HIV This Week

Yap L, Butler T, Richters J, Kirkwood K, Grant L, Saxby M, Ropp F, Donovan B. Do condoms cause rape and mayhem? The long-term effects of condoms in New South Wales' prisons. Sex Transm Infect. 2006 Dec 19; [Epub ahead of print]

Concerns raised by opponents to condom provision in prisons have not been objectively examined and the issue continues to be debated. Yap and colleagues examined the long-term effects of the introduction of condoms and dental dams into New South Wales prisons in 1996, focusing on particular concerns raised by politicians, prison officers, prison nurses, and prisoners. These groups were worried that: (a) condoms would encourage prisoners to have sex, (b) condoms would lead to an increase in sexual assaults in prisons, (c) prisoners would use condoms to hide and store drugs and other contraband, and (d) prisoners would use condoms as weapons. Data sources included the New South Wales Inmate Health Surveys in 1996 and 2001 and official reports from the New South Wales Department of Corrective Services. The 1996 IHS involved 657 men and 132 women randomly selected from all prisons with a 90% response rate. The 2001 survey involved 747 men and 167 women inmates with an 85% response rate. There was a decrease in reports of both consensual male-to-male sex and male sexual assaults 5 years after the introduction of condoms into prisons in 1996. Condoms were often used for concealing contraband items and other purposes but this was not associated with an increase in drug injecting in prison. Only three incidents of a condom being used in assaults on prison officers were recorded between 1996 and 2005; none were serious. The authors conclude that they found no evidence of serious adverse consequences of distributing condoms and dental dams to prisoners in New South Wales. Condoms are an important public health measure in the fight against HIV and sexually transmitted diseases; they should be made freely available to prisoners as they are to other high- risk groups in the community.

Editors’ note: Condoms have been available in Canadian penitentiaries since 1994 and in prisons in New South Wales since 1996 but the vast majority of prisons worldwide do not make condoms available to inmates with dire results. Results such as these can be used to influence correctional system leadership, particularly when national laws invest them with responsibility for detainee health on their watch.