Correctional facilities concentrate populations that are at risk for HIV infection: persons of color, persons with substance abuse histories, and persons living in poverty.1,2 As a result, the prevalence of HIV among US incarcerated populations is five to seven times that of the general US population.3,4 Furthermore, about 25% of people living with HIV in the US have been incarcerated.5 These statistics support the need for access to effective means of HIV prevention and harm reduction strategies in correctional facilities.
Condoms are highly effective at preventing the transmission of HIV.6 Despite the fact that there is a growing consensus that in-custody HIV transmission is not trivial,7 condoms are made available to only a minute fraction of the US prisoner population. The manner in which condoms are currently made available to prisoners in California varies widely. In the Los Angeles County Jail, the Center for Health Justice distributes condoms to a segregated gay male population only, one condom per week by request. In San Francisco, prior to this project, condoms were distributed by request through the Forensic AIDS Project’s public health staff in one-on-one health counseling sessions, one per person, per request.