Penal Violations

Texas prisons say they canít allow condoms because they donít allow sex. So they donít need condoms. They just need $12 million a year to treat all the HIV-positive prisoners.

Outside the United States, condom distribution has been a mainstay in many European prisons. In Canada, some provincial systems provide bleach (for sanitizing needles) in addition to condoms.

But the prison system of only one American state, Vermont, makes condoms available for nonconjugal visits. However, county jails in New York, Los Angeles, Philadelphia and Washington, D.C. have provided condoms for years, while maintaining a no-sex policy.

"It was considered a public health issue," says Bob Eskind, spokesman for Philadelphia's county jail system. Eskind says condoms have been available in the county's jails since 1988. "[Our] inmates should have access to the same level of protection as...citizens on the street."

McCann: Wall Talk educates both those inside and outside prison.
Daniel Kramer
McCann: Wall Talk educates both those inside and outside prison.

Beverly Young of the D.C. Department of Corrections had a similar explanation. In an e-mail to the Houston Press, Young wrote: "While sexual activity among inmates is strictly prohibited...the prison HIV/AIDS issue may present [greater consequences] than the consequences resulting from the infraction inmates commit as a result of sexual behavior."

And while many in the medical community have backed condom distribution for years, politicians have largely avoided the subject.

So far, Senator Rodney Ellis says he has avoided the subject for strategic reasons.

Last year, the Houston Democrat successfully pushed legislation for Texas prisoners to be tested for HIV before they are released. (While there is no mandatory HIV testing upon entry, TDCJ officials say about 80 percent agree to be tested.)

Ellis says he considered adding condom distribution to his proposal. "But I was afraid it would kill the bill," he says from his Houston office. He's clear in saying he doesn't want TDCJ to encourage or condone sex among inmates. "But I think that, in the year of our Lord 2006, they ought to be willing to accept reality."

Department spokeswoman Michelle Lyons says TDCJ is not ignoring the issue, but is addressing HIV in ways that don't violate the no-sex policy, chiefly via the Wall Talk program. She also cites concerns shared by other prison authorities: Condoms can be used to smuggle contraband like drugs, and can also be used in the popular prisoner pastime of "chunking" -- throwing urine and feces on guards.

But for Kelly McCann, head of AIDS Foundation Houston, the public health threat is just too great.

"We have to acknowledge that it is not a good public health practice to prohibit condoms and bleach," she says. "Now, on the other hand, we have to realize that the prison system is not in the business of public health as much as they are in the business of security...But I have to say, with this particular disease, if we're ever going to make a dent in it -- whether we're talking free world or prison -- we've got to address safer sex."

If Daniel Harris did indeed contract HIV in prison, he's the exception to the rule.

There are probably harder things to measure than the transmission of HIV behind bars, like, say, proving the existence of God.

For all the years that researchers have studied HIV-positive prisoners, the research is largely considered to be flawed, outdated or both.

But a Centers for Disease Control and Prevention study released in April has come the closest to achieving consensus in the field. The study, which tracked HIV transmission among male prisoners in the Georgia prison system from 1992 to 2005, concluded that 91 percent of the inmates studied had HIV before they went to prison.

The HIV-positive inmates were 13 times as likely to have been tattooed in prison and ten times as likely to have had sex with another inmate.

Other findings included:

¥ 72 percent of prisoners reporting sexual encounters said the sex was consensual

¥ 30 percent of those inmates reported using makeshift condoms (rubber gloves or plastic wrap)

The study also looked for characteristics associated with HIV-positive inmates, as follows: inmates who engaged in homosexual activity; inmates who were tattooed in prison; a body-mass index of 25.4 or lower; and black inmates.

The CDC recommended implementing an educational program but stopped short of endorsing condom distribution.

"Providing condoms to sexually active persons is an integral part of HIV prevention...outside prisons," the study stated. "A recent survey in [a Washington, D.C. jail] reported that condom distribution was acceptable to most inmates and correctional officers...Departments of corrections without condom distribution programs should assess relevant state laws, policies and circumstances to determine the feasibility and benefits and risks of implementing such programs."

Regardless of how many offenders contract HIV while in prison, researcher Theodore Hammett says prisons need to provide all preventive measures possible.

As part of Abt Associates, a Massachusetts-based consulting firm, Hammett has conducted HIV research for the National Institute of Justice and the CDC. In 1997, he was part of a panel commissioned to review TDCJ's HIV policies and recommend improvements.

"Certainly there is nonconsensual sex going on in prison," Hammett says from Cambridge, "but there's also a lot of consensual sex that goes on in prison. And in those instances, [inmates] may well be more likely to use a condom."

Hammett says political pressure is one of the main obstacles. Prison officials don't want anyone thinking they can't enforce a zero-tolerance policy; distributing condoms would admit defeat.

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