Help is on the way for Teton County Health Department nurses buckling under their hefty case loads.
Two new positions — a nurse and a sexual health educator — will be funded for the next three years thanks to a grant from the Wyoming Department of Health’s Communicable Disease Unit.
“We’re really excited to have these additional positions because we’ve seen a significant increase in the demand for our sexual and reproductive health services,” nurse manager Janet Garland said.
The nurse position will assist in sexually transmitted disease screening, HIV case management and outreach activities geared toward populations at high risk for HIV. That person will work to build up pre-exposure prophylaxis — a medicine for those at high risk for HIV — and increase condom distribution sites.
The sexual health educator will serve as outreach coordinator, developing connections with schools and other community venues for sexual health education.
The two employees will work in tandem — one doing education to bring more people in for screening, the other doing the screening itself along with the three nurses already on staff, who also handle everything from influenza to tuberculosis
“Our current staff is trying to do both while trying to keep up with the increase in demand for screenings,” Garland said.
High STD rates and a larger population of at-risk people is why Teton is one of six counties to receive funding for these two positions. The others are Campbell, Carbon, Laramie, Natrona and Sweetwater.
Money is coming from federal funds generated from the purchase of medications and are part of the Ryan White HIV/AIDS Program.
Brittany Wardle, the prevention program manager in the Wyoming Department of Health’s Communicable Disease Unit, said counties were chosen by looking at a variety of metrics, like volume of testing and case loads for HIV case management.
“Each of those counties have a different need in each of those areas, but it was pretty much based on those factors,” Wardle said.
Teton was one of the first to be identified “because we know they could use the help for sure,” she said.
“They have some of the highest volumes for testing in the state,” she said. “They do a great job. And they have a lot of people who are living with HIV that we’re managing.”
Teton County’s high ranking doesn’t come as a surprise to local health professionals — sexual and reproductive health are frequently identified as a priority in the community health needs assessment, including in the 2018 survey.
Unsafe sex was the third most selected choice in the assessment’s community health survey. Twenty-four percent of respondents chose it as the first, second or third choice of risky behaviors that need to be addressed in the community.
Garland said the Health Department has seen a 20 to 25 percent increase in requests for STD screenings. That kind of increase, she said, happens every year. For example, last year her staff conducted 925 chlamydia and gonorrhea screenings, a 25 percent increase from the year before.
“Not only are we seeing an increase in demand for the services, but we’re seeing increased STD rates,” she said. “The bigger issue is that we’re testing more people and we’re maintaining the same rate, so it’s more positive tests.”
Garland pointed to several factors that could be at play in the rise of positive STD tests: an increase in the overall population and a young population at that. Those 15 to 24 years old are at the highest risk, and, in Teton County, 18 percent of the 23,125 residents are under 18 years old.
“We have this younger population, and we have a transient population,” Garland said. “We just have a larger population of at-risk people to screen.”
With the Health Department more fully staffed, Garland said, the community can expect more outreach. The department already works with the public schools as part of their “Making Proud Choices” sexual health curriculum, but Garland said she’d like to see the sexual health educator in more schools.
There’s room for improvement in the younger populations. Youth condom use, for example, is just over 52 percent statewide. The nation’s Office of Disease Prevention and Health Promotion’s goal is 88 percent by 2020, but Teton County teens are lagging behind with a 25 percent use rate.
Any money left over from the two positions’ salary and benefits will be used to pay contracted counselors to work with newly diagnosed STD patients or higher-risk clients, a partnership that doesn’t exist currently.
“We see a lot of people who come in and who are in a lot of distress,” Garland said. “When somebody tests positive, that’s a big impact on their life.”
The newly hired people are expected to hit the ground running. The Health Department has three trainings already scheduled involving their help. One is for health care providers on prescribing pre-exposure prophylaxis, another will cover the counseling approach of motivational interviewing, and the third is a sexual health educator course, parent night and adolescent peer-to-peer training, something other communities are doing that Garland said “we wanted to bring here.”
“The ultimate goal is to reduce STD rates and unintended pregnancies,” Garland said. “We can do that through making connections with some of these higher-risk populations and conducting outreach outside of our building and going where people gather.”