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Open Access Highly Accessed Debate

The catch 22 of condoms in US correctional facilities

Joseph D Tucker1*, Suzanne W Chang2 and Jacqueline P Tulsky3

Author Affiliations

1 Division of Infectious Diseases, Massachusetts General Hospital, Jackson 504, 55 Fruit Street, Boston, MA, 02139, USA

2 Department of Medicine, University of California San Francisco, San Francisco, CA, USA

3 Department of Medicine and the Positive Health Program, University of California San Francisco, San Francisco, CA, USA

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BMC Public Health 2007, 7:296  doi:10.1186/1471-2458-7-296

Published: 21 October 2007

Abstract

Background

Despite the high prevalence of sexually transmitted infections (STIs) and HIV infection in US correctional settings, most jails and prisons in the United States prevent inmates from using condoms to prevent STIs/HIV.

Discussion

This article makes the following arguments to justify a scalable and feasible next step in the prevention of HIV/STIs among inmates: condoms are a basic and essential part of HIV/STI prevention, HIV/STI transmission occurs in the context of corrections, and several model programs show the feasibility of condom distribution in prisons. A lower end estimate for HIV incidence among incarcerated applied to 2,000,000 new inmates annually results in thousands of new HIV infections acquired each year in corrections that could be prevented with condoms in corrections facilities. Programs from parts of the United States, Canada, and much of Europe show how programs distributing condoms in correctional facilities can be safe and effective.

Summary

Public health and corrections officials must work together to ensure that condoms and broader sexual disease prevention programs are integrated into US jail and prison health systems.