After feeling lost and confused while experiencing their own sexual health issues, Stephanie Estey and Daphne Chen decided to open their own clinic, TBD Health.
“We often felt like we weren’t sure what to do,” said Estey. “Whether it was a one-night stand or a condom breaking, in those moments of panic we weren’t sure who to turn to.”
Initially, the co-founders began offering at-home sexually transmitted infection testing kits, with the idea of making it easier for individuals to test at home and reduce any anxiety or stigma. Now, Estey and Chen are opening the doors of their second in-person location of TBD Health in Denver’s ballpark district at 2101 Larimer St. on Oct. 4. The healthcare hub is a sex-positive space where individuals can access comprehensive sexual healthcare.
“We really set out to build something that felt sex-positive, nonjudgmental, human, and approachable. Something that people could access in a way that felt comfortable for them,” said Estey.
The opening of the healthcare hub comes months after the Center for Disease Control and Prevention released the 2021 STD surveillance data, which reported an increase in STI cases across the country. And Denver is no exception. Dr. Zeeshan Ahmed, an emergency medicine specialist at AFC Urgent Care in Denver, said STIs are a very common thing they see at urgent care.
“I’ve been practicing for 16 years now and anecdotally, I’ve noticed an increase in STIs,” Dr. Ahmed said. “We see patients that are young and healthy, they come to us for periodic STI testing, but we also treat a number of STIs. It’s a very common thing.”
Lacy Mulleavey, prevention and field services program manager for the Colorado Department of Public Health and Environment, has primarily worked in the office of HIV/STI and viral hepatitis for the past 12 years, where they have seen an increase in cases throughout the state.
“It’s evident that the burden of STIs has been increasing over the years,” Mulleavey said. “We have seen the most drastic increase in syphilis—from 2021 to 2022 we saw a 35% increase.”
While there can be multiple factors that contribute to the increase in cases, Dr. Ahmed believes there are four main components causing issues.
“We can’t point to one specific factor, but I think it’s the combination of funding for campaigns have reduced, condom use has decreased, online dating, hook up apps has contributed, and I think the increase in risky sexual behavior,” he said.
Although COVID-19 has largely been left in the past, Mulleavey said it also played a role in the increase of cases, by stretching the public health workforce thin and causing a limitation in testing sites around communities.
“We had individuals who were providing services and they got deployed to doing COVID outreach and deployed to doing monkeypox. When we were referring people to testing, there weren’t places because clinics were shutting down,” she said.
One important aspect of remedying the increase in STIs is to combat social stigma, which Mulleavey said can have a big impact on how and when people access sexual health services. However, she said it is important to acknowledge that anyone who is sexually active can get an STI and there are many ways to prevent these forms of infections, some as simple as an open and honest conversation with your partner.
“The easiest ways to prevent an STI are going to be through condom use, making sure you talk to your partners, getting tested and maybe perhaps getting tested with them,” Mulleavey said. “If testing positive, make sure that you are getting treated as soon as possible.”
For many people, STI symptoms can be asymptomatic. Dr. Ahmed says symptoms can vary depending on the infection. He has encountered patients who visit his location for recurrent STI testing, but for many this possibility may be difficult or uncomfortable. The TBD Health team has taken this issue into consideration and has created multi-platform hybrid care.
“When it comes to sexual health, people want to access it differently,” Estey said. “Some people want to have a private experience at home where you can go online, order a kit, and have it shipped to you. Other people prefer to talk to someone. We’ve really tried to build TBD to be as comfortable for so many different people and how accessing sexual healthcare feels [right] to them.”
The modern 1,400-square-foot TBD Health facility will be equipped with sensitivity-trained, trauma-aware clinicians who offer a shame-free environment.
“We ask about pronouns, ask if it’s okay to touch you, walk you through all the steps that will happen in an appointment, so you feel comfortable,” Estey said.
They will offer patients access to STI testing, birth control, exams, treatments, and in-person or telemedicine consultations at an affordable price.
Aside from the variety of services, TBD Health will also offer coaching sessions and community workshops to help better understand individuals’ sexual health. Estey and Chen chose the LoDo neighborhood because they believe TBD Health will be most beneficial to the surrounding communities.
“We really tried to build TBD to be as comfortable for so many different people,” Estey said. “If people are looking at how they can have a great sex life in all the different factors, not just the medical side of things, TBD is a place they can come.”