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California considers providing condoms - but not STD testing - to prisoners

Category: HIV

A bill in the California Senate will determine whether the state will provide condoms to prisons in order to help alleviate the epidemic of sexually transmitted infections, namely HIV. The bill, AB999, proposed by Democratic Assemblyman Rob Bonta of Oakland, Calif., would compel the Department of Corrections and Rehabilitation to provide condoms, via dispensing machines donated to the state, to five prisons by 2015 and to all 33 adult prisons by 2020. Since the prevalence of HIV is approximately 10 times higher among California prisoners than the general population, according to the University of California, San Francisco, the problem is of an urgent nature.

According to the CDC, condoms - if used "consistently and correctly" - can reduce but do not eliminate one's chance of developing a sexually transmitted disease. In addition, since individuals with STDs - especially HIV - often do not exhibit symptoms, the most effective way to reduce one's risk of contracting an STD is for one and one's partner to receive STD testing before engaging in sexual intercourse.

Prison contraception in California
In spite of the fact that lower-level California prisons in San Francisco and Los Angeles have adopted contraception programs in 1989 and 2001, respectively, the present bill is likely to receive intense debate. Currently, California law prohibits sexual intercourse between prisoners and limits condom use to conjugal visits between qualified prisoners and their spouses or domestic partners.

In 2007, Gov. Arnold Schwarzenegger effectively compromised by vetoing a bill that would have let non-profit organizations provide prisoners with condoms while recommending that a condom-distribution program be piloted. The pilot, which involved 800 prisoners in the California State Prison, Solano, provided prisoners condoms via vending machines for one year. The report on the program was favorable and suggested that the program be expanded. However, until now, the state government has not heeded the report's recommendation.

Prison contraception in Vermont
While Canada, a majority of the members of the European Union and other countries already provide condoms to all prisoners, Vermont is the only U.S. state to do so.

Prisoners in Vermont may request condoms from nurses, who distribute them one at a time and may counsel the prisoner with regard to sexual health. The director of Vermont's department of health services, Delores Burroughs-Biron, M.D., noted that the state's program has not created any problems.

Enforce the law or accept and manage the reality?

The California bill passed Assembly on a vote of 44-22, with opposition and support from both parties.

Opponents, like Assemblyman Dan Logue of Marysville, who stated that condoms would "encourage inmates to break the law," suggest that a more effective way of curbing the problem of STDs in prisons would be to enhance enforcement of the existing law forbidding sex.

Proponents maintain that sex between prisoners should be accepted and managed. Spokesman for the Los Angeles County Sheriff's Department, Steve Whitmore, said, "[w]e want to prevent people from dying." Bonta said that while Logue's argument may possess a kernel of truth, "[s]exual contact between prisoners is technically illegal. But it happens, and I think we need to deal with reality as it stands."

Those outside the political sphere likewise hold strong opinions about the bill. Director of the San Francisco's HIV Services, Kate Monico Klein, said that while "[a]t first we thought this [was] sort of a wrong use for a condom ... we [feel] this is a way of destigmatizing it."

Indeed, stigma and knowledge about the health benefits of contraception may play leading roles in whether one chooses to receive STD testing or use condoms, respectively. A 2009 study suggested that adolescents who considered STDs stigmatizing are less likely than their counterparts to receive testing, and a 2007 study suggested that STD prevention efforts among adolescents may be effective if they associate condom use with a decreased likelihood of infection.

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