Sexual Activity of Male and Female Prisoners in Prison and The

Impact on Sexual Orientation

A Systematic Review

Ely Rahmatika Nugrahani, Amalia Kusumaningsih, Nurilla Kholida, Siti Kholifah and Ah Yusuf

Faculty of Nursing, Universitas Airlangga, Kampus C Mulyorejo, Surabaya, Indonesia

Keyword: Sexual Activity, Prison, Sexual Orientation, Male Prisoners, Female Prisoners.

Abstract: Introduction: Psychological problems occurred in prisoners one that is sexual orientation disorder. This

research has not been widely developed. The purpose of this study was to explain the difference betwee

sexual activity of female and male prisoners as well as the impact of sexual orientation in prison. Method:

Systematic review included: 1) Scopus, PubMed, Sage Journals, Springer Link, Science Direct database

2)search on 22 February-10 March 2018, publication 2012-2018 3) English language 4) focus on sexual

activity of prisoners and the impact of sexual orientation during imprisonment 5) PICOS approach. Results:

The review identifies that female prisoners has decline sexuality desire, while men is opposite. Sexual

activity imprisoned is masturbation, stroking, kissing, while men do coercion oral sex, finger sex. Female

prisoners perform homosexual, while male perform bisexual, heterosexual, homosexual. Discussion: The

sexual activity of male and female prisoners has a difference. Higher men have sexual desires than female.

Sexual orientation disorders affect the needs, hope, Axis I Axis II disorder, period of detention. Sexual

orientation is influenced by sexual activity, religion, belief, history, drug use. Conclusion: Prisoners commit

sexual perversions during the period of detention, thus affecting sexual orientation. Sexual orientatio

disorders can cause depression, suicidal ideation.

1 BACKGROUND

Prisons are a place that has limitations to individual

freedom (Ben Ammar et al., 2015). Prisoners must

follow the rules set by the prison. Lack of freedom

of prisoners in activities, can trigger the occurrence

of various problems during the period of detention,

such as health, social, and economic problems.

Prisoners are a vulnerable population and they are at

risk of health problems (Carcedo, Perlman, López,

Orgaz, & Fernández-Rouco, 2015). Factors at risk of

increasing health problems in prisons include the

onset of HIV/AIDS. Injecting drug use, as well as

consensual and non-consensual activities (Jürgens,

Nowak, & Day, 2013). Consensual and non-

consensual activities are activities related to the

willingness or coercion among prisoners in

performing an activity, such as sexual activity.

Sexual activity limited to prisoners in prison can be

one of the trigger factors of sexual orientation

disorder, but it is still unexplained.

The number of inmates in the United States who

are undergoing a period of detention has increased

over 30 years, about 1.6 million people (Rowell-

Cunsolo, Szeto, Sampong, & Larson, 2016). Every

year in the local prison there is also an increase in

the number of inmates, about 11 million people

(Schneider, Lancki, & Schumm, 2017). So it can be

concluded that the number of inmates experienced

an increase.

The period of detention is a period that has a

high risk of disease transmission, one of which is

due to the influence of bad health condition of

prisoners (Catz et al., 2012). Life during detention

also alters the pattern of sexual activity with couples

(Ben Ammar et al., 2015). One study mentions that

inmates actively engage in sexual activity during

their time of punishment (Rowell-Cunsolo et al.,

2016).

Sexual activity during the period of detention can

cause problems. The problem is that the risk is high

risk of contracting HIV/AIDS, or due to unhealthy

406

Nugrahani, E., Kusumaningsih, A., Kholida, N., Kholifah, S. and Yusuf, A.

Sexual Activity of Male and Female Prisoners in Prison and The Impact on Sexual Orientation.

DOI: 10.5220/0008325904060412

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 406-412

ISBN: 978-989-758-336-0

sexual activity. Sexual behavior in prison is also

affected by the use of drugs (Rowell-Cunsolo et al.,

2016). Sexual activity can also lead to violent

behavior in the prison environment, as well as the

stigmatization that still occurs to date (Rowell-

Cunsolo et al., 2016). So it can be concluded that

psychiatric, psychological, physical, or sexual

disturbance is an important problem of prisoners to

watch out for, managed, and prevented properly.

The results suggest that sexual behavior during

the period of detention is a relatively common

behavior performed by inmates (Gibson & Hensley,

2013). The hierarchy of sexual activity during the

prison term mentioned vulnerability to coercion or

non-consensual, as well as sexual harassment among

prisoners in prison (Kelly-Hanku, Kawage, Vallely,

Mek, & Mathers, 2015). So it can be concluded that

sexual activity while in prison, and supported by the

freedom limitations of prison, can affect the

prisoners in doing violence.

Non-consensual or coercive activities by inmates

in sexual activity in prison are offensive (Young, J.

E., Rygh, J. L., Weinberger, A. D., & Beck, 2014).

The non-consensual sexual activity perpetrated by

inmates in prison is a medium for the satisfaction of

sexual desires. Characteristics such as race, age,

sexual orientation, and gender can consistently affect

sexual activity while in prison (Gibson & Hensley,

2013).

The sexual activity of prisoners in prison may be

affected by the type of kelami. Sexual behavior

while in prison between female prisoners and male

prisoners is different. The study found that 46% of

male prisoners were actively engaged in sexual

activity while in prison, while 44% of female

detainees performed sexual activity during

imprisonment (Rowell-Cunsolo et al., 2016). In

addition to gender, past sexual activity, and sexual

orientation prior to prison, it may be possible to

influence sexual activity during the period of

detention (Rowell-Cunsolo et al., 2016).

Disturbance of sexual orientation in prisoners,

may be affected by the prisoners being held by

prisoners. The longer the convict is serving a

sentence and staying in prison, the greater the

likelihood that the individual may experience a

deviant sexual orientation. The longer the inmates

stay in jail, the more likely the prisoner will engage

in sexual activity with a deviant sexual orientation

(Gibson & Hensley, 2013).

The sexual orientation of prisoners can be

influenced by three models, including import

models, social construction models, and deprovation

models (Gibson & Hensley, 2013). The existence of

failure in heteronormative sexual identity, causing

prisoners tend to engage in sexual activity of sea

cucumbers, that is a homosexuals. Prisoners who

experience the failure of heteronotmative sexual

identity cause prisoners to create independent

subcult social values within the prison. Building

social situations and values related to sexual activity

is also done by inmates while in prison.

Sexual orientations that deviate to prisoners in

prison may cause some problems. Depression is a

serious problem experienced by prisoners

undergoing detention. Depression can cause a person

to desire suicide, if the problem he or she faces is

not resolved. The study says that as many as two-

fifths (21%) inmates have serious thoughts of

committing suicide, while one in 10 inmates has

attempted suicide (Piselli et al., 2015). Thus it can

be concluded that inmates who experience sexual

orientation disorders in meeting their sexual activity,

can be at risk of committing suicide. So in this case

researchers are interested to examine the differences

between fefmale prisoners and male prisoners in

sexual activity during imprisonment, as well as the

impact on sexual orientation during the detention

period.

The output of this study was to analyze

differences in prisoner sexual activity as well as the

impact on their sexual orientation. This study is

important to do to improve knowledge about sexual

activity of prisoners in prison. In addition, this study

is expected to be a source of reference information

for health workers in this case nurses, to develop the

world of nursing in the realm of the mental health,

maternity, and community. This study is also

expected to change the view in the fulfillment of the

sexuality of inmates to be viewed as one of the basic

human needs. Finally this study is expected to

prevent the existence of sexual orientation disorder

in prisoners, sexual violence between inmates, and

suicide prevention.

2 METHODS

2.1 Search Strategy

The search strategy of the journal begins by asking

the research question, "how is the difference

between the sexual activity of male with female

prisoners in the prisoner, and the impact on their

Sexual Activity of Male and Female Prisoners in Prison and The Impact on Sexual Orientation

407

sexual orientation?". The results of research on all

indexed journals related to sexual activity in prison

as well as impacted on sexual orientation.

The database used for journal searching is the

Scopus, PubMed, Sage Jornals, Springer Link, and

Science Direct databases. Keywords used are

TITLE-ABS-KEY (sexual AND activity AND in

AND prison) AND DOCTYPE (ar) AND

PUBYEAR>2011; TITLE-ABS-KEY (sexual AND

orientation AND in AND prison) AND

DOCTYPE (ar) AND PUBYEAR>2011; TITLE-

ABS-KEY (sexual AND activity AND sexual AND

orientation AND in AND prison) AND DOCTYPE

(ar) AND PUBYEA >2011. The journal searching

begins on February 22-March 10, 2018. Study

characteristics are selected from 2012 to 2018. The

language chosen on the characteristics of this study

is using the English language.

Data extraction is done by first searching the

journals related to the variables to be studied.

Researchers then select the appropriate areas and

titles to the variable of the variable sexual activity in

men and women and then sexual orientation. Then

the researcher reviewed the abstracts, the contents of

the journal, and finally found the appropriate

journal.

The first step of the researcher identified the

search through 5 databases, that are Scopus,

PubMed, Sage Jornals, Springer Link, and Science

Direct databases. Found as many as 167 displayed

and matching titles. A total of 101 journals are

according with abstact to the title of sexual activity

and sexual orientation. Then the researchers do the

assessment on full text and obtained results as many

as 29 appropriate. Then the researchers went on the

search and got 17 journals that compare the male

and female prisoners.

2.2 Selection Procedures and Data

Extraction

Selection of study and criteria this Systematic

Review by PICOS approach.

2.2.1 Population

The selected population is adult inmates (18-45

years) who are stay in prison.

2.2.2 Intervention

This study does not use an intervention, but conducts

interviews of inmates associated with sexual activity

during imprisonment and the impact on sexual

orientation.

2.2.3 Comparison

The study compared sexual activity between male

with female prisoners as well as the impact of sexual

orientation on them while in prison.

2.2.4 Output

Studies had to report that there is a difference

between sexual activity in both men and women.

Sexual activity describes the desire for sexual desire,

the frequency of sexual intercourse, the purpose of

sexual activity imprisoned, the impact on sexual

orientation, and other effects from sexual orientation

disorder in prison.

3. RESULTS

3.1 Study Review Results

3.1.1 Characteristics of Population Studies

The results of the study found that most female

prisoners have an average age of 30 years. Education

level is a general high school graduation. The

previous work was either housewife or also did not

work. The socioeconomic level of inmates is the

average standard (Ben Ammar et al., 2015) Fifty

percent are mostly prisoners in jail for the first time,

which is over a period of 5-10 years.

Characteristics of population studies on male

prisoners are mostly aged 18-45 years. The level of

education is high school. The job before

imprisonment is as the head of the family. Most of

the inmates have been imprisoned for 5-10 years

(Banbury, Lusher, & Morgan, 2016).

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Figure 1: PRISMA flow Diagram Sexual Activity and

Sexual Orientation.

3.1.2 Sexual Activity before Imprisonment

The results obtained that most female inmates do

sexual activity in adolescence. Prisoners describe

their sexual activity mostly as a husband-wife

activity, partly due to pleasure, the rest to meet

physiological needs, and for the needs of bonds.

Most inmates have had sexual activity at least once a

month. Inmates engage in mastrurbation activities

before detention, and a small proportion have

committed homosexuality (Ben Ammar et al., 2015).

Sexual activity before imprisonment, obtained

the result that most male prisoners perform sexual

activity in adolescence. During the last six months

inmates engaged in sexual activity (Rowell-Cunsolo,

Szeto, Sampong, & Larson, 2016). Most of the

sexual activities of inmates are influenced by

narcotic drugs.

3.1.3 Sexual Activity in Prison

The results of most female prisoners say that sexual

activity is essential for psychological and

physiological well-being. The restraint of

imprisoned sexuality is something that can be

frustrating (Ben Ammar et al., 2015). Most of the

inmates said that the lack of sexual activity had an

impact on prisoners to violent behavior. Some

inmates experience a decrease in sexuality desire.

Most say that sexual activity conducted in prison is

massive masturbation, homosexual, stroked, and

kissing (Catz et al., 2012). Compared with women,

sexual activity is imprisoned in men more actively

engaged in sexual activity (Ben Ammar et al., 2015).

Unlike women who experience a decrease in sexual

desire, male prisoners tend to continue to have these

desires. Sexual activity in male prisoners may

include rape, oral sex, fondling, sex through fingers,

as well as sexual activity affected by drugs (Banbury

et al., 2016).

3.1.4 Sexual Orientation

The results suggest that there are limitations to

sexual activity, causing female prisoners to engage

in homosexual activity. Most inmates commit

homosexuality due to lack of heterosexual couples.

The inmates say that the relationship is not

important because of the lack of men, fellow women

are more gentle in sexual activity, the need for

affection between prisoners, and a small proportion

of inmates who choose to homosexual due to fear of

contracting the disease (Ben Ammar et al., 2015).

Sexual orientation in prison on male prisoners is

likely during the last 6 months of sexual misconduct.

Unlike female prisoners who tend to engage in

homosexual sexual activity, male prisoners are more

likely to engage in bisexual sexual activity.

Homosexual sexual activity is also done, but more

on heterosexual or bisexual (Carcedo et al., 2015).

4 DISCUSSION

Prisons are a place that has a very complex problem.

Women prisoners engaged in sexual activity in

prison in different ways. Sexual activity is a human

need and a cramped shortage can lead to violence.

The need for sexuality between men and women

has a difference. Men have sexual needs more often

than women (Brenot & Wunsch, 2016). Men want

Record identified

through database

searching (n= 167)

Other source

(n=0)

Record title and abstract

(n=101)

Record screen

(n=101)

Record exclude title

and abstract (n= 66)

Full text article

assessed for

eligibility

(n= 29)

Articles accordingly (n= 17)

Article exclude didn’t

compare sexual activity

male with female prisoners

Sexual Activity of Male and Female Prisoners in Prison and The Impact on Sexual Orientation

409

sexual fulfillment done to try new things and be

more active in their frequency. Whereas in women

sexual desire is lower. Women need more

understanding, tenderness and affection in the

fulfillment of sexual needs (Brenot & Wunsch,

2016). The above statement can be concluded that

sexual activity between men and women have

differences.

The sexual activity of inmates during

imprisonment has limitations, causing impaired

inmates in sexual orientation. Sexual orientation can

be caused by anxiety and love needs (Hart &

Howard, 2016). Due to the anxiety and the need for

affection, will affect the emergence of intimate

desire and hope that ultimately affects a person's

sexual orientation.

Poor mental health contributes to a person's

sexual orientation disorder. The results of the study

indicate that inmates suffer from Axis I and II

disorders, as much as 65% (Piselli et al., 2015). Axis

I is a mental health disorder associated with clinical

syndrome, cognitive impairment, and psychotic

disorders, while Axis II is associated with

personality disorders. The presence of these two

disorders can cause a person to experience sexual

orientation disorder.

Changes in sexual orientation to prisoners may

change with length of stay in prison. Research says

that there is a change of sexual orientation while in

prison. A total of 79.1% of inmates changed sexual

orientation to bisexual, whereas previously 70% of

inmates committed heterosexuals (Gibson &

Hensley, 2013). It can thus be concluded that the

period of detention may alter the sexual orientation

of the prisoners.

Most female prisoners engage in sexual activity

in prisons by massive masturbation. Masturbation is

chosen by inmates to replace sexual activity, and

avoid sexual intercourse that can adversely affect

their physical and mental health. Active

masturbation activity is also influenced by the

religious level of inmates, where masturbation is

considered a dirty and forbidden activity. Broadly

speaking the sexual activity of women in prison

decreased sexual desire. Prisoners no longer engage

in sexual activity out of joy, but with some

embarrassment and guilt they do to a limitation and

suffering.

Homosexuals are chosen by inmates to prevent

sexual harassment behavior on them. It is a form of

loving and tender fulfillment, unlike actual sexual

relationships. In general, prisoners who engage in

homosexual activity in female prisoners are more

affected by past histories prior to the period of

detention.

Female prisoners who engage in sexual activity

are more likely to engage in prisoners' interactions.

They prefer to have consensual sexual intercourse,

in which there is no coercion and self-will (Jürgens

et al., 2013).

In contrast to women, male prisoners of sexual

activity are essential to be met. This is consistent

with the results of research that prisoners will

remain actively pursuing inappropriate relationships

with the correctional staff (Rowell-Cunsolo et al.,

2016). Male prisoners are more active and

aggressive in the mobilization of their needs through

coercion of other inmates or prison staff. To

overcome this, the prison provides sagging to meet

with his wife, as a form of maintaining harmony and

preventing any deviant sexual orientation.

Drug use may also affect the sexual orientation

of prisoners. The results showed that personality

disorder is a common disorder in prisoners due to

the use of substances, about 80% (Piselli et al.,

2015). The duration of detention is also associated

with sexual behavior in prison (Rowell-Cunsolo et

al., 2016). Thus, it can be concluded that users of

illicit drugs will be at risk of having psychiatric

disorders.

Male prisoners are more likely to engage in

aggressive action in their sexual activities. If

prisoners get enough of the drugs they want, then it

will protect the group's members, but if the inmates

do not get enough medicine, it will have an impact

on violent behavior, or sexual violence (Banbury et

al., 2016). So it can be concluded that drugs have an

important effect on sexual activity on male

prisoners.

One of the prevention of transmission of HIV /

AIDS as one of impact of existence of deviant

sexual orientation is by using condom. The use of

condoms intended to reduce the transmission of

infectious diseases does not show appropriate

results. Besides it is a condom that is able to help

search for agreement on sexual activity in prison.

Sexual violence to prisoners is still present in prison

(Pardue, Arrigo, & Murphy, 2013). Thus condoms

are presented to reduce the existence of sexual

violence behavior.

Condoms used as an alternative to prevention of

non-consensual activities do not help much. In fact

there are still many non-consensual and sexual

violence activities among prisoners. The study says

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as much as 1-2% of sexual activity in prisons is

conducted by consensual means (Jürgens et al.,

2013). Thus it can be concluded that sexual activity

imprisoned is still mostly done by non consensual.

There are still many inmates who engage in non-

consensual sexual activity. Condoms are not a tool

that can affect sexual activity in prisoners (Butler,

Richters, Yap, & Donovan, 2013). In this case it can

be concluded that the use of condoms on prisoners

has no effect on consensual sexual activity, even

non-consensual.

Deviation of sexual orientation, can cause

inmates depressed. The study represent that

prisoners may experience depression while in prison

due to inadequate sexual fulfillment. Female

prisoners are one-off more at risk of depression

when subjected to detention related to sexual

dysfunction (Baltieri, 2014). Male prisoners who

experience sexual orientation disorders may

experience depression and anxiety (Schneider et al.,

2017). Thus it can be concluded that inmates who

experienced deviations sexual orientation both men

and women vulnerable to depression.

The worst impact of depression resulting from

inadequate sexual needs that leads to a disorder of

sexual orientation is death. Depressed prisoners tend

to have suicidal ideas. The results show prisoners

have a serious idea to commit suicide, about 21%.

Prisoners who have attempted suicide, as many as

one in 10 inmates (Piselli et al., 2015). The study

represent, based on sex of inmates who conducted

suicide attempts, diantarnya are 93% men and 7%

women (Fazel, Ramesh, & Hawton, 2017). Thus it

can be concluded that male prisoners are at risk of

committing suicide in prison.

Limitations in this study are the presence of a

small sample. This limitation makes the results can

not be summed up globally. The second limitation is

the use of different languages with researchers,

although English is an international language, but

did not rule out in interpreting the sentence by the

researchers are not in accordance with what is to be

conveyed by the journal.

4.1 Implications

Based on the results of research that has been done a

study, it can be concluded that the results of the

journal can be applied in the realm of Nursing Soul.

Aspects of Nursing The broad mind needs to touch

specific places one of them is prison. Nurses of the

soul are expected to do so as a form of nursing

development development of the soul.

Innovation in the world of nursing, especially

mental health, maternity, and community of nursing

are needed to support science. Overview of sexual

activity imprisoned is an important phenomenon that

should always be developed to improve the coverage

of soul nursing goals, to obtain maximum results. In

the application of continuous innovations related to

the phenomenon, it is necessary to conduct a special

study related to the conformity characteristics of

clients in Indonesia.

5 CONCLUSIONS

Conclusions The results of this study indicate that

sexual activity does exist in the prison environment,

albeit in various ways. Women prisoners tend to

engage in sexual activity in prisons to seek affection

and tenderness, with male prisoners tending to find

satisfaction and channeling sexual desires. Sexual

orientation while in prison is impaired. Women tend

to be sexually oriented homosexual, while men tend

to be bisexual, but did not close the possibility for

both heterosexual. Orientasi sexual disorder that can

cause depression even the most severe is suicide.

Further research suggestions to undertake research

related to the impact that can be inflicted on

prisoners who have a sexual orientation disorder and

how appropriate interventions to do.

ACKNOWLEDGMENTS

Thank you for all those who have assisted in this

systematic review. Thank you to Universitas

Airlangga for giving us the opportunity, thanks also

to our mentors who have always helped to provide

input and direction to this research. Thanks to all

members of the group who have given spirit and

dedication for the implementation of this systematic

review, and all parties who helped and we can not

mention one by one.

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