SAN ANTONIO — Bill Day doesn't fancy himself an outlaw -- and with his Mr. Rogers demeanor, he definitely doesn't look the part. But soon the 73-year-old lay chaplain could spend up to a year in jail for breaking a law that he considers immoral.
Day hands out clean needles to drug addicts on some of the seediest streets in this south Texas city. He does it because he's convinced that it reduces human suffering by curtailing the spread of HIV, a view that has been supported by medical research for more than a decade.
However, Day's actions are illegal in Texas -- the only state that has not started a needle-exchange program of some kind. So when a San Antonio police officer spotted him swapping syringes with prostitutes and junkies this month, he was arrested on drug paraphernalia charges.
"This is a moral imperative," said Day, whose nonprofit group, the Bexar Area Harm Reduction Coalition, gets funding from his church. "I come from a family of altruistic people. My mother made clothes for the poor during the Depression. My father never turned down a hobo. I have to keep doing what I think is right."
Day also has a personal reason for wanting to stop others from contracting AIDS: He has the disease. Sick and weary a decade ago, he called an ambulance, thinking he was suffering from pneumonia. At the hospital, he was informed that he had full-blown AIDS -- and about two weeks to live. He fiercely fought on and overcame the odds, but not before his once-athletic frame had shrunk to 120 pounds.
"I don't want anyone else to go through that," Day said as he stood on San Antonio's west side next to a vacant lot strewn with used needles. He said his AIDS, which he did not contract through drug use, has been stabilized for six years.
Needle-exchange programs have long been controversial. Critics have claimed that they encourage drug use and send a defeatist message about the government's war on drugs.
But acceptance of the programs has grown far beyond New York and San Francisco over the last decade, due largely to concerns about the spread of AIDS and hepatitis C. The Centers for Disease Control and Prevention has estimated that more than a third of all AIDS cases in the U.S. stem from intravenous drug use.
Though some studies have questioned their effectiveness, most research has concluded that needle-exchange programs reduce transmission of diseases and save taxpayers money. A 2002 UC Davis study found that drug users with access to clean needles were up to six times less likely to risk contracting HIV than those without such access.
"There is conclusive scientific evidence that syringe-exchange programs, as part of a comprehensive HIV prevention strategy, are an effective public health intervention that reduces transmission of HIV and does not encourage the illegal use of drugs," U.S. Surgeon General David Satcher found in 1998.
Texas politicians, however, continue to regard the research with skepticism.
Neel Lane, a high-powered San Antonio lawyer who agreed to defend Day for free after learning about his case through their church, St. Mark's Episcopal, said it was time for the Lone Star State to admit it was behind the times.
"When you're the only state that doesn't have [a needle-exchange program], you're either the 2% smartest or 2% dumbest in the country," Lane said.
Though Texas is the only state that has not begun at least a pilot needle-exchange program in any city, lawmakers last year authorized one -- for San Antonio.
Bexar County public health officials are studying whether to launch it, but Dist. Atty. Susan Reed has warned that she could prosecute anyone who distributes needles because she considers the act illegal.
"I'm telling [local officials], and I'm telling the police chief, I don't think they have any kind of criminal immunity," Reed said in August, according to the San Antonio Express-News.
Reed has not explained why she opposes the program, and her office did not return requests for comment. But at the request of a state lawmaker, Texas' attorney general is reviewing the dispute.
Day and two associates, cited with him on Jan. 5, initially faced Class C misdemeanors, which are punishable by a fine of up to $500. But Reed's office and police plan to increase the charges to distributing drug paraphernalia, a Class A misdemeanor, which carries a possible one-year jail sentence.
Day said he told San Antonio Police Chief William P. McManus before the arrest that he was distributing needles to drug addicts for health reasons and was never warned that he could be arrested. Police spokeswoman Sandy Gutierrez acknowledged the meeting but said, "We did not tell them this was OK."
Day's supporters say they are outraged that police and prosecutors are treating the activists as criminals.
"How silly to arrest senior citizens who are trying to stop the spread of HIV in their community," said Jill Rips, deputy executive director of the San Antonio AIDS Foundation, which provides HIV testing and runs a hospice. "Don't police have something better to do?"
Day said he accepted the arrest as part of a process that his community must go through before it could begin a healthy debate about reducing the spread of AIDS by addicts.
"This has happened everywhere," Day said. "Every needle-exchange program has started underground. The knee-jerk reaction was the same: 'You're encouraging people to do drugs.' Then there was a slow metamorphosis, and acceptance."
For someone who claims he's not an outlaw, Day was sounding like a revolutionary.
"Well, looks can be deceiving sometimes," he said, with a smile.
Then he got into his white minivan and drove away.