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Dallas Morning News
Ragland: Condom decision is a practical step toward fighting HIV
James Ragland, Op-Ed Columnist
January 13, 2009
I'm all for telling kids to steadfastly abstain from sex until they're married and urging adults to embrace monogamous relationships.

That's why, in theory at least, I had no problems whatsoever with Dallas County's bullheaded ban on free condom handouts in high-risk neighborhoods.

Handing out condoms can readily be perceived as tacit, throw-your-hands-up consent to promiscuous and irresponsible conduct, the sort of sordid sexual behavior that leads to unplanned pregnancies, diseases and ubiquitous moral decay.

Some commissioners certainly felt that way in 1995 when a narrow majority voted to put a quick end to county health workers doling out condoms and needle sterilization kits to those at greatest risk of HIV infections.

It was a well-intentioned - if well-worn - moral stance, a nod to religious conservatives who dutifully argue that the only surefire way to combat sexually transmitted diseases is to preach abstinence and practice celibacy.

Problem is, the condom clampdown hasn't worked here. And Dallas County has suffered the consequences of its highly principled, yet impractical, policy.

Consider this: Dallas County had the state's highest HIV rate in 2006 and 2007. More than 13,500 folks are living with HIV/AIDS in Dallas, a 35 percent increase in the last five years, according to a report by the county's Health and Human Services Department.

The black community is really feeling the brunt of careless lifestyle choices: Black residents make up just 20 percent of the county's population, but they represented a whopping 46 percent of new HIV/AIDS diagnoses in 2007.

Worse still, the infection rate among 13- to 24-year-olds nearly tripled over the last five years. That's a group we can least afford to have succumbing to a virulent disease, particularly when you consider the mounting costs of HIV care. We're talking hundreds of millions of dollars a year, most of which is coming out of the federal till.

So, it's clear that we can no longer rest on the noble notion that faithful and consistent proselytizing alone will lead Dallas - or the nation, for that matter - out of this darkness. We need more practical tools.

Make no mistake, my conservative religious cohorts are right on the mark when they argue that our fundamental challenge still is in overhauling the value systems of those who willingly or unwittingly put themselves in harm's way by sleeping around or sharing needles.

But changing deep-rooted behaviors - an ongoing, epic battle whose end is nowhere in sight - is only part of the solution to this health crisis.

It's also vitally incumbent upon public-health officials to do everything they can to control and curb a disease that poses a very tangible threat.

Dallas County officials took an important step in that direction yesterday by lifting the free condom ban.

It was disconcerting to see county commissioners Kenneth Mayfield and Mike Cantrell vote "no" after Mayfield failed to win a substitute motion that would have precluded health officials from issuing condoms in schools - an issue that certainly bears watching.

Tarrant County has a free condom program, too. And health officials there don't distribute condoms at schools where they go in to talk about sex, said Mark Wilson, the adult health services program manager in Tarrant County's Public Health Department.

But overall, Dallas commissioners did the right thing. And health officials indicated they'll work closely with school districts to allay any concerns.

Wilson, who has worked in seven states and three foreign countries, said it's simply smart, practical public policy to offer free condoms in high-risk areas to stem the rise of HIV infections.

"It's just one tool used to change behavior and help people reduce their risks," he said. "This problem hasn't gone away. It still exists and it's growing."