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Top 10 Clinical Review

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Condoms in U.S. Prisons: A Top HIV Clinical Development of 2014

December 15, 2014

Some facts:

  1. Condoms have been found to reduce the transmission of sexually transmitted diseases, including HIV, in most every setting in which they have been introduced and studied.
  2. Some people in prison and jails have sex.
  3. Despite facts 1 and 2, condoms are not permitted in most every jail and prison in the U.S.

About 14% of all people with HIV in the U.S., and over 20% of all HIV-infected African-American men, pass through a correctional facility each year. As such, prisons and jails are concentrated with people living with HIV as well as people at risk for acquiring the virus. While available data suggest that media depictions of sex behind bars are exaggerated, there is undoubtedly sex occurring in our correctional facilities. As condoms are considered contraband in such facilities, such sex is unprotected.

In California, at least, that is about to change. In September, Gov. Jerry Brown signed into law a bill that will introduce condoms into his state's prison system, the nation's largest.

The excuses that have kept U.S. prisons from providing condoms have long been feeble. Concerns regarding security -- e.g., that they will be used as weapons or to smuggle drugs -- have been debunked by experiences with condoms in other countries such as Canada and in the U.K. In fact there is nothing that is scientific about opposition to condoms in prisons. One medical director from a state correctional system told me the issue is cultural, and that providing condoms to prisoners just did not sit well within his community or peers.

While perceptions that condoms promote or signal condoning of sexual activity by inmates is not borne out by any research, studies of condoms in correctional settings indicate they can be successfully and safely distributed and are desired by inmates. It is about time.

What are some other top clinical developments of 2014? Read more of Dr. Wohl's picks.

David Alain Wohl, M.D., is an associate professor of medicine in the Division of Infectious Diseases at the University of North Carolina and site leader of the University of North Carolina AIDS Clinical Trials Unit at Chapel Hill.


Copyright © 2014 Remedy Health Media, LLC. All rights reserved.



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