There are a number of factors which place the prison population at risk from contracting the HIV virus. However, homosexuality per se is not one of them. Each one of the sexual contacts described earlier may take place in a safe or an unsafe manner. A 1989 study on infection risk among transvestites identified several factors which facilitate the spread of the AIDS virus. It is important to consider their impact on sexual relations among inmates.
ALCOHOLISM AND DRUGS
There is a high rate of drug consumption in prison. Despite rigorous controls, cocaine, marihuana and barbiturates are readily available and are consumed daily. It is common for inmates to prepare “chicha”, an alcoholic drink made by fermenting any grain or food. Using recipients which they have previously hidden, the inmates pour in water and then food (such as bread) and allow it to ferment. Sometimes they add discarded batteries. A few days later they drink the liquid that results from this mixture. The large amounts of drugs and “chicha” that are consumed daily constitute a major risk factor in the transmission of AIDS.
This risk begins with the way in which the drugs are introduced into the prison. During Sunday visits, women bring drug-filled condoms, hidden in their vaginas, through the prison gates. There, a transvestite will introduce a condom, carried by one of the women, into his rectum. This maneuver, conducted very hurriedly, clearly constitutes a major risk of infection. “Some transvestites are chosen for this difficult mission because of the ample size of their backsides,” says Pico de Lora. “La Carrasqueri is the favorite one because she has the biggest backside. She can put up to a pound of coke up her ass.”
In the study on transvestites, the group admitted using marihuana before having sex. Of those who smoke, 42% said they used it always or nearly always before sex. Many inmates (59%) had also tried cocaine.13
Continuing with the analysis of the link between drugs and unsafe sex, the study found that cocaine use is related to the practice of active and passive anal penetration without the use of a condom. Moreover, a significant link was found between liquor consumption and passive sexual relations. This is corroborated by the fact that 42% of the group interviewed admitted that taking alcohol or drugs had influenced their decision on condom use.14
This same result was obtained through the questions which referred to the respondents’ sense of self-control. Here, 55% agreed that they had problems with safe sex when they were intoxicated. These findings confirm the results of similar studies conducted by Stall15 and others, and Bye16 among homosexuals in San Francisco and Connell17 in Australia. Baumann and others18, in a study of 160 gay men in New York, found that the combination of drugs and sexual activity was the most important factor in predicting a seropositive condition. Prieur,19 in an ethnographic study in Oslo, found that men who became intoxicated prior to a sexual encounter tended to practice unprotected anal intercourse.
Drugs are a part of prison culture. They are intimately related to the problem of time. When a person is in jail and the sentence is long, the only consolation is intoxication. It not only serves as an escape from reality, but for something else to which little attention has been paid: time control. An inmate lacks power over the most basic aspects of his life: he cannot decide where or when to eat, sleep, exercise, relax, receive visits or see a doctor. But he can, thanks to drugs, play with time. A good dose of cocaine or Lorazepan can make a week seem like a day. A tranquilizer taken with ‘chicha’ makes the months seem shorter. A snort of crack increases the sense of well-being and reduces the waiting. When drugs are combined with sex, the pleasure extends beyond the few seconds that an orgasm lasts. “When I rub cocaine on my penis,” says Toro, “I can go for hours before coming. The orgasm seems to last forever. When I finally come, I feel days have gone by since I got into the bed.” Certain days are not even felt because the inmates are completely asleep.
Drugs reduce the inmates’ capacity for reason. It is not surprising that they should wish to forget their daily woes and miseries. “Who wants to think about life when you’re stuck in this shithole?”, says Pico de Lora. But forgetting has its price. And prevention is one of the things that people forget about when they are intoxicated.
CONDOM USE AND ATTITUDES TOWARDS THE CONDOM
In his study on condom use, Bye20 found that negative attitudes towards condom use are related to unsafe sexual practices. In work groups with gay American men, it was found that those who enjoyed unprotected anal sex had negative attitudes towards condom use. In Australia, Connell and others21 observed that positive attitudes towards condom use were related to the practice of safe sex.
A 1989 study of homosexuals in La Reforma found that a low percentage of inmates always used a condom, while nearly three-quarters of those studied had been penetrated without a condom during the previous 30-day period.22
This means that inmates in that particular prison constitute a group which has reservations about condom use, and 73% said they felt condoms reduce sexual pleasure.
A study of the inmates who participated in the AIDS prevention workshops of 1993, reveals that the situation had improved. Of the 188 inmates who completed the questionnaire, the percentage who said they “never” used a condom decreased from 51% in the pre-test questionnaire to 36% in the post-test. However, nearly four out of every ten inmates said they “never” use a condom, and another 22% “almost never” do. Only 12% said they use a condom “almost always”, and 35% believe that “when you love your partner, you stop using a condom”. Only 19% said they found it pleasurable to use a condom.
“Toro, why do you think that it’s hard for inmates to use a condom ?”, we asked. “Because it doesn’t feel the same. Here in jail, we want to have contact with flesh. We want to feel the juices, the milk (semen) like a sign of power. I personally like Angelita to feel my warm milk up her ass. It’s like I’m fertilizing her.” Toro believes that prisoners’ bodies are so repressed that coming freely is one of the few freedoms they have. “Think about it, you’re in jail and you can’t get out. The condom is like another jail which imprisons the semen. It traps it, tricks it, grabs it and kills it. You want your dick to be free of constraints and limitations.” We ask Toro about prevention. “Don’t prisoners worry about being infected with AIDS and dying from it?” “Sure,” he replies “but that’s just one of the many dangers you face in jail and maybe not the most immediate. Here you can die from many things worse than AIDS.”
INTIMACY
The type of relationship in which an inmate is involved is important. From this, it is possible to deduce that condom use in transvestites and open homosexuals depends on the decision of their clients and lovers. Despite this situation, in a group with such well-defined patterns as prison inmates, a hierarchy is clearly established, especially in relation to the dominance exercised by the “cachero’ over the transvestite, who is constantly under threat. An outburst of jealousy can easily turn into a knife fight. Nearly all the transvestites are marked by scars, evidence of fights with their partners. In assuming the role of the “woman” in the couple, they are trapped by the obligations and the virtual absence of rights experienced by women in Latin American societies. Even though both are aware of the effectiveness of condoms in the prevention of sexually transmitted diseases, the “cachero” refuses to use one. This is evident in the closed types of relationships between “cacheros” and transvestites, where unsafe sex is most frequently practiced. For example, in this type of relationship, an average of 10.7 anal penetrations occur each month, without the protection of a condom, while in a more open relationship, the monthly average is 4.3. In this last case, the practice of anal penetration with a condom is minimal, while in a closed relationships it is not used at all.
Source: Jacobo Schifter and Johnny Madrigal, Hombres que aman hombres, ILEP-SIDA, San Jose, Costa Rica, 1992, p 193.
In the AIDS awareness training course, transvestites said they found major problems in trying to convince “cacheros” to use a condom when practicing anal sex. The very suggestion arouses the latter’s suspicions about their partners’ faithfulness. The transvestite’s lack power, given his role in the relationship, makes it difficult to successfully obtain his request. This is evident if we see that among other factors that influence the decision on condom use, 58% of the interviewees said their partner’s attitude was the determinant factor.23
When asked if the AIDS prevention workshops had helped them in any way, their answer was a definite yes. They said they had received information on how to protect themselves from infection, and this had helped to improve their relationships with partners, girlfriends, wives and family members. A typical response came from Juan Alberto:
| Interviewer: | How did you find out about AIDS? |
| Juan Alberto: | Through the holistic course I took in San Sebastian, given by Don Tomas (a facilitator) and your team of co-facilitators. That’s how I found out about it, how I heard about AIDS. Before that workshop, I was green and didn’t know what it was. I’d heard comments, that you could catch it through a sexual relationship with a man or a woman, but mostly between homosexuals, and that’s how the AIDS virus developed. And thanks to that course I did with you, and other cofacilitators, I heard that anyone could infect you and I got an idea of what it is and how to prevent that disease. |
| Interviewer: | How do you prevent it? |
| Juan Alberto: | Well, by using condoms and also by taking care when you get a tattoo. You shouldn’t get stuck with a needle that isn’t new, because someone can pass the virus on to you that way -- it’s also transmitted that way. |
| Interviewer: | Do you like using a condom, or not? |
| Juan Alberto: | Well, let’s say there are people who don’t feel the same about condoms, right, but for me prevention is better, so I prefer to use a condom. |
| Interviewer: | Do you insist that the “cachero” uses a condom? |
| Juan Alberto: | Sure! I always take a condom and give it to him. Otherwise I won’t do anything with him. |
| Interviewer: | Have you seen people using condoms in here? |
| Juan Alberto: | Here there’s just a few, but in San Sebastian nearly the majority of us who were in there used condoms. Rojas, our group facilitator, would start to tell the gays and the “cacheros” about that, to take care, to ask for condoms and all those things, and most of us used them. |
In addition, some recognize that the theme of drugs has prompted them to seek help to give up their drug habit.
| Interviewer: | Tell me a little about your relationship with drugs. |
| Juan Alberto: | When I was in the other jail, I was heavily into crack and all that, but in here I’ve been keeping away from it. I smoke marihuana and I’m getting into pills. But I’ve felt a little freer from crack, because at the other place I was heavily into that vice and now, thank God, I’ve been keeping away from it and avoiding it. Only, from time to time I smoke my (marihuana) joints. |
| Interviewer: | Did you take the ILPES anti-drugs workshop? |
| Juan Alberto: | Sure. |
| Interviewer: | Did it help you at all? |
| Juan Alberto: | Yeah, the workshop helped me a lot in giving up crack and (explaining ) what drug-addiction is. However, through that (course) I was able to give up crack, which was the worst problem I had. And now, like I say, I’m doing okay, because I still have a joint (of marihuana) and now I’m getting into pills. |
| Interviewer: | But you gave up crack? |
| Juan Alberto: | Sure I did! I haven’t smoked crack again. Only when I’m here and I get the urge I smoke a joint, but it’s not all the time. |
However, when asked about condom use, many inmates give a different answer: they use condoms in casual sexual encounters, but do not use them with their regular or permanent partners. Martinez believes his partner is faithful to him and will not betray him. Toro is certain that Angelita makes love “only with me”, and moreover, “I don’t like condoms”. When we ask him how he can be so sure, he replies: “I knew her without AIDS and we’ve had tests done and we’re fine. We do them (the tests) every three months, and if one of us turns out to be infected, there would have to be a reason, and we would know that there had been infidelity.” Daniel believes that since “my partner is faithful”, he only needs to use the condom “from time to time”. When we ask him if he found the workshop useful, he replies: “ The workshop was very useful. I’ve seen many “cacheros” who use condoms, really, but in my case, I don’t feel it’s necessary because if this “güila” is unfaithful to me, he knows I’ll kill him.” The inmates feel it is important for them to take certain risks through the promises they make to each other. Their lives are not without danger, so it is hardly surprising that their relationships should include danger. Removing the risk from a relationship is something that, apparently, they do not wish to do. Although we may consider this position to be “illogical”, it is not entirely irrational. For example, in Angelita’s case, she knows that if she infects her man, she will be stabbed to death. Perhaps this threat is not as effective as a condom, but it is, without a doubt, one that leads her to use a condom if she should sleep with another man.
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13 Schifter, Jacobo and Madrigal, Johnny. Hombres que aman hombres.
14 Ibid.
15 Stall. R. Et al. Health Education Quarterly, Winter 1986:13 (4):359-371. “Alcohol and Drug Use during sexual activity and compliance with safe sex guidelines for AIDS: the AIDS behavioral research project.”
16 Bye. L. “A Report on: Designing an effective AIDS prevention campaign strategy for San Francisco: results for the fourth probability sample of an urban gay male community. Report prepared by Communications Technology for The San Francisco AIDS Foundation. 1987.
17 Connell, R.et al. Social aspects of the prevention of AIDS: Report 1. “Methods and sample”. Report 2: “Information about AIDS: the accuracy of knowledge possessed by gay and bisexual men”, Australia, Marquaire University, 1988.
18 Baumann, L. , Siegel, K. “Misperception among gay men of the risk of AIDS associated with their sexual behavior”. Journal of Applied Social Psychology, 1987: 17 (3):329-350.
19 Prieur, A. Gay men: reasons for continued practice of unsafe sex. Presented at the First International Symposium on Information and Education on AIDS, Ixtapa, Mexico, 1988.
20 Bye, L. Designing an effective AIDS prevention campaign strategy for San Francisco: results for the fourth probability sample of an urban gay male community. Report prepared by Communications Technology for The San Francisco AIDS Foundation, 1985.
21 Connell, R. et al. Social aspects of the prevention of AIDS: Report 1. “Methods and sample”. Report 2: “Information about AIDS: the accuracy of knowledge possessed by gay and bisexual men”, Australia, Marquaire University, 1988.
22 Schifter, Jacobo and Madrigal, Johnny, Hombres que aman hombres. ILEP-SIDA, San Jose, Costa Rica, 1992.
23 Schifter , Jacobo and Madrigal, Johnny. Hombres que aman hombres