Punish but protect

WHEN YOU THINK OF prisoners protecting themselves, the images that come to mind are probably makeshift knives made out of toothbrushes or blunt objects hidden under bunks. But the protection inmates need most may be one that’s even harder to come by: a condom.

National studies have shown that about 30% of incarcerated men will have sex during their terms, even though it is illegal in California and most other states. Yet prophylactics are officially off-limits for most prisoners in the state. (Self-identified homosexuals in Los Angeles County are one of the few exceptions.) The results are predictable. Inmates in the United States are three times more likely to have AIDS than the general population, according to the Department of Justice.

Since two out of three new prisoners are black or Latino men, and one out of three black men will serve time behind bars in their lifetime, infection rates have skyrocketed in minority communities -- particularly among unknowing girlfriends and wives of reticent ex-cons. In 2003, black and Latino women accounted for 83% of all new AIDS cases among women in the U.S., according to the Centers for Disease Control and Prevention. Two researchers at UC Berkeley have shown that more black women have AIDS because of the disproportionate number of black men in prison. Minority men are contracting HIV in jail and passing it to minority women once they are released.

The obvious solution is to let inmates use condoms. Yet the idea continues to meet resistance. Assemblyman Paul Koretz (D-West Hollywood) guided a bill through Sacramento’s lower house last year that would have allowed public health organizations to distribute condoms to inmates at no charge to the state (and with considerable potential savings on treatment costs).

The bill was slowed in a Senate committee by, of all things, environmental objections from the California Department of Corrections. The department worries that condoms will muck up the plumbing, and officials have proposed the installation of expensive condom-disposal boxes in each prison.

This argument is easily disposed of. Condoms have not proved to be especially problematic to plumbing systems elsewhere. And infectious disease specialists say the boxes would actually increase the risk of other infections for the officers who handle them.

There are more serious criticisms -- that condoms could be used to smuggle contraband or that their distribution would encourage illegal sex and even rape within the jails. But a decade’s worth of experience in places such as Canada, Vermont and Philadelphia have shown that these concerns can be adequately managed.

Keeping the status quo is worse -- and unacceptable. Sex does happen behind bars, like it or not, and it is a leading cause of the alarming growth of HIV among minorities -- prisoners and non-prisoners alike. Making protection available for inmates is a public health issue for us all.