But here's the funny part: "I really didn't want them," says Metairie resident Bill Graham, describing how he drove in the heat of a day last July to 3101 West Napoleon Ave. -- the Jefferson Parish Human Services Authority. Staff members at the Human Services Authority say that Graham told them that he was "Mr. Allen," that he ran a busy clinic and would easily be able to distribute all of the condoms to high-risk women. But Graham's version describes him going to the door, saying, "I'm here to pick up these condoms," and then personally lugging each of the boxes down a hallway and a flight of stairs to load them into his vehicle.
Graham would later lift the boxes one more time as he heaved them into a local trash dumpster.
It was hardly the fate that the condoms' provider had intended. The boxes were the property of the state of Louisiana, which had purchased them as part of their ongoing HIV/AIDS Condom Availability Program. The program has a project within it called Operation Protect, which has existed since 1994. Operation Protect targets high-risk neighborhoods in an effort to reduce the transmission of sexually transmitted infections such as HIV, the virus that causes AIDS. Last year alone, they gave away 12 million condoms.
No one at the Human Services Authority or the HIV/AIDS Program knew the fate of those boxes until 10 p.m. Monday, April 29, when television reporter Paul Gates aired an investigative report on the Baton Rouge station WAFB.
According to some people close to the situation, Gov. Mike Foster reacted to Gates' report by telling staff that he would announce the elimination of the entire condom-giveaway program, and that he would make the announcement during his regular Thursday radio call-in program, Live Mike. Bob Johannessen, the director of communications for the Louisiana Department of Health and Hospitals (DHH), says that it was a tense time in their office, but adds that he's not aware that the governor had ever threatened to cut the entire program.
On Thursday, the staff was on pins and needles when Foster took a call from someone asking about Graham and the program. Foster noted that he does not like being in the condom-distribution business and will not stand for condom distribution to youth. Yet, Foster said, despite the fact that the HIV/AIDS Program had "egg on its face" as a result of the Graham incident, he defers to his medical experts, who advise him that the program is worth funding from an economic standpoint alone. One full-blown AIDS case can cost more than $200,000 in medical costs alone over a lifetime. If the program averts four AIDS cases each year, he said, it pays for itself.
The cornerstone of Louisiana's HIV/AIDS Program is its 1,900 distribution sites: neighborhood bars, gay clubs, corner stores, substance-abuse and public-health clinics, beauty shops, gas stations, and neighborhood centers. Each site makes available condoms at no cost to the customer, usually through plastic fishbowls that sit on a countertop or a bar.
Graham laughs heartily at the idea that visitors to his house might be able to grab a handful of condoms from a fishbowl. Yet Graham was able to pick up his cargo at the Jefferson Parish Human Services Authority only because he had, on June 20, completed the HIV/AIDS Program's distribution-site registration form. Graham says that he wasn't trying to be deceptive and so he only used the name Causeway Women's Day Clinic for the shipping address, "because that's the formal terminology" he uses for his business.
But, he emphasizes, the rest of his state signup form was done under the name of the Causeway Women's Center and that he had even had provided a customized description of his work, which is conducted solely over the telephone from his home. (To protect the anonymity of the women he advises, he says, he allows no one to visit his business in person.) "It (the check-off box) says 'private clinic' and we put down underneath, 'We do pregnancy testing, referrals, and family planning.'"
The HIV/AIDS Program says that not only did Graham use the name Causeway Women's Day Clinic throughout his application but that he also called himself "Mr. Allen" in all his dealings with the Program.
The difference between "clinic" and "center" is particularly relevant in Graham's case, since Causeway Medical Clinic, a nearby abortion provider, claims that he is a pro-lifer masquerading as an abortion clinic in order to confuse women seeking abortions. In fact, Graham last appeared in Gambit Weekly in a story about his work ("No Choice," Jan. 8), when a pregnant college student seeking an abortion accused him of posing as an abortion referral agent and then stringing her along until it was too late for her to have the procedure. Graham denied those accusations at the time and now notes that, despite the controversy, he sees it as a story with a happy ending, since the woman was able to carry the baby to full-term.
Graham says that he also did the state a service. When he claimed and dumped the condoms, he says, he saved the citizenry from being exposed to what he calls "toxic condoms." They were toxic, he says, because they were coated with Nonoxynol-9 (N-9), a spermicide commonly used in condom lubricants and other birth-control products.
N-9 was introduced several years ago to high praise, because lab tests showed that it killed HIV and the bacteria that causes gonorrhea and chlamydia. However, the spermicide has since become controversial, with some researchers contending that the use of N-9 actually increases the risk of contracting HIV because it strips off surface cells in the vagina and rectum, and thus opens up more possible routes for infection.
Johannessen says the DHH was aware of the reports about N-9. He says that other experts have questioned the reports, and notes that the chief study showing increased susceptibility to HIV was conducted without condoms, but rather with high rates of N-9 inserted vaginally with a small group of very high-risk sex workers in South Africa. Nonetheless, the state has decided not to purchase any more condoms containing N-9, even though the national Center for Disease Control's position is that using a condom with N-9 is much safer than using no condom at all.
In fact, the CDC issued a statement last Friday recommending that programs continue to distribute condoms lubricated with N-9 as long as the condoms had not passed their expiration date. The HIV/AIDS Program stopped purchasing N-9 condoms two years ago but told its contractors, including the Jefferson Parish Human Services Authority, that they could decide on their own what to do with remaining N-9 stock.
Graham says that it was because of N-9 that he became involved in all of this. He says that an individual -- he declines to provide a name -- had asked him to find out if the state views N-9 as harmful, and if the state program hands out condoms coated with N-9. Graham says that he was merely trying to find out those answers and that's why he went through the condom-distribution paperwork.
But, he admits, it's not just about N-9. In fact, Graham came home one day this spring and on his doorstep found three cases of Lifestyle condoms, without N-9, addressed to the Causeway Women's Day Clinic. "I didn't want these either," he says, noting that his Metairie neighbors were probably amused to see three big boxes on his porch labeled "Lifestyle" in big letters. He says that he has "hereby distributed them in accordance with what the state asked us to do" and says that he did not hand them out in a mall, did not stand on a street corner and hand them out, did not give them out at a party, and did not transfer them to the custody of his trashmen. Beyond that, he declines to give any details.
Graham admits that he has used condoms, but only during his Army service. "We put them over the barrel of a rifle," he says. "It keeps moisture out. That's the only things I've ever seen them good for."
Graham goes on to cite what he calls a high failure rate for condoms in preventing pregnancy, and emphasizes a recent study by the National Institute of Health that found that condoms do not prevent the spread of viral STDs such as the human papillomavirus (HPV), which is linked to cervical cancer. For Graham, that study alone is reason enough not to distribute condoms. "How much more data do we need to have?" he says. "We're advocating something that is not a good idea; in fact it's a horrible idea. It's encouraging behavior that is detrimental to individuals."
Johannessen stresses that, for sexually active people, there's no denying that condoms are an effective means of preventing HIV and STDs. He points to statistics provided by the Office of Public Health that show the decreases in STD and HIV rates since the onset of the program. A 2001 HIV/AIDS Program survey found condom use among survey participants -- sexually active women with two or more partners -- had increased from 26 percent when the condom-giveaway program first started in 1993 to 40 percent in 2000. And in neighborhoods with high STD rates, condom use among men went from 40 to 54 percent during that same period.
Those numbers don't convince Graham. He also rejects distributing condoms with a message encouraging abstinence. "That's like saying, 'We don't want you to rob a bank, but here's the key to the getaway car," he says. Plus, he says, look at who the state is giving condoms to. "I mean, if I can get them, anyone can."
Johannessen replies that what Bill Graham did is fraud, plain and simple. "It's like someone going into a bank, taking all the money and then complaining that the bank's surveillance system doesn't work properly," he says.