When news broke that a new needle exchange program in Covington, Kentucky, can’t offer condoms because it’s on the grounds of a Catholic hospital, no one was more surprised than the city’s mayor.

“I’m just sitting here sort of stunned,” Mayor Joseph Meyer said Tuesday, when Rewire.News told him about it. “You’ve literally left me speechless.”

But he found some words to express his concern that, as the region faces an uptick in HIV cases among injection drug users, a key part of the response is blocked by religious dictates.

“Obviously, condoms should be made available,” said Meyer, who took office after commissioners approved the exchange two years ago.

“Is this the 21st century or the 15th century? Where’s Galileo when you really need him, huh?” he said with a hearty chuckle.

The Cincinnati Enquirer reported Tuesday that mobile needle exchange units in the Northern Kentucky cities of Covington and Newport cannot offer condoms because they will be located in the parking lots of St. Elizabeth Healthcare, a Catholic system that dominates the local landscape. St. Elizabeth follows Catholic directives that restrict access to contraception and govern care for one in six acute-care beds nationwide. In Kentucky, their share is more than 30 percent.

The news comes as the Trump administration is poised to grant unprecedented latitude to Catholic hospitals and other providers to deny medical care on religious or moral grounds. In January, the administration unveiled a draft rule and a new office to empower religious objectors.

Refusing to offer condoms is “extremely uncommon” for needle exchange programs, said Daniel Raymond, deputy director at the Harm Reduction Coalition. There is at least one other example: Project Safe Point, a program of Catholic Charities Care Coordination Services in upstate New York, does not offer condoms, but tells clients where to find them, said Joe Filippone, director of prevention services there.

Such arrangements are unusual.

“Virtually every program in the country offers condoms,” Raymond said, adding that it’s considered best practice to address sexual as well as injection-related risks for HIV and Hepatitis C.

In a statement, St. Elizabeth said it “is dedicated to caring for our patients’ medical needs without compromise of the Catholic Church’s teachings concerning birth control.”

“Syringe exchange itself is not about birth control. It is about removing dirty needles from our communities to reduce the potential spread of disease,” spokesperson Guy Karrick wrote. “We recognize there are additional measures our patients can take (including abstinence) to reduce the spread of disease.”

Karrick said St. Elizabeth also opposes “birth control literature” on the property.

Kentucky has been one of the states hardest hit by the nationwide opioid crisis. The Northern Kentucky Health Department says it is investigating a “cluster of HIV cases,” with 45 diagnoses since the beginning of 2017, 21 of which involved injection drug use as a risk factor, said spokesperson Emily Gresham-Wherle. The region used to see between zero and five cases a year with that risk factor.

Kentucky state lawmakers voted in 2015 to allow needle exchanges, but the programs must be approved by local authorities. In both cities, officials said they chose St. Elizabeth’s parking lots near highways over county health centers located near schools, homes, and businesses.

Newport Mayor Jerry R. Peluso, who said he also learned of the condom ban from Rewire.News Tuesday, stood by the choice of St. Elizabeth.

“We did the right thing,” Peluso said. “Now we have [a needle exchange program], as opposed to not having one.”

Newport city commissioners unanimously approved the exchange last month. Covington had made their exchange contingent on a neighboring area stepping up.

Peluso’s fellow commissioner, Ken Rechtin, said that while the Newport commission never discussed St. Elizabeth’s condom rules together before voting on the location, he heard about them from St. Elizabeth CEO Garren Colvin during “a discussion that he and I had when he was arguing against the St. E. site.”

In Covington, Steve Frank, vice mayor at the time of the 2016 vote, said he had also just learned of the condom ban. But he said he would have opposed locating the needle exchange in the county health center, where condoms are offered.

“I would not vote to endanger high school students and residents by having people who are still under the influence of heroin drive through the center of my town,” Frank said.

Officials in both Covington and Newport bemoaned the failure of nearby communities to approve exchanges, which they feel has unfairly burdened their cities.

“What I feel is, like, no good deed goes unpunished, here,” Frank said. “We’re about to catch hell when we were the only city to step up to shoulder a region of 400,000’s heroin addiction problem.”

But even if they did step up, other areas might face the same restrictions on condoms.

“That’s all we have around here,” Frank said, referring to Catholic hospitals. “South of the Ohio River, the main medical provider is St. Elizabeth.” 

Laura Huss contributed to this report. 

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