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Health Education & Behavior
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A Qualitative Study of Substance Use and Sexual Behavior Among 18- to 29-Year-Old Men While Incarcerated in the United States

David Wyatt Seal, PhD

Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee

Lisa Belcher, PhD

Behavioral Intervention Research Branch, Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Kathleen Morrow, PhD

Miriam Hospital/Brown Medical School, Providence, Rhode Island

Gloria Eldridge, PhD

Jackson State University, Mississippi

Diane Binson, PhD

Center for AIDS Prevention Studies, University of California, San Francisco

Deborah Kacanek, PhD

Miriam Hospital/Brown Medical School, Providence, Rhode Island. Gloria Eldridge, Jackson State University, Mississippi

Andrew D. Margolis, MPH

Behavioral Intervention Research Branch, Division of HIV and AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

Tim McAuliffe, PhD

Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee

Rodney Simms

Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee

Project START Study Group

The article describes men’s perceptions of and experience with substance use and sexual behavior during incarceration. Grounded theory content analyses were performed on qualitative interviews conducted with 80 men, aged 18 to 29, in four U.S. states. Participants believed that drugs were easily available in prison. Half reported using substances, primarily marijuana or alcohol, while incarcerated. Key themes included the role of correctional personnel in the flow of substances in prison and the economic significance of substance traffic king. With regard to sexual behavior, most men acknowledged that it occurred but were hesitant to talk in-depth about it. There was a strong belief in "don’t look, don’t tell," and sex in prison was often associated with homo sexual behavior or identity. Sex during incarceration was reported by 12 men, mostly with female partners. Participants were pessimistic about HIV/STD/hepatitis prevention efforts inside correctional facilities. These findings highlight the need for risk reduction programs for incarcerated men.

Key Words: HIV/AIDS • prisons • prevention

Health Education & Behavior, Vol. 31, No. 6, 775-789 (2004)
DOI: 10.1177/1090198104264134
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