Dallas County commissioners will decide this morning whether to
allow county health workers to distribute free condoms in
high-risk neighborhoods to combat the spread of HIV.
Before 1995, county health workers routinely ventured into
communities to hand out condoms and needle sterilization kits to
those with the greatest risk of infection. But that year, a
narrow majority of commissioners voted to end the practice,
saying it encouraged illegal and immoral behavior.
Commissioner John Wiley Price raised the issue in a December
meeting after looking at county AIDS statistics, saying it's time
to admit that abstinence education doesn't work.
When they enacted the condom ban, commissioners approved
regulations requiring county health programs to emphasize
Dallas County had the highest HIV rate in Texas in 2006 and 2007,
state officials say. Although the number of new cases is down,
more people are living with AIDS because of better treatments,
county officials say.
County Judge Jim Foster, who supports reversing the condom
policy, says he has enough votes to overturn the ban.
"We should have never had it to start with," he said.
The county health department, the county medical director and the
Dallas County Medical Society also support reversing the ban.
Commissioner Kenneth Mayfield, who voted for the ban in 1995,
plans to present a substitute order that would allow for limited
condom distribution. Under his order, condoms would be given out
only after the recipients received counseling about their risky
behaviors and were told that condoms are not 100 percent
In addition, under Mayfield's proposal, county health workers
could give free condoms only to high-risk individuals with
HIV/AIDS or a sexually transmitted disease, those who have had
sex with someone infected with the virus or an STD, and those who
have had sex with prostitutes.
Mayfield's order would ban condom distribution in schools or "any
venues where children are present."
The current version of the order does not stipulate who should or
should not receive the free condoms. Foster said he does not
support the substitute order, because it limits the ability of
county health workers to distribute condoms as a preventive
Mayfield said that all his version does is state which people
should get the free condoms because of their risky behavior.
"I think that's reasonable," he said.
The county's Health and Human Services department has issued a
report on HIV and AIDS in Dallas County, in which director
Zachary Thompson recommends condom distribution as an option.
His other recommendations include encouraging early testing and
quality medical care for people living with the disease.
The report said the estimated cost to care for HIV patients in
Dallas County in 2007 was $148 million, with public � mostly
federal � money used in nearly 60 percent of cases. The lifetime
cost of caring for the 749 people in Dallas County newly
diagnosed in 2007 is estimated to be $463 million, the report
Other findings include:
* The rate of infection for new cases is disproportionately higher
in blacks. Although they make up just 20 percent of the county
population, blacks represented 46 percent of new HIV/AIDS
diagnoses in 2007.
* The infection rate among 13- through 24-year-olds has nearly
tripled during the past five years.
* More than 13,500 people are living with HIV/AIDS in Dallas, a 35
percent increase in the past five years.
* Men who have sex with men accounted for two-thirds of new HIV
cases, while heterosexual transmission accounted for 27 percent
of new cases.
* The lifetime cost to treat someone diagnosed with HIV is more
In Dallas County, condom availability is not about money. The
Texas Department of State Health Services provides free condoms
to the county's health department, which makes them available in
its clinics to those who ask for them.
Thompson said his department has a mobile medical clinic that
visits neighborhoods with people who have a high risk of
contracting AIDS and other sexually transmitted diseases. It
offers screenings, treatment, testing, counseling and referrals �
but no condoms.
By contrast, health departments in Houston, Austin, San Antonio
and Fort Worth all distribute condoms as part of their outreach
and prevention programs, according to the Dallas County health