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A new California law requires condoms to be made available to all state prisoners. That makes California the second state after Vermont to do so even though sex between prisoners is forbidden. But San Francisco has been distributing condoms to inmates in county jails for decades. As George Lavender reports, it's a program state officials might look to as a model.
KATE MONICO KLEIN: They simply turn a knob.
GEORGE LAVENDER, BYLINE: Kate Monico Klein runs the public health department's HIV services for San Francisco County Jails. She stands in front of an inconspicuous metal box mounted on the wall here in the gym of Jail No. 4.
KLEIN: We set it off to the side so that people would have a minor amount of privacy.
LAVENDER: Condom machines like this one are installed in all of San Francisco's male jails, dispensing condoms for free in small cardboard packets.
ROBERT GREVE: I get about 10 of them every time (laughter).
LAVENDER: That's Robert Greve, an inmate who's serving a short sentence in the jail. In and out of prison in several states, this is the first time Greve's been locked up somewhere that provides condoms.
GREVE: Condoms are very good to have around, I think, you know, because it's a life-saving device. A lot of people don't care about their health, I think.
LAVENDER: But even though condoms are available inside the jail, Greve says deputies still enforce rules against inmates having sex.
GREVE: They freak out about it - like, I've seen them catch people in bed together and they're like hey, what are you doing?
RENE ANGEL RAMIREZ: We still have the need of sex. And believe it or not, the straight men, while they're in custody, they do have sexual activity with other males.
LAVENDER: Inmate Rene Angel Ramirez, who is gay and HIV positive, says condoms keep his partners safer and protect him from other diseases like gonorrhea, chlamydia or hepatitis C.
RAMIREZ: It's sad because I heard from other inmates how they have got infected with HIV while incarcerated.
LAVENDER: Back in the 1980s, San Francisco became one of the first places in the country to hand out condoms to inmates in the county jail. But it's still one of only a handful of prison and jails in the country that do so. And often that's down to one simple reason.
ROSS MIRKARIMI: Sex in prison or jails is illegal under the California Penal Code 286(e).
LAVENDER: That's San Francisco Sheriff Ross Mirkarimi. In fact, in prisons and jails across the U.S., sex between inmates is against the rules, even if it's consensual. In some states, like California, it's actually a crime. Still, Mirkarimi says he supports the condom distribution program if it helps slow the spread of HIV and other sexually transmitted diseases.
MIRKARIMI: The law is the law. But should this behavior occur - that there is a safer way. We want people to be protected - and we insist on it that they be protected.
LAVENDER: The Centers for Disease Control estimate that 1 in 7 people living with HIV pass through correctional facilities each year. But even with condoms in steady supply, not all deputies are comfortable with condoms being available.
MATTHEW FREEMAN: I could not report to you that there still is buy-in from the uniformed staff.
LAVENDER: San Francisco Chief Deputy Sheriff Matthew Freeman says there are reasons even consensual sex is prohibited in jail.
FREEMAN: We know from our experiences running and managing these county jails that even consensual sexual activity amongst inmates can lead to very real problems.
LAVENDER: Problems like disharmony in the jail, which the sheriff's department says is a potential security risk. In the early days, deputies were also concerned that condoms could be used as weapons or to smuggle drugs. And while Kate Monico Klein of the public health department says that hasn't happened, she says condoms have been put to some more unusual uses.
KLEIN: We found that, among other things, the prisoners take the condoms and they use them as hair ties. They use them as pillows. One of the deputies told me that they blow them up and use them as balloons.
LAVENDER: And although that initially bothered some people...
KLEIN: One of the things we realized is that it is another way of de-stigmatizing HIV.
LAVENDER: California's state prison system has five years to come up with a plan to provide condoms in all of its facilities. For NPR News, I'm George Lavender.