A “harm reduction” approach to public health, rather than an abstinence or look-the-other-way policy, scored another win this month when the California state legislature gave the green light to a bill that would provide condoms for adult prison inmates. The plan, to furnish all the state’s prisons with condoms–likely through vending machines–was put forward despite the fact that it’s illegal in the Golden State to have sex behind bars. The bill, approved last week by the state’s assembly and senate, now heads to Gov. Jerry Brown’s desk, where it will await its fate.

As a group, prisoners have higher rates of HIV, hepatitis C and other sexually transmitted infections than the free population, so providing condoms could disproportionately assist efforts to curb the spread of these diseases. The bill would require the California Department of Corrections and Rehabilitation to provide condoms to five of the state’s prisons by 2015 and to incrementally expand to all 34 adult male and female prisons. The condoms and the machines would be provided through external donations.

Putting condoms in the hands of inmates has met with stiff opposition in the past. In 2007, then-Gov. Arnold Schwarzenegger vetoed a bill that would have enabled health groups to provide condoms to state prisoners. Nonetheless, he also called for the state corrections department to set up a pilot condom distribution program in one prison. The trial was deemed a success: roughly 800 inmates at Solano State Prison in California were able to access free condoms via vending machines without major incident. A 2011 report on the pilot penned by Calif. Correctional Health Care Services and the Calif. Dept. of Public Health praised the initiative, and said the program should be expanded. Against that backdrop, the new bill was introduced by Assemblyman Rob Bonta, D-Oakland.

Opponents of the current bill maintain that supplying condoms for inmates when inmate sex is on the books as a crime is tantamount to encouraging prisoners to break the law. Correctional officers have also expressed concern that condoms could encourage more sex or be used to conceal or transport weapons—or even be used as a weapon itself (via a phenomenon called “gassing” where bodily fluids are weaponized…look it up). Improper disposal of condoms, they say, could also pose a health risk. But numerous studies of populations among which condoms are distributed have not observed a rise in security risks, health concerns or in self-reported sex among prisoners. Moreover, studies of prison populations indicate that, legal or not, sex occurs between prisoners and between prisoners and prison guards. Without condoms available, most sex goes unprotected.

The idea of staving STIs via condoms in prison is nothing new. The World Health Organization has recommended for the past decade that condoms be made available to incarcerated populations. Meanwhile, about 80 percent of the European Union, as well as the governments of Canada, Australia, Brazil, Indonesia, South Africa and Iran, already supply prophylactics in prison.

Vermont, home to a prison population of about 2,000 people, is the only state that currently provides condoms for all its inmates. For about a decade, inmates there have been able to request condoms from a health worker, as well as to receive information about sexual coercion and how to seek help. (Mississippi, too, supplies condoms to prisoners, but only for conjugal visits between couples contingent upon proof that they are married). About a half dozen jail systems in the U.S., including those in New York City and Washington, D.C., also provide condoms.

California, with 120,027 current inmates, has one of the largest prison populations in the country. So, ramping up protections for that population could help put a sizable dent in the transmission of HIV, hepatitis B and other STI infections nation-wide.


Check out these other articles on prison health concerns from Scientific American:

Solitary Confinement is Cruel and Ineffective

Brain Injury Rate 7 Times Greater among U.S. Prisoners

Prisons in Post-Soviet Russia Incubate a Plague