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Sexual practices and dental dam use among women prisoners – a mixed methods study

Lorraine Yap A E , Juliet Richters A , Tony Butler B , Karen Schneider A , Kristie Kirkwood C and Basil Donovan D
+ Author Affiliations
- Author Affiliations

A School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW 2052, Australia.

B National Drug Research Institute, Shelby Street, Shenton Park, WA 6008, Australia.

C Centre for Health Research in Criminal Justice, Justice Health, Matraville, NSW 2036, Australia.

D Sydney Sexual Health Centre, Sydney Hospital, and National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2001, Australia.

E Corresponding author. Email:

Sexual Health 7(2) 170-176
Submitted: 7 December 2009  Accepted: 19 March 2010   Published: 14 May 2010


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. Method: 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. Conclusion: 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.

Additional keywords: Australia, cunnilingus, oral sex, prisons.


The Sexual Health and Attitudes of Australian Prisoners study was funded by NHMRC Project Grant No. 350860. Additional funding was provided by the NSW Department of Health and the Faculty of Medicine, University of New South Wales. Tony Butler was supported by the Centre for Health Research in Criminal Justice during much of the project, and Juliet Richters and Lorraine Yap were at the National Centre in HIV Social Research, University of New South Wales until mid-2007. Tony Butler is supported by an NHMRC Career Award (ID No. 350992) and Basil Donovan is supported by a NHMRC Practitioner Fellowship (ID No. 568613). We also would like to thank Luke Grant, Assistant Commissioner for Offender Services and Programs, NSW Department of Corrective Services, for additional information and insightful comments on this paper and Max Saxby, NSW Department of Corrective Services, for his assistance in facilitating access to each prison. We are grateful to all prison staff, current and former prisoners, and prisoner community organisations who contributed to this study.


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