I 

110TH CONGRESS 

1ST SESSION H. R. 178 

To reduce the spread of sexually transmitted infections in correctional 

facilities, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 4, 2007 

Ms. LEE introduced the following bill; which was referred to the Committee 

on the Judiciary 

A BILL 

To reduce the spread of sexually transmitted infections in 

correctional facilities, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Justice for the Unpro5 tected Against Sexually Transmitted Infections among the 

6 Confined and Exposed Act of 2007’’ or the ‘‘JUSTICE 

7 Act of 2007’’. 

8 SEC. 2. FINDINGS. 

9 The Congress makes the following findings: 


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1 (1) According to the Bureau of Justice Statis2 tics (BJS), 2,186,230 persons were incarcerated in 

3 the United States as of midyear 2005. Between 

4 1995 and midyear 2005, the number of persons in5 carcerated in Federal or State correctional facilities 

6 increased by an average of 3.4 percent per year. One 

7 in every 136 United States residents was incarcer8 ated in a Federal, State, or local correctional facility 

9 as of midyear 2005. 

10 (2) As of 2001, 64 percent of incarcerated per11 sons were racial or ethnic minorities. Based on cur12 rent incarceration rates, BJS estimates that 32 per13 cent of African-American males will enter State or 

14 Federal correctional facilities during their lifetime, 

15 compared with 17 percent of Hispanic males and 5.9 

16 percent of White males. 

17 (3) There is a disproportionately high rate of 

18 HIV/AIDS among incarcerated persons, especially 

19 among minorities. Approximately 25 percent of the 

20 HIV-positive population of the United States passes 

21 through correctional facilities each year. BJS deter22 mined that the rate of confirmed AIDS cases is 3 

23 times higher among incarcerated persons than in the 

24 general population. Minorities account for the major25 ity of AIDS-related deaths among incarcerated perVerDate Aug 31 2005 21:33 Jan 16, 2007 Jkt 059200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H178.IH H178

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1 sons, with African-American incarcerated persons 

2 3.5 times more likely than White incarcerated per3 sons and 2.5 times more likely than Hispanic incar4 cerated persons to die from AIDS-related causes. 

5 (4) Studies suggest that other sexually trans6 mitted infections (STIs), such as gonorrhea, 

7 chlamydia, syphilis, genital herpes, viral hepatitis, 

8 and human papillomavirus, also exist at a higher 

9 rate among incarcerated persons than in the general 

10 population. For instance, researchers have estimated 

11 that the rate of Hepatitis C (HCV) infection among 

12 incarcerated persons is somewhere between 8 and 20 

13 times higher than that of the general population. 

14 (5) Correctional facilities lack a uniform system 

15 of STI testing and reporting. Establishing a uniform 

16 data collection system would assist in developing and 

17 targeting counseling and treatment programs for in18 carcerated persons. Better developed and targeted 

19 programs may reduce the spread of STIs. 

20 (6) Although Congress has acted to reduce the 

21 spread of sexual violence in correctional facilities by 

22 enacting the National Prison Rape Elimination Act 

23 (PREA) of 2003, BJS reported 8,210 allegations of 

24 sexual violence in correctional facilities in 2004. 


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1 (7) Approximately 95 percent of all incarcer2 ated persons eventually return to society. According 

3 to one study, every year approximately 100,000 per4 sons infected with both HIV and HCV are released 

5 from correctional facilities. These individuals com6 prise approximately 50 percent of all persons with 

7 both infections in the United States. 

8 (8) According to the Centers for Disease Con9 trol and Prevention (CDC), latex condoms, when 

10 used consistently and correctly, are highly effective 

11 in preventing the transmission of HIV. Latex 

12 condoms also reduce the risk of other STIs. Despite 

13 the effectiveness of condoms in reducing the spread 

14 of STIs, the Bureau of Prisons does not recommend 

15 their use in correctional facilities. 

16 (9) The distribution of condoms in correctional 

17 facilities is currently legal in certain parts of the 

18 United States and the world. The States of Vermont 

19 and Mississippi and the District of Columbia allow 

20 condom distribution programs in their correctional 

21 facilities. The cities of New York, San Francisco, 

22 Los Angeles, and Philadelphia also allow condom 

23 distribution in their correctional facilities. However, 

24 these States and cities operate fewer than 1 percent 

25 of all correctional facilities. In one study, researchers 


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1 found that 18 of 31 countries surveyed allowed 

2 condom distribution in correctional facilities. 

3 (10) In 2000 and 2001, researchers surveyed 

4 300 incarcerated persons and 100 correctional offi5 cers at the Central Detention Facility, a correctional 

6 facility operated by the District of Columbia at 

7 which condoms are available. Researchers found that 

8 both incarcerated persons and correctional officers 

9 generally supported the condom distribution pro10 gram and considered it to be important. Further11 more, the researchers determined that the program 

12 had not caused any major security infractions. In 

13 Canada, the Expert Committee on AIDS and Pris14 ons surveyed more than 400 correctional officers in 

15 the Federal prison system of Canada in 1995 and 

16 reported that 82 percent of those responding indi17 cated that the availability of condoms had created no 

18 problems at their facility. 

19 (11) The American Public Health Association, 

20 the United Nations Joint Program on HIV/AIDS, 

21 and the World Health Organization have endorsed 

22 the effectiveness of condom distribution programs in 

23 correctional facilities. 

24 (12) Many correctional facilities in the United 

25 States do not provide comprehensive testing and 


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1 treatment programs to reduce the spread of STIs. 

2 According to BJS surveys from 2000, only 899 of 

3 the 1,668 Federal and State correctional facilities 

4 (i.e. 54 percent) provided HIV/AIDS counseling pro5 grams. Only 1,104 of the 1,584 State correctional 

6 facilities (i.e. 70 percent) reported having a policy of 

7 treating incarcerated persons for HCV. 

8 SEC. 3. AUTHORITY TO ALLOW COMMUNITY ORGANIZA9 TIONS TO PROVIDE STI COUNSELING, STI 

10 PREVENTION EDUCATION, AND SEXUAL BAR11 RIER PROTECTION DEVICES IN FEDERAL 

12 CORRECTIONAL FACILITIES. 

13 (a) DIRECTIVE TO ATTORNEY GENERAL.—Not later 

14 than 30 days after the date of enactment of this Act, the 

15 Attorney General shall direct the Bureau of Prisons to 

16 allow community organizations to distribute sexual barrier 

17 protection devices and to engage in STI counseling and 

18 STI prevention education in Federal correctional facilities. 

19 These activities shall be subject to all relevant Federal 

20 laws and regulations which govern visitation in correc21 tional facilities. 

22 (b) INFORMATION REQUIREMENT.—Any community 

23 organization permitted to distribute sexual barrier protec24 tion devices under subsection (a) must ensure that the 

25 persons to whom the devices are distributed are informed 


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1 about the proper use and disposal of sexual barrier protec2 tion devices in accordance with established public health 

3 practices. Any community organization conducting STI 

4 counseling or STI prevention education under subsection 

5 (a) must offer comprehensive sexuality education. 

6 (c) POSSESSION OF DEVICE PROTECTED.—No Fed7 eral correctional facility may, because of the possession or 

8 use of a sexual barrier protection device— 

9 (1) take adverse action against an incarcerated 

10 person; or 

11 (2) consider possession or use as evidence of 

12 prohibited activity for the purpose of any Federal 

13 correctional facility administrative proceeding. 

14 (d) IMPLEMENTATION.—The Attorney General and 

15 Bureau of Prisons shall implement this section according 

16 to established public health practices in a manner that 

17 protects the health, safety, and privacy of incarcerated 

18 persons and of correctional facility staff. 

19 SEC. 4. SENSE OF CONGRESS REGARDING DISTRIBUTION 

20 OF SEXUAL BARRIER PROTECTION DEVICES 

21 IN STATE PRISON SYSTEMS. 

22 It is the sense of Congress that States should allow 

23 for the legal distribution of sexual barrier protection de24 vices in State correctional facilities to reduce the preva25 lence and spread of STIs in those facilities. 


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1 SEC. 5. SURVEY OF AND REPORT ON CORRECTIONAL FA2 CILITY PROGRAMS AIMED AT REDUCING THE 

3 SPREAD OF STIS. 

4 (a) SURVEY.—The Attorney General, after consulting 

5 with the Secretary of Health and Human Services, State 

6 officials, and community organizations, shall, to the max7 imum extent practicable, conduct a survey of all Federal 

8 and State correctional facilities no later than 180 days 

9 after the date of enactment of this Act and annually there10 after for five years to determine: 

11 (1) PREVENTION EDUCATION OFFERED.—The 

12 type of prevention education, information, or train13 ing offered to incarcerated persons and correctional 

14 facility staff regarding sexual violence and the 

15 spread of STIs, including whether such education, 

16 information, or training— 

17 (A) constitutes comprehensive sexuality 

18 education; 

19 (B) is compulsory for new incarcerated 

20 persons and for new staff; and 

21 (C) is offered on an on-going basis. 

22 (2) ACCESS TO SEXUAL BARRIER PROTECTION

23 DEVICES.—Whether incarcerated persons can— 

24 (A) possess sexual barrier protection de25 vices; 


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1 (B) purchase sexual barrier protection de2 vices; 

3 (C) purchase sexual barrier protection de4 vices at a reduced cost; and 

5 (D) obtain sexual barrier protection devices 

6 without cost. 

7 (3) INCIDENCE OF SEXUAL VIOLENCE.—The in8 cidence of sexual violence and assault committed by 

9 incarcerated persons and by correctional facility 

10 staff. 

11 (4) COUNSELING, TREATMENT, AND SUP12 PORTIVE SERVICES.—Whether the correctional facil13 ity requires incarcerated persons to participate in 

14 counseling, treatment, and supportive services re15 lated to STIs, or whether it offers such programs to 

16 incarcerated persons. 

17 (5) STI TESTING.—Whether the correctional 

18 facility tests incarcerated persons for STIs or gives 

19 them the option to undergo such testing— 

20 (A) at intake; 

21 (B) on a regular basis; and 

22 (C) prior to release. 

23 (6) STI TEST RESULTS.—The number of incar24 cerated persons who are tested for STIs and the outVerDate Aug 31 2005 21:33 Jan 16, 2007 Jkt 059200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H178.IH H178

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1 come of such tests at each correctional facility, 

2 disaggregated to include results for— 

3 (A) the type of sexually transmitted infec4 tion tested for; 

5 (B) the race and/or ethnicity of individuals 

6 tested; 

7 (C) the age of individuals tested; and 

8 (D) the gender of individuals tested. 

9 (7) PRE-RELEASE REFERRAL POLICY.—Wheth10 er incarcerated persons are informed prior to release 

11 about STI-related services or other health services in 

12 their communities, including free and low-cost coun13 seling and treatment options. 

14 (8) PRE-RELEASE REFERRALS MADE.—The 

15 number of referrals to community-based organiza16 tions or public health facilities offering STI-related 

17 or other health services provided to incarcerated per18 sons prior to release, and the type of counseling or 

19 treatment for which the referral was made. 

20 (9) OTHER ACTIONS TAKEN.—Whether the cor21 rectional facility has taken any other action, in con22 junction with community organizations or otherwise, 

23 to reduce the prevalence and spread of STIs in that 

24 facility. 


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1 (b) PRIVACY.—In conducting the survey, the Attor2 ney General shall not request or retain the identity of any 

3 person who has sought or been offered counseling, treat4 ment, testing, or prevention education information regard5 ing an STI (including information about sexual barrier 

6 protection devices), or who has tested positive for an STI. 

7 (c) REPORT.—The Attorney General shall transmit 

8 to Congress and make publicly available the results of the 

9 survey required under subsection (a), both for the Nation 

10 as a whole and disaggregated as to each State and each 

11 correctional facility. To the maximum extent possible, the 

12 Attorney General shall issue the first report no later than 

13 1 year after the date of enactment of this Act and shall 

14 issue reports annually thereafter for 5 years. 

15 SEC. 6. STRATEGY. 

16 (a) DIRECTIVE TO ATTORNEY GENERAL.—The At17 torney General, in consultation with the Secretary of 

18 Health and Human Services, State officials, and commu19 nity organizations, shall develop and implement a 5-year 

20 strategy to reduce the prevalence and spread of STIs in 

21 Federal and State correctional facilities. To the maximum 

22 extent possible, the strategy shall be developed, trans23 mitted to Congress, and made publicly available no later 

24 than 180 days after the transmission of the first report 

25 required under subsection 5(c) of this Act. 


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1 (b) CONTENTS OF STRATEGY.—The strategy shall in2 clude the following: 

3 (1) PREVENTION EDUCATION.—A plan for im4 proving prevention education, information, and 

5 training offered to incarcerated persons and correc6 tional facility staff, including information and train7 ing on sexual violence and the spread of STIs, and 

8 comprehensive sexuality education. 

9 (2) SEXUAL BARRIER PROTECTION DEVICE AC10 CESS.—A plan for expanding access to sexual barrier 

11 protection devices in correctional facilities. 

12 (3) SEXUAL VIOLENCE REDUCTION.—A plan 

13 for reducing the incidence of sexual violence among 

14 incarcerated persons and correctional facility staff, 

15 developed in consultation with the National Prison 

16 Rape Elimination Commission. 

17 (4) COUNSELING AND SUPPORTIVE SERVICES.— 

18 A plan for expanding access to counseling and sup19 portive services related to STIs in correctional facili20 ties. 

21 (5) TESTING.—A plan for testing incarcerated 

22 persons for STIs during intake, during regular 

23 health exams, and prior to release, and that— 


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1 (A) is conducted in accordance with guide2 lines established by the Centers for Disease 

3 Control; 

4 (B) includes pre-test counseling; 

5 (C) requires that incarcerated persons are 

6 notified of their option to decline testing at any 

7 time; 

8 (D) requires that incarcerated persons are 

9 confidentially notified of their test results in a 

10 timely manner; and 

11 (E) ensures that incarcerated persons test12 ing positive for STIs receive post-test coun13 seling, care, treatment and supportive services. 

14 (6) TREATMENT.—A plan for ensuring that 

15 correctional facilities have the necessary medicine 

16 and equipment to treat and monitor STIs and for 

17 ensuring that incarcerated persons living with or 

18 testing positive for STIs receive and have access to 

19 care and treatment services. 

20 (7) STRATEGIES FOR DEMOGRAPHIC GROUPS.— 

21 A plan for developing and implementing culturally 

22 appropriate, sensitive, and specific strategies to re23 duce the spread of STIs among demographic groups 

24 heavily impacted by STIs. 


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1 (8) LINKAGES WITH COMMUNITIES AND FACILI2 TIES.—A plan for establishing and strengthening 

3 linkages to local communities and health facilities 

4 that provide counseling, testing, care, and treatment 

5 services and that may receive persons recently re6 leased from incarceration who are living with STIs. 

7 (9) OTHER PLANS.—Any other plans developed 

8 by the Attorney General for reducing the spread of 

9 STIs or improving the quality of health care in cor10 rectional facilities. 

11 (10) MONITORING SYSTEM.—A monitoring sys12 tem that establishes performance goals related to re13 ducing the prevalence and spread of STIs in correc14 tional facilities and which, where feasible, expresses 

15 such goals in quantifiable form. 

16 (11) MONITORING SYSTEM PERFORMANCE INDI17 CATORS.—Performance indicators that measure or 

18 assess the achievement of the performance goals de19 scribed in paragraph (9). 

20 (12) COST ESTIMATE.—A detailed estimate of 

21 the funding necessary to implement the strategy at 

22 the Federal and State levels for all 5 years, includ23 ing the amount of funds required by community or24 ganizations to implement the parts of the strategy in 

25 which they take part. 


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1 (c) REPORT.—The Attorney General shall transmit 

2 to Congress and make publicly available an annual 

3 progress report regarding the implementation and effec4 tiveness of the strategy described in subsection (a). The 

5 progress report shall include an evaluation of the imple6 mentation of the strategy using the monitoring system and 

7 performance indicators provided for in paragraphs (9) and 

8 (10) of subsection (b). 

9 SEC. 7. APPROPRIATIONS. 

10 (a) IN GENERAL.—There are authorized to be appro11 priated such sums as may be necessary to carry out this 

12 Act for each of the fiscal years 2007 through 2013. 

13 (b) AVAILABILITY OF FUNDS.—Amounts made avail14 able under paragraph (1) are authorized to remain avail15 able until expended. 

16 SEC. 8. DEFINITIONS. 

17 For the purposes of this Act: 

18 (1) CORRECTIONAL FACILITY.—The term ‘‘cor19 rectional facility’’ means any prison, penitentiary, 

20 adult detention facility, juvenile detention facility, 

21 jail, or other facility to which persons may be sent 

22 after conviction of a crime or act of juvenile delin23 quency within the United States. 

24 (2) INCARCERATED PERSON.—The term ‘‘incar25 cerated person’’ means any person who is serving a 


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1 sentence in a correctional facility after conviction of 

2 a crime. 

3 (3) SEXUALLY TRANSMITTED INFECTION.—The 

4 term ‘‘sexually transmitted infection’’ or ‘‘STI’’ 

5 means any disease or infection that is commonly 

6 transmitted through sexual activity, including HIV/ 

7 AIDS, gonorrhea, chlamydia, syphilis, genital her8 pes, viral hepatitis, and human papillomavirus. 

9 (4) SEXUAL BARRIER PROTECTION DEVICE.— 

10 The term ‘‘sexual barrier protection device’’ means 

11 any FDA-approved physical device which has not 

12 been tampered with and which reduces the prob13 ability of STI transmission or infection between sex14 ual partners, including female condoms, male 

15 condoms, and dental dams. 

16 (5) COMPREHENSIVE SEXUALITY EDUCATION.— 

17 The term ‘‘comprehensive sexuality education’’ 

18 means sexuality education that includes information 

19 about abstinence and about the proper use and dis20 posal of sexual barrier protection devices and which 

21 is— 

22 (A) based on evidence; 

23 (B) free from bias; and 

24 (C) comprehensive. 


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1 (6) COMMUNITY ORGANIZATION.—The term 

2 ‘‘community organization’’ means a public health 

3 care facility or a non-profit organization which pro4 vides health or STI related services according to es5 tablished public health standards. 

6 (7) STATE.—The term ‘‘State’’ includes the 

7 District of Columbia, American Samoa, the Com8 monwealth of the North Mariana Islands, Guam, 

9 Puerto Rico, and the Virgin Islands of the United 

10 States. 

Æ 


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