The Sexual Health and Behaviour of Male Prisoners: The Need for Research

Sexually transmitted infections (STIs) are a major public health problem in the United Kingdom (UK) and the limited data available may suggest high prevalence rates (especially of HIV, hepatitis B and C) in the escalating male prison population. Sex, rape and injecting drug use are a part of prison life, yet screening for STIs does not routinely take place and there are inconsistencies in the availability of condoms and other harmreduction devices. Numerous characteristics of male prisoners (for example, social disadvantage, drug dependency, younger age, black ethnic origin, on remand), their offences (drug, sex, violent) and overcrowded prisons (for example, sharing cells, staff shortages, enforced idleness, transfers) are also considered ‘high risk’ from a sexual health perspective, especially the spread of STIs between prisoners and into the wider population when they are released. There is, therefore, an urgent need for research so that sexual health information and HIV/STI prevention initiatives can be successfully targeted. Sexually transmitted infections (STIs) are a major public health problem in the United Kingdom (UK), and their escalating prevalence rates are largely the result of unprotected sex and, to some extent, sharing contaminated needles. It is acknowledged that consensual and nonconsensual sex and drug abuse are part of prison life, and the limited data available show that prisoners have high prevalence rates of STIs, especially human immunodeficiency virus (HIV), hepatitis B and C, which can be brought into prison, acquired there and, if undetected and untreated, spread into the wider population when prisoners are released (HM Prison Service 1999, 2001; Yirrell et al. 1997; Chalmers 2002). STIs, however, are not the only sexual health-related problems experienced by prisoners. It is estimated that approximately 10,000 of the 200,000 prisoners who pass through the prison system annually may have been coerced sexually (Banbury 2004). Symptoms of the psychological problems resulting from sexual assault are similar to those of post-traumatic stress disorder, for example, intrusive thoughts, flashbacks, anxiety, avoidance behaviour, depression (Matthews et al. 2000), and these may be particularly difficult to deal with in the prison environment, continue when prisoners are released, and may play a part in reoffending. The Howard Journal Vol 46 No 1. February 2007 ISSN 0265-5527, pp. 43–59