Sex happens in prisons but are condoms provided: Kenya, Rwanda, USA.
Subject: Prisoners (Health aspects)
Prisoners (Sexual behavior)
Condoms (Distribution)
Pub Date: 05/01/2010
Publication: Name: Reproductive Health Matters Publisher: Reproductive Health Matters Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2010 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2010 Source Volume: 18 Source Issue: 35
Topic: Event Code: 690 Goods & services distribution Advertising Code: 59 Channels of Distribution Computer Subject: Company distribution practices
Product: Product Code: E199650 Prisoners; 3069770 Prophylactics & Diaphragms NAICS Code: 326299 All Other Rubber Product Manufacturing SIC Code: 3069 Fabricated rubber products, not elsewhere classified
Geographic: Geographic Scope: Kenya; Rwanda; United States Geographic Code: 6KENY Kenya; 6RWAN Rwanda; 1USA United States
Accession Number: 236247762
Full Text: Prisoners in Kenya are at high risk of contracting HIV, and unless the issue of unprotected sex is addressed, HIV transmission will continue unchecked. According to a 2008 study, 8.6% of the 722 male prisoners interviewed at 13 prisons admitted having sex in prison, 74.6% of whom had had unprotected sex. Of the 59 inmates who had engaged in sex while in prison, 21 reported having consented while two were raped. Prisoners engaged in sex for food, money, cigarettes, or exemption from certain duties. Numerous HIV-related services are offered to prisoners including education, testing and provision of antiretroviral drugs, but the government does not provide condoms because both homosexual sex and sex in prison are against the law. HIV prevalence rates in prison are 10% compared to 7.4% nationally. (1)

In Rwanda, where an estimated 15% of male prisoners are HIV-positive, health authorities have embarked on a campaign to teach prisoners about HIV and encourage testing and treatment, but the new strategy does not include condom provision, because sex in prison is illegal. Reports recommend the removal of laws that criminalise and discriminate against these groups and prevent condom provision. Aside from sexual activity, inmates in prisons risk contracting HIV through shared needles for intravenous drug use, razors and tattooing needles. Overcrowding also puts prisoners at high risk of tuberculosis. (2)

Since 1989, the prison system of San Francisco, California, USA, has provided condoms to male prisoners through individual counselling sessions. Given the limitations of this approach, they decided to install, stock and monitor a free condom-dispensing machine in a jail to examine the feasibility of this way of providing condoms to prisoners. After the machine was installed, prisoners' awareness of access to condoms increased as well as their likelihood of having obtained condoms. Particularly large increases in condom uptake were reported among those in high-risk groups. Sexual activity did not increase, custody operations were not impeded, and staff acceptance of condom access for prisoners increased. (3)

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(1.) Kenya: Condom conundrum puts prisoners at risk. IRIN PlusNews, 16 February 2010.

(2.) Rwanda: New HIV awareness drive targets prisoners. IRIN PlusNews, 18 February 2010.

(3.) Sylla M, Harawa N, Grinstead Resnick O. The first condom machine in a US jail: the challenge of harm reduction in a law and order environment. American Journal of Public Health 2010; 15 April. E-pub ahead of print.
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