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April 26, 2006
Busted! Georgia Prison Study Shakes Down Some HIV Myths
by Laura Whitehorn
A new study tracking HIV through the Georgia prison system is busting some myths about life behind bars and raising questions about why condoms are still so much harder for inmates to get their hands on than junk food, cigarettes and dirty tattoo needles.
The Georgia Department of Corrections and the federal Centers for Disease Control (CDC) questioned 68 Georgia prisoners who had gotten HIV while behind bars between 1988 and 2003 along with 68 serving sentences during the same 15 years without picking up the virus. Here are some of the myths debunked:
Myth #1: Prisons are a breeding ground for HIV. “HIV transmission is not rare in prison, but neither is it rampant,” says Madeleine LaMarre, LPN, a study coauthor who used to work as a nurse in the Georgia system and now advises prison administrators on HIV care. “We knew of 9% [of all positive Georgia prisoners] who’d acquired HIV in the Georgia system,” LaMarre said. Meaning that 91% already had it when they got there.
Myth #2: Rape is the main form of prison sex. By a wide majority (72%), consensual sex was the number one male-to-male sexual activity reported. And the nonconsensual category included 13 men who traded sex for money, food or cigarettes, along with seven reports of rape. “People [accept the] media portrayals of prison rape,” says the CDC’s Patrick Sullivan, PhD, a study coauthor who is an epidemiologist. “When there’s no data, other information fills in the gap.”
Myth #3: Sex between prisoners and guards happens mostly in women’s prisons. Of the 59 men who said they’d had sex in prison, 26 reported encounters with male staffers and 21 with female staffers—higher than expected numbers on both sides.
Myth #4: Prisoners are reckless, putting others at risk. Seventy-five percent of the positive men in the study said that upon release, they would let family and sex partners know about the sex they had in prison, welcome news considering how much HIV is blamed on ex-cons. And 30% of all those who reported having consensual sex said they did use some sort of protection—usually makeshift barriers like latex gloves or plastic wrap.
Myth #5: Prison tattooing does not transmit HIV. These may be the oddest of the report’s findings—and they’re still under investigation. Twelve positive men in the study reported prison tattooing as their only risky behavior. More interviews and some genetic testing will say for sure. In the past, however, only the hardier hepatitis B and C viruses were known to be transmitted through tattooing with shared needles and dirty equipment.
What solutions do these findings suggest for the state of Georgia and the CDC? Prison advocates and public officials interviewed by POZ say it all points directly to more condoms and HIV education. Take the overestimation of rape, for instance: While rapists don’t often use condoms, consensual sex partners might—if they were available. And if staff are having so much more sex with prisoners than we thought, says Sullivan, “When Georgia looks at educational efforts, they need to recognize the prevention needs of staff too.”
Since 1994, the CDC has officially backed condom distribution in prisons along with education and testing. But fewer than 1% of correctional facilities in the U.S. currently offer condoms.
One proposal on the table recently in Georgia involves “clustering” positive prisoners in separate facilities. Sullivan says, “There are no data about the effectiveness of separate housing as a prevention strategy,” while Robert Cohen, MD, who monitors prison HIV care for the federal courts, suggests that segregation raises more problems than it solves. The bottom line, he says, is that “HIV is transmitted among prisoners just as it is among anyone else—and it can be prevented the same way too.”