title: Sexual practices and dental dam use among women prisoners--a mixed methods study.
abstract: BACKGROUND
  Dental dams have been distributed to women prisoners for protection against HIV and other sexually transmissible infections (STIs) in some Canadian and Australian prisons for over a decade. However, we do not know whether they serve any useful public health purpose.
  
  
  OBJECTIVE
  To determine how dental dams are used in women's prisons in New South Wales (NSW), Australia.
  
  
  METHODS
  Using quantitative and qualitative methods, we investigated women's sexual practices with a focus on how dental dams are used in NSW prisons.
  
  
  RESULTS
  Although 71 of the 199 (36%) women reported having had sex with another inmate, with oral sex involved in most encounters, only eight (4%) had ever used a dental dam. The main sources of STI transmission risk among women prisoners were oral sex, manual sex and sharing dildos. Furthermore, sharing razors could also allow the transmission of blood-borne viruses, which could occur during sex in the presence of cuts or menstrual fluid. The high rates of hepatitis B and C among incarcerated women compound this risk.
  
  
  CONCLUSIONS
  Dental dams are not widely used by women prisoners and we question their utility in women's prisons. Oral sex is an important risk factor for acquisition of herpes simplex virus type 1, but most women in NSW prisons (89%) are already infected. Condoms and latex gloves may have more use. Condoms could be used as a barrier on shared dildos and sex toys, while latex gloves could be used to protect cut and grazed hands from vaginal and menstrual fluids.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia. l.yap@unsw.edu.au
authors.forename: Lorraine
authors.initials: L
authors.lastname: Yap
authors.forename: Juliet
authors.initials: J
authors.lastname: Richters
authors.forename: Tony
authors.initials: T
authors.lastname: Butler
authors.forename: Karen
authors.initials: K
authors.lastname: Schneider
authors.forename: Kristie
authors.initials: K
authors.lastname: Kirkwood
authors.forename: Basil
authors.initials: B
authors.lastname: Donovan
mesh_terms: D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003274:Contraceptive Devices, Female / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D012307:Risk Factors; D016733:Rubber Dams / Q000706:statistics & numerical data; D021841:Safe Sex / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult