“sex in prison will always be there”: A qualitative examination of prison sexuality from the perspective of incarcerated black men

Background: The U.S. has one of the highest incarceration rates in the world, with Black men disproportionately represented among prisoners. Black men are also disproportionately infected with Human Immunodeficiency Virus (HIV), which some have attributed to their involvement in sexual activities while incarcerated. Methods: An anonymous and confidential self-report questionnaire on prison sexual behavior was administered to randomly selected incarcerated Black men housed in a large maximum-security correctional institution from April to August, 2008. Sixty-three participants expressed their thoughts and experiences with sexual behavior while incarcerated. Responses were transcribed, and narrative analysis was used to categorize and describe participants' viewpoints and sexual experiences among prisoners within this facility. Results: Several themes emerged through narrative analysis about sexual behavior that occurs within the facility. The following themes became evident through our analysis. Awareness of consensual and non-consensual sexual behavior in this environment was widespread, despite institutional policies prohibiting such behaviors. Second, disapproval of same-sex sexual behavior was common among participants, although there were some comments that conveyed a level of understanding due to inmates being deprived of heterosexual sexual relationships. Finally, participants were mindful of the potential spread of HIV/AIDS in the environment among inmates who are sexually active while incarcerated. Conclusions: Despite institutional policies prohibiting such behavior, sexual behavior was common in this prison, which elevates the risks of Black men contracting HIV/AIDS. Prison-based HIV/AIDS prevention programs should seek to effectively address the prisoners' unique needs and experiences; further, harm reduction strategies in this setting should be explored.