If you’ve raised children, you’ve likely experienced the challenge of balancing discipline with harm reduction. For example, parents may set clear rules against drinking and drug use but also tell their child to call them if they need a safe and sober ride home, no questions asked.
California has recently faced down a similar dilemma in its decision to authorize distribution of condoms to prison inmates.
Under current law, sex between prison inmates is not allowed, which is a reasonable, appropriate, and necessary restriction. Nevertheless, some inmates do wind up having sexual contact and, since it’s prohibited, they don’t have access to protection. As you might expect, significant health consequences are one result, including the spread of HIV, AIDS, and Hepatitis.
The fact that sexual contact will still be illegal under the new plan has raised concerns that condom distribution will simply encourage illegal acts in the state’s prisons. However, a study of a pilot condom project (PDF) in one California prison showed that providing condoms to inmates had no identified negative effects:
We found no evidence that providing condoms posed an increased risk to safety and security or resulted in injuries to staff or inmates in a general population prison setting. Providing condoms from dispensing machines is feasible and of relatively low cost to implement and maintain. Providing condoms would likely reduce the transmission of HIV, STDs, and hepatitis in CDCR prisons, thereby reducing medical costs in both CDCR and the community. Very few HIV infections (2.7 to 5.4) would need to be prevented for a cost-neutral program.
In addition to reducing medical costs in prisons, preventing health problems inside facilities also has implications for community health more broadly. Well over 90% of all inmates are eventually released back to the community. And, to the extent that they bring with them untreated transmittable diseases, the larger community suffers.
So, despite the apparent contradictions, California has chosen to protect health over rigidly enforcing laws that may paradoxically contribute to health risks. In 2007, Governor Schwarzenegger summed up the central argument of this apprpach by pointing out that it is “consistent with the need to improve our prison healthcare system and overall public health,” which is an important social goal.
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