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Dallas Morning News
Dallas County officials to vote on free condom distribution
Kevin Krause,
January 13, 2009
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 abstinence.

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 effective.

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 measure.

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 said.

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 than $600,000.

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 department.