Durham, North Carolina places fourth on the list with condom sales that place it 18th in the nation, birth rates that rank ninth, and a 27th ranking in STD rates.

Statue of James Buchanan Duke located just outside the Duke Chapel at Duke University in Durham, North Carolina. In December, 1924, James Buchanan Duke established The Duke Endowment as a permanent trust fund with Trinty College, a college Washington Duke helped relocate to Durham, being the main beneficiary. Trinty was later re-chartered Duke Universtiy in honor of the Duke family.
Leonard Ortiz/Orange County Register
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