Unsafe Sex among Incarcerated Populations

Unsafe sex is frequently covered in studies of transferrable disease risk among incarcerated populations before and after prison release. Though verboten in prisons, there is still evidence of sexual relations among the inmates themselves or sometimes between inmates and staff. Research has reported instances of sexual assaults in prisons by fellow inmates or staff in favor of protection and others or based on intimidation (Beck, 2015). While most of the incidences are likely to go unreported because of fear of retaliation, research in the United States incarceration settings indicates that at least 4.5% of inmates experienced sexual abuse one or more time during the incarceration (Nijhawan, 2016). A survey of convicts in the southeastern state penitentiary system predicted that 44% of the inmates had a sexual encounter with fellow inmates on average. In another literature, about 2% to 65% of inmates have homosexual contacts while incarcerated (Meyer et al., 2017).

Unsafe sex is prospective in infectious disease spread in prisons since protection is not widely accessible in prison environments. Even in an incarcerated facility where protection measures such as condoms and dental dams are accessible, homosexual activities are likely illegal or highly stigmatized, leading to inmates’ reluctance to request protection for fear of being identified, and inmates who reported sexual intercourse during incarceration admitted not using any form of protection (Wiersema et al. 2019). Research shows that inmate rates of “Chlamydia trachomatis and Neisseria gonorrhea infections” are 3 to 5 times that of the general population. Chlamydia positivity is 6.9% for female inmates age 14-39 compared to 2% in the general public (Nijhawan, 2016). This study explores the prevalence of unsafe sex among incarcerated populations before and after prison release and the risk of infectious disease spread in such people.

Group Design

Group Structure

In this study, the researcher will interview a group of inmates in minimum and medium-security prisons. The researcher opted for minimum and medium prisons as the environment allows some interactions between inmates themselves and staff and is less stressful than maximum prison. Minimum and medium-security prisons in some states such as California, Washington, and New York allow for conjugal visits. The factors make it possible to obtain information concerning sexual behavior without feeling stigmatized or too stressed to give information.

Format

The researcher will adopt an open group interview format with the inmates as it will allow the interviewer to get information for several inmates simultaneously, saving time. Behavioral questions will be adopted in this interview setting.

Size

The total targeted sample size is 40 inmates. The researcher will interview the inmates from two selected prisons in a group of 10 inmates each. That means a sample of 10 female and ten male inmates in each of the two selected prisons will be interviewed. A group of 10 subjects is a manageable number for a behavioral interview as the researcher can have a full view of their behaviors, including body language, during the discussion.

Composition

The researcher will interview a mix of both males and females. However, each interview group will comprise a single-gender to encourage free and open conversations. From the psychology perspective, like-minded people, in this case, the same sex, tend to embrace similar behavior when grouped. Hence, they can be free to talk about anything.

Duration

The survey in the two selected prisons will run for two days. The researcher feels that one day per prison is adequate to prepare, interview and interact with the inmates to understand sexual behavior patterns fully sufficiently.

Session length

Each interview session will last for 20 minutes, which adequate to conceptualize behavior for a group interview.

Sequential Topics and Related Group Objectives

1. Inmates sex life and accessibility of safe sex measures

This topic aims to evaluate the frequency of sex and accessibility of safe sex measures such as condoms and dental dams within the prison facilities.

Questions

• Why do you think aspects such as conjugal visits are essential for minimum and medium security prisons?
• How do you gauge the prison’s strictness on homosexuality?
• Does the prison provide sexual protective gear such as condoms?
• How do you rate the accessibility, and how does it encourage or deter unsafe sex within the prison setting?
• Sexual assaults

The objective of this topic is to assess the incidence of sexual assaults within the prison and how inmates respond to the cases

Questions

• How many have experienced or witnessed a case of sexual assaults within the prison?
• How did you respond to the incident?
• What impact do you think it had or still has on you?

Group Script

Moderator: Good morning, everyone. First of all, I would like to welcome you to this interactive session, where we will talk about one of the toughest but important topics to discuss in a setting like this one you are today. That topic is sex and narrowed to unsafe sex in our prison, and I beg your understanding and correction should any of my questions and statements appear offensive…Thank you

Interventions

Interventions to reduce unsafe sex in the prison setting, as proposed during the interview, including behavioral and social support such as peer education and individual counseling. Community and small group interventions include community-building empowerment activities and group counseling.

References

Beck, A. J. (2015). Use of restrictive housing in US prisons and jails, 2011–12. Washington, DC: US Department of Justice.

Meyer, I. H., Flores, A. R., Stemple, L., Romero, A. P., Wilson, B. D., & Herman, J. L. (2017). Incarceration rates and traits of sexual minorities in the United States: National Inmate Survey, 2011–2012. American Journal of Public Health, 107(2), 267-273.

Nijhawan, A. E. (2016). Infectious diseases and the criminal justice system. The American journal of the medical sciences, 352(4), 399-407.

Wiersema, J. J., Santella, A. J., Canady, P., & Jordan, A. O. (2019). Self-justifications for unsafe sex among incarcerated young men who have sex with men and live with HIV result from a New York City jail-based pilot intervention. Journal of community health, 44(4), 729-739.