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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Justice for the Unpro-
tected Against Sexually Transmitted Infections among the 
Confined and Exposed Act of 2007’’ or the ‘‘JUSTICE 
Act of 2007’’. 
SEC. 2. FINDINGS. 
The Congress makes the following findings: 
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(1) According to the Bureau of Justice Statis-
tics (BJS), 2,186,230 persons were incarcerated in 
the United States as of midyear 2005. Between 
1995 and midyear 2005, the number of persons in-
carcerated in Federal or State correctional facilities 
increased by an average of 3.4 percent per year. One 
in every 136 United States residents was incarcer-
ated in a Federal, State, or local correctional facility 
as of midyear 2005. 
(2) As of 2001, 64 percent of incarcerated per-
sons were racial or ethnic minorities. Based on cur-
rent incarceration rates, BJS estimates that 32 per-
cent of African-American males will enter State or 
Federal correctional facilities during their lifetime, 
compared with 17 percent of Hispanic males and 5.9 
percent of White males. 
(3) There is a disproportionately high rate of 
HIV/AIDS among incarcerated persons, especially 
among minorities. Approximately 25 percent of the 
HIV-positive population of the United States passes 
through correctional facilities each year. BJS deter-
mined that the rate of confirmed AIDS cases is 3 
times higher among incarcerated persons than in the 
general population. Minorities account for the major-
ity of AIDS-related deaths among incarcerated per-
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sons, with African-American incarcerated persons 
3.5 times more likely than White incarcerated per-
sons and 2.5 times more likely than Hispanic incar-
cerated persons to die from AIDS-related causes. 
(4) Studies suggest that other sexually trans-
mitted 
infections 
(STIs), 
such 
as 
gonorrhea, 
chlamydia, syphilis, genital herpes, viral hepatitis, 
and human papillomavirus, also exist at a higher 
rate among incarcerated persons than in the general 
population. For instance, researchers have estimated 
that the rate of Hepatitis C (HCV) infection among 
incarcerated persons is somewhere between 8 and 20 
times higher than that of the general population. 
(5) Correctional facilities lack a uniform system 
of STI testing and reporting. Establishing a uniform 
data collection system would assist in developing and 
targeting counseling and treatment programs for in-
carcerated persons. Better developed and targeted 
programs may reduce the spread of STIs. 
(6) Although Congress has acted to reduce the 
spread of sexual violence in correctional facilities by 
enacting the National Prison Rape Elimination Act 
(PREA) of 2003, BJS reported 8,210 allegations of 
sexual violence in correctional facilities in 2004. 
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(7) Approximately 95 percent of all incarcer-
ated persons eventually return to society. According 
to one study, every year approximately 100,000 per-
sons infected with both HIV and HCV are released 
from correctional facilities. These individuals com-
prise approximately 50 percent of all persons with 
both infections in the United States. 
(8) According to the Centers for Disease Con-
trol and Prevention (CDC), latex condoms, when 
used consistently and correctly, are highly effective 
in preventing the transmission of HIV. Latex 
condoms also reduce the risk of other STIs. Despite 
the effectiveness of condoms in reducing the spread 
of STIs, the Bureau of Prisons does not recommend 
their use in correctional facilities. 
(9) The distribution of condoms in correctional 
facilities is currently legal in certain parts of the 
United States and the world. The States of Vermont 
and Mississippi and the District of Columbia allow 
condom distribution programs in their correctional 
facilities. The cities of New York, San Francisco, 
Los Angeles, and Philadelphia also allow condom 
distribution in their correctional facilities. However, 
these States and cities operate fewer than 1 percent 
of all correctional facilities. In one study, researchers 
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found that 18 of 31 countries surveyed allowed 
condom distribution in correctional facilities. 
(10) In 2000 and 2001, researchers surveyed 
300 incarcerated persons and 100 correctional offi-
cers at the Central Detention Facility, a correctional 
facility operated by the District of Columbia at 
which condoms are available. Researchers found that 
both incarcerated persons and correctional officers 
generally supported the condom distribution pro-
gram and considered it to be important. Further-
more, the researchers determined that the program 
had not caused any major security infractions. In 
Canada, the Expert Committee on AIDS and Pris-
ons surveyed more than 400 correctional officers in 
the Federal prison system of Canada in 1995 and 
reported that 82 percent of those responding indi-
cated that the availability of condoms had created no 
problems at their facility. 
(11) The American Public Health Association, 
the United Nations Joint Program on HIV/AIDS, 
and the World Health Organization have endorsed 
the effectiveness of condom distribution programs in 
correctional facilities. 
(12) Many correctional facilities in the United 
States do not provide comprehensive testing and 
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treatment programs to reduce the spread of STIs. 
According to BJS surveys from 2000, only 899 of 
the 1,668 Federal and State correctional facilities 
(i.e. 54 percent) provided HIV/AIDS counseling pro-
grams. Only 1,104 of the 1,584 State correctional 
facilities (i.e. 70 percent) reported having a policy of 
treating incarcerated persons for HCV. 
SEC. 3. AUTHORITY TO ALLOW COMMUNITY ORGANIZA-
TIONS TO PROVIDE STI COUNSELING, STI 
PREVENTION EDUCATION, AND SEXUAL BAR-
RIER PROTECTION DEVICES IN FEDERAL 
CORRECTIONAL FACILITIES. 
(a) DIRECTIVE TO ATTORNEY GENERAL.—Not later 
than 30 days after the date of enactment of this Act, the 
Attorney General shall direct the Bureau of Prisons to 
allow community organizations to distribute sexual barrier 
protection devices and to engage in STI counseling and 
STI prevention education in Federal correctional facilities. 
These activities shall be subject to all relevant Federal 
laws and regulations which govern visitation in correc-
tional facilities. 
(b) INFORMATION REQUIREMENT.—Any community 
organization permitted to distribute sexual barrier protec-
tion devices under subsection (a) must ensure that the 
persons to whom the devices are distributed are informed 
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about the proper use and disposal of sexual barrier protec-
tion devices in accordance with established public health 
practices. Any community organization conducting STI 
counseling or STI prevention education under subsection 
(a) must offer comprehensive sexuality education. 
(c) POSSESSION OF DEVICE PROTECTED.—No Fed-
eral correctional facility may, because of the possession or 
use of a sexual barrier protection device— 
(1) take adverse action against an incarcerated 
person; or 
(2) consider possession or use as evidence of 
prohibited activity for the purpose of any Federal 
correctional facility administrative proceeding. 
(d) IMPLEMENTATION.—The Attorney General and 
Bureau of Prisons shall implement this section according 
to established public health practices in a manner that 
protects the health, safety, and privacy of incarcerated 
persons and of correctional facility staff. 
SEC. 4. SENSE OF CONGRESS REGARDING DISTRIBUTION 
OF SEXUAL BARRIER PROTECTION DEVICES 
IN STATE PRISON SYSTEMS. 
It is the sense of Congress that States should allow 
for the legal distribution of sexual barrier protection de-
vices in State correctional facilities to reduce the preva-
lence and spread of STIs in those facilities. 
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SEC. 5. SURVEY OF AND REPORT ON CORRECTIONAL FA-
CILITY PROGRAMS AIMED AT REDUCING THE 
SPREAD OF STIS. 
(a) SURVEY.—The Attorney General, after consulting 
with the Secretary of Health and Human Services, State 
officials, and community organizations, shall, to the max-
imum extent practicable, conduct a survey of all Federal 
and State correctional facilities no later than 180 days 
after the date of enactment of this Act and annually there-
after for five years to determine: 
(1) PREVENTION EDUCATION OFFERED.—The 
type of prevention education, information, or train-
ing offered to incarcerated persons and correctional 
facility staff regarding sexual violence and the 
spread of STIs, including whether such education, 
information, or training— 
(A) constitutes comprehensive sexuality 
education; 
(B) is compulsory for new incarcerated 
persons and for new staff; and 
(C) is offered on an on-going basis. 
(2) ACCESS TO SEXUAL BARRIER PROTECTION 
DEVICES.—Whether incarcerated persons can— 
(A) possess sexual barrier protection de-
vices; 
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(B) purchase sexual barrier protection de-
vices; 
(C) purchase sexual barrier protection de-
vices at a reduced cost; and 
(D) obtain sexual barrier protection devices 
without cost. 
(3) INCIDENCE OF SEXUAL VIOLENCE.—The in-
cidence of sexual violence and assault committed by 
incarcerated persons and by correctional facility 
staff. 
(4) COUNSELING, 
TREATMENT, 
AND
SUP-
PORTIVE SERVICES.—Whether the correctional facil-
ity requires incarcerated persons to participate in 
counseling, treatment, and supportive services re-
lated to STIs, or whether it offers such programs to 
incarcerated persons. 
(5) STI TESTING.—Whether the correctional 
facility tests incarcerated persons for STIs or gives 
them the option to undergo such testing— 
(A) at intake; 
(B) on a regular basis; and 
(C) prior to release. 
(6) STI TEST RESULTS.—The number of incar-
cerated persons who are tested for STIs and the out-
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come of such tests at each correctional facility, 
disaggregated to include results for— 
(A) the type of sexually transmitted infec-
tion tested for; 
(B) the race and/or ethnicity of individuals 
tested; 
(C) the age of individuals tested; and 
(D) the gender of individuals tested. 
(7) PRE-RELEASE REFERRAL POLICY.—Wheth-
er incarcerated persons are informed prior to release 
about STI-related services or other health services in 
their communities, including free and low-cost coun-
seling and treatment options. 
(8) PRE-RELEASE
REFERRALS
MADE.—The 
number of referrals to community-based organiza-
tions or public health facilities offering STI-related 
or other health services provided to incarcerated per-
sons prior to release, and the type of counseling or 
treatment for which the referral was made. 
(9) OTHER ACTIONS TAKEN.—Whether the cor-
rectional facility has taken any other action, in con-
junction with community organizations or otherwise, 
to reduce the prevalence and spread of STIs in that 
facility. 
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(b) PRIVACY.—In conducting the survey, the Attor-
ney General shall not request or retain the identity of any 
person who has sought or been offered counseling, treat-
ment, testing, or prevention education information regard-
ing an STI (including information about sexual barrier 
protection devices), or who has tested positive for an STI. 
(c) REPORT.—The Attorney General shall transmit 
to Congress and make publicly available the results of the 
survey required under subsection (a), both for the Nation 
as a whole and disaggregated as to each State and each 
correctional facility. To the maximum extent possible, the 
Attorney General shall issue the first report no later than 
1 year after the date of enactment of this Act and shall 
issue reports annually thereafter for 5 years. 
SEC. 6. STRATEGY. 
(a) DIRECTIVE TO ATTORNEY GENERAL.—The At-
torney General, in consultation with the Secretary of 
Health and Human Services, State officials, and commu-
nity organizations, shall develop and implement a 5-year 
strategy to reduce the prevalence and spread of STIs in 
Federal and State correctional facilities. To the maximum 
extent possible, the strategy shall be developed, trans-
mitted to Congress, and made publicly available no later 
than 180 days after the transmission of the first report 
required under subsection 5(c) of this Act. 
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(b) CONTENTS OF STRATEGY.—The strategy shall in-
clude the following: 
(1) PREVENTION EDUCATION.—A plan for im-
proving prevention education, information, and 
training offered to incarcerated persons and correc-
tional facility staff, including information and train-
ing on sexual violence and the spread of STIs, and 
comprehensive sexuality education. 
(2) SEXUAL BARRIER PROTECTION DEVICE AC-
CESS.—A plan for expanding access to sexual barrier 
protection devices in correctional facilities. 
(3) SEXUAL
VIOLENCE
REDUCTION.—A plan 
for reducing the incidence of sexual violence among 
incarcerated persons and correctional facility staff, 
developed in consultation with the National Prison 
Rape Elimination Commission. 
(4) COUNSELING AND SUPPORTIVE SERVICES.— 
A plan for expanding access to counseling and sup-
portive services related to STIs in correctional facili-
ties. 
(5) TESTING.—A plan for testing incarcerated 
persons for STIs during intake, during regular 
health exams, and prior to release, and that— 
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(A) is conducted in accordance with guide-
lines established by the Centers for Disease 
Control; 
(B) includes pre-test counseling; 
(C) requires that incarcerated persons are 
notified of their option to decline testing at any 
time; 
(D) requires that incarcerated persons are 
confidentially notified of their test results in a 
timely manner; and 
(E) ensures that incarcerated persons test-
ing positive for STIs receive post-test coun-
seling, care, treatment and supportive services. 
(6) TREATMENT.—A plan for ensuring that 
correctional facilities have the necessary medicine 
and equipment to treat and monitor STIs and for 
ensuring that incarcerated persons living with or 
testing positive for STIs receive and have access to 
care and treatment services. 
(7) STRATEGIES FOR DEMOGRAPHIC GROUPS.— 
A plan for developing and implementing culturally 
appropriate, sensitive, and specific strategies to re-
duce the spread of STIs among demographic groups 
heavily impacted by STIs. 
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(8) LINKAGES WITH COMMUNITIES AND FACILI-
TIES.—A plan for establishing and strengthening 
linkages to local communities and health facilities 
that provide counseling, testing, care, and treatment 
services and that may receive persons recently re-
leased from incarceration who are living with STIs. 
(9) OTHER PLANS.—Any other plans developed 
by the Attorney General for reducing the spread of 
STIs or improving the quality of health care in cor-
rectional facilities. 
(10) MONITORING SYSTEM.—A monitoring sys-
tem that establishes performance goals related to re-
ducing the prevalence and spread of STIs in correc-
tional facilities and which, where feasible, expresses 
such goals in quantifiable form. 
(11) MONITORING SYSTEM PERFORMANCE INDI-
CATORS.—Performance indicators that measure or 
assess the achievement of the performance goals de-
scribed in paragraph (9). 
(12) COST ESTIMATE.—A detailed estimate of 
the funding necessary to implement the strategy at 
the Federal and State levels for all 5 years, includ-
ing the amount of funds required by community or-
ganizations to implement the parts of the strategy in 
which they take part. 
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(c) REPORT.—The Attorney General shall transmit 
to Congress and make publicly available an annual 
progress report regarding the implementation and effec-
tiveness of the strategy described in subsection (a). The 
progress report shall include an evaluation of the imple-
mentation of the strategy using the monitoring system and 
performance indicators provided for in paragraphs (9) and 
(10) of subsection (b). 
SEC. 7. APPROPRIATIONS. 
(a) IN GENERAL.—There are authorized to be appro-
priated such sums as may be necessary to carry out this 
Act for each of the fiscal years 2007 through 2013. 
(b) AVAILABILITY OF FUNDS.—Amounts made avail-
able under paragraph (1) are authorized to remain avail-
able until expended. 
SEC. 8. DEFINITIONS. 
For the purposes of this Act: 
(1) CORRECTIONAL FACILITY.—The term ‘‘cor-
rectional facility’’ means any prison, penitentiary, 
adult detention facility, juvenile detention facility, 
jail, or other facility to which persons may be sent 
after conviction of a crime or act of juvenile delin-
quency within the United States. 
(2) INCARCERATED PERSON.—The term ‘‘incar-
cerated person’’ means any person who is serving a 
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sentence in a correctional facility after conviction of 
a crime. 
(3) SEXUALLY TRANSMITTED INFECTION.—The 
term ‘‘sexually transmitted infection’’ or ‘‘STI’’ 
means any disease or infection that is commonly 
transmitted through sexual activity, including HIV/ 
AIDS, gonorrhea, chlamydia, syphilis, genital her-
pes, viral hepatitis, and human papillomavirus. 
(4) SEXUAL BARRIER PROTECTION DEVICE.— 
The term ‘‘sexual barrier protection device’’ means 
any FDA-approved physical device which has not 
been tampered with and which reduces the prob-
ability of STI transmission or infection between sex-
ual partners, including female condoms, male 
condoms, and dental dams. 
(5) COMPREHENSIVE SEXUALITY EDUCATION.— 
The term ‘‘comprehensive sexuality education’’ 
means sexuality education that includes information 
about abstinence and about the proper use and dis-
posal of sexual barrier protection devices and which 
is— 
(A) based on evidence; 
(B) free from bias; and 
(C) comprehensive. 
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