37:33
it's becoming increasingly difficult to find
37:35
high -quality information online. Kids and teens
37:39
are going to have questions about this stuff.
37:41
And so we want to make sure that they're getting
37:43
their questions answered by trusted resources.
37:46
And so I think parents can think like, okay,
37:48
would I rather have ChatGPT answer this question?
37:51
Would I rather have some influencer on TikTok
37:53
answer this question? Or would I rather have,
37:55
you know, the parents answer this question or
37:58
their pediatrician answer this question? And
38:00
so, you know, kids are going to have these questions.
38:03
And so just having an open dialogue. And it's
38:07
okay to tell them, you know, if they have a question
38:09
you don't know, tell them you don't know. I think
38:11
learning how to find good answers when you don't
38:14
know is something you could explore together,
38:15
right? And so I think the first step is just
38:18
doing it. It's, it's awkward for parents and
38:21
that's okay. So owning that even with your kid
38:24
is, is important saying like, this stuff is hard
38:26
to talk about. I do it for a living and it's
38:28
still hard to talk about sometimes. And so putting
38:31
that out there sometimes helps kind of set the
38:35
tone. Like we're in this together. This stuff
38:37
is tricky. It's complicated. We can feel kind
38:40
of. awkward talking about it, but that's not
38:43
a reason we shouldn't talk about it. That's probably
38:44
a reason we need to dig deeper and have that
38:46
conversation. Because you, like I said, you really
38:51
want your kids to be coming to you with these
38:54
questions and not trying to find the answers
38:57
elsewhere. So Meg, if somebody wanted to then,
39:00
you know, find more information or contact the
39:03
health department, how can they find us? Yeah,
39:05
they can give us a call at 970 - 498 -6700 or
39:10
find us on Larimer .gov slash sexual health.
39:13
Perfect. Thank you so much, Meg, for joining
39:14
us. We really appreciate you making the time.
39:16
Thanks for having me. Thanks for listening, Larimer
39:19
County. Until next week, stay well, stay connected,
39:22
and remember, we really are healthier together.