"You can't do nothing in this damn place": sex and intimacy among couples with an incarcerated male partner.

When people think about sex and prison they usually contemplate male-on-male rape and conjugal visits. They also consider the regulation of sexual expression to primarily concern convicts' bodies. As human immunodeficiency virus (HIV)-prevention scientists who have been working since 1995 with women visiting their male partners at a California state prison, we have come to understand that correctional control extends to these women's bodies as well, both when they are within the facility's walls visiting their mates and when they are at home striving to remain connected to absent men. Various studies indicate that approximately 50% of incarcerated men consider themselves to be in committed heterosexual relationships and intend to return to their partners upon release from custody (Carlson & Cervera, 1991; Grinstead, Zack, & Faigeles, 1999; Jorgensen, Hernandez, & Warren, 1986; NACRO, 1994). No exact number of individual males who are processed by the United States correctional system each year is available, since the official figure of 13 million (Bureau of Justice Statistics, 2002) may include a number of repeat arrestees who factor more than once into the total. (1) However, even if "only" 6 million individual men were processed by the correctional system annually, as many as 3 million women could be affected by the incarceration of their partners. Moreover, it may be conservative to tally one woman

per inmate, since a portion of the men who are in relationships are likely to have more than one partner either simultaneously or sequentially over a year's time. Thus, their incarceration would affect multiple women.

Although the prevalence of women with incarcerated partners has not been systematically documented, 7% of the 4,349 female respondents to the National Sexual Health Survey (a national household probability sample) reported having a male primary partner who had been in prison or jail (Catania, 2000). In addition, a general population study of urban African American women found that 22% had a current sexual partner who had been incarcerated (Battle, Cummings, Barker, & Krasnovsky, 1995). The latter figure is consistent with the fact that African American men have been disproportionately affected by incarceration: 832,000 of the nation's 1.9 million male inmates are African American, and 13% of Black men in their 20s are behind bars compared to 3.7% of Hispanics and 1.6% of Whites (Harrison & Karberg, 2004).

The public health impact of the more than 7.5 million people who leave jail and prison to return to their communities each year is only beginning to be explored (Hammett, 2000; Travis, 2000). Incarcerated men have rates of hepatitis and sexually transmitted diseases (STDs) that are notably higher than those of the general population (Hammett, 1998; National Commission on Correctional Health Care, 2002; Rohde, 2001). In 2001, 2% of male state prisoners were known to be HIV-positive, and the overall confirmed rate of AIDS among prisoners was 3 times that of the general population (Maruschak, 2004). Given the overrepresentation of poor and minority men behind bars (Bonczar & Beck, 1997; Harrison & Karberg, 2004), the women who are most likely to have intimate sexual and needle-sharing relationships with recently imprisoned men are also likely to be low-income African Americans and Hispanics, populations accounting for nearly 82% of new HIV infections among women (Centers for Disease Control, 2004).

Despite a recent surge in research addressing the "collateral consequences" of imprisonment and in particular the impact of high rates of incarceration on families and communities (Braman, 2004; Hagan & Dinovitzer, 1999: King, 2003; Mauer & Chesney-Lind, 2002), little consideration has been given to the influence of punitive surveillance and regulation on romantic intimacy and the resulting implications for women's sexual health. Previous studies of women with incarcerated partners have focused more on stigma and shame (Bakker, Morris, & Janus, 1978; Daniel & Barrett, 1981; Fishman, 1990) or on the logistical difficulties of visiting prisoners (Girshick, 1996; Jorgensen et al., 1986) than on questions of relationship development and intimacy maintenance. Journalistic accounts of the lives of low-income women of color (Dash, 1997; LeBlanc, 2003) and personal memoirs written by wives of prisoners (Bandele, 1999: Maksymowicz, 2000) offer in-depth case studies of how romantic ties are altered by men's incarceration but are difficult to generalize to larger populations and typically do not discuss sexual health repercussions. Meanwhile, analyses of low-income women of color's sexual decision making (Sobo, 1995: Wingood & DiClemente, 1997) have not examined the peculiar circumstances of having a partner who is or recently was confined in a correctional facility (for a notable exception, see Lichtenstein, 2005).

For nearly a decade we have conducted a series of studies to develop and evaluate HIV-prevention interventions for incarcerated men and their female partners and to understand the impact of incarceration on couples, families, and communities. Our work with incarcerated men has involved evaluating an ongoing orientation program for new inmates and developing, implementing, and evaluating a single session peer-led prerelease intervention (Grinstead, Faigeles, & Zack, 1997; Grinstead, Zack, Faigeles, Grossman, & Blea, 1999), an 8-week prerelease program for HIV-seropositive inmates (Grinstead, Zack, & Faigeles, 2001), and a 12-week intervention for 18- to 29-year-old men conducted prior to and following release from prison (Grinstead et al., 2003). Our pilot program for the female partners of prisoners included a descriptive cross-sectional survey and a single-session peer-led educational intervention that we evaluated using pre- and post-intervention surveys as well as a 1-month follow-up survey (Comfort, Grinstead, Faigeles, & Zack, 2000: Grinstead, Faigeles, Bancroft, & Zack, 2001). All of our programs and research studies have been specifically designed for our target populations, and many of them were created and evaluated with on-going input from program participants and peer educators.

In an effort to deepen our understanding of how circumstances of forced separation and the interdiction of physical congress affect women's sexual behavior, our recent work has examined the development and maintenance of heterosexual couples' intimacy when the male partner is incarcerated. (2) Guiding research questions have included the following: How is intimacy established and expressed in situations that are observed, monitored, and judged by outside others who are invested with the punitive powers of the state? How is intimacy transformed in these situations? What are the repercussions of these transformations once the incarceration period is over? This paper analyzes the impact of a peculiar public "place"--a state penitentiary--on couples' romantic and sexual interactions, drawing out the implications of imprisonment for relationship decision making, sexual health, and HIV risk.

METHODS

Procedures

The majority of our previous research used quantitative methods to obtain information about women's demographic profiles, sexual behaviors, attitudes toward condom use, and other relevant topics (Comfort et al., 2000; Grinstead, Faigeles, et al., 2001). However, as we undertook the formative research for a new intervention-development study for women with incarcerated male partners, we established that qualitative methods were most appropriate for exploring women's relationship histories, the emotional, social, and interpersonal impact of their partners' incarceration, their perceptions of sexual intimacy and sexual health, and their perspectives on HIV risk in prison. We based this decision on two prior experiences of successfully using qualitative methods with this population to obtain fine-grained, nuanced data. One study used ethnographic observation and in-depth interviewing to document the sociological consequences of large-scale imprisomnent policies on women with incarcerated husbands and boyfriends (Comfort, 2002, 2003). The other study comprised one component of our pilot HIV-prevention intervention for women visiting men in prison (Comfort et al., 2000), in which we recruited and trained women with incarcerated partners to become peer educators who were given stipends and received ongoing supervision as they taught a single-session educational intervention. Peer educators also participated in qualitative interviews to describe their experiences with the program, including the impact of being a peer educator on their attitudes and behaviors related to relationships and HIV risk. Supporting data from these qualitative interviews are included in this paper.

We conducted our current study at San Quentin State Prison, an all-male institution located 18 miles northeast of San Francisco and housing approximately 6,000 inmates. Several hundred people come to San Quentin on each of the four weekly visiting days to spend anywhere from 1 to 7 hours with their incarcerated family members and friends. When visitors arrive at San Quentin, they wait in a long corridor, colloquially known as "the Tube," until they are granted entry to the prison. With the permission of the San Quentin administration, our two female interviewers approached a convenience sample of women who were in the Tube, explained the purpose of our study, and asked if they were visiting a romantic partner who would be released within the next 12 months. Women over the age of 18 who answered affirmatively were invited to participate in a 60- to 90-minute interview. Participants received $40 for their time, and free childcare and refreshments were provided.

Between February and June of 2003 we conducted 20 interviews, all of which were tape-recorded and transcribed verbatim. The majority of the interviews took place at "the House" at San Quentin, a facility located across the street from the prison's gates and owned by Centerforce, a nonprofit organization providing services to incarcerated people and their families in California. Four interviews were conducted in women's homes, and two occurred at our offices in San Francisco, because these were convenient locations for the participants. Due to the heightened vulnerability of imprisoned populations and their kin, we followed especially rigorous informed consent and anonymity procedures.

We also conducted qualitative interviews with correctional officers throughout 2003 and early 2004 with the goal of documenting an alternative perspective on HIV risk in prison, the experience of prison visiting, and the issues involved in maintaining a relationship with an incarcerated man. We received permission from the San Quentin administration to recruit 14 of the 20 correctional officers working directly with visitors at the prison, 13 of whom agreed to be interviewed. Once again we followed rigorous informed consent and anonymity procedures. In accordance with standard prison policy these interviews were not tape recorded, but extensive notes were taken during the interview and written up in detail afterwards. The interviews took place in various offices within San Quentin State Prison during the participants' normal working hours. The visiting lieutenant arranged for coverage of the participants' posts while they were being interviewed, and participants received a $10 gift certificate for their time. All procedures were approved by the University of California, San Francisco Committee on Human Research.

Three members of the research team (including the principal investigator and the project director) also conducted two observational visits to San Quentin. With institutional permission we were allowed to tour the visiting facilities and related areas while they were in use. The team produced 21 pages of fieldnotes based on these visits. Finally, we also drew on a combined total of 3 years of participant observation and interview experience with women with incarcerated partners on the part of the project director (first author of this article) to inform our interview guide and analysis.

Measures

We used semistructured interview guides with both the women with incarcerated partners and the correctional officers. Interviews with the former group began with general questions about how the women had met their partners and how often the partners had been incarcerated over the course of the relationships. The interviewers then explored how the women's lives changed when their partners were incarcerated, including probes about experiences visiting men in prison, ways of staying in touch and maintaining intimacy, changes in sexual behavior, experiences with drugs and alcohol (with and without their partners), and experiences with domestic violence. Questions toward the end of the interview focused on women's perceptions of health care, health risks, and HIV transmission in prison, and on their opinions about a proposed intervention for women with incarcerated partners.

The guide for the correctional officer interviews began with questions about the officers' professional backgrounds and how long they had been working with visitors at the prison. The interviewer then asked participants about their observations of interactions that transpired in the visiting room, including common problems and complaints, and for recommendations about how to meet the social-service needs of women visitors. Finally, officers were asked for their perceptions of the levels of HIV knowledge and awareness among prisoners and their visitors and for their suggestions about how to best design an HIV intervention for women with incarcerated partners.

Analysis

Our analysis team consisted of two qualitative specialists, the principal investigator, the project director, the project assistant, and the interviewers. For the analysis of the interviews with the women with incarcerated partners, we adopted a holistic approach that focused on keeping participants' stories intact rather than fragmenting the narratives into specific topical codes. To do so, we created a list of 12 domains we felt were significant for understanding the interviews. Five of these 12 domains were geared toward providing context, ideas for intervention development, and analytical reflection. The remaining 7 domains related to a theoretical model of HIV risk and risk behavior we developed based on findings from our previous research identifying five variables that enhance the likelihood that women will engage in unprotected sexual intercourse with their partners upon the men's release from prison. These 5 variables are misinformation, risk minimization and denial, social isolation, relationship pressures, and the impact of institutional policies. Each variable in this model takes into account the specific bearing of the correctional facility on women's perceptions of, attitudes about, and behaviors regarding their relationships.

Using the analysis domains, each interview was read and analyzed by two qualitative team members, one primary and one secondary. The primary analyst organized information from the interview under the domain headings, providing a brief narrative. The secondary analyst read the summary created by the primary analyst and inserted commentary throughout, providing a second perspective and additional information and bringing in a dissenting viewpoint or supporting the interpretation of the primary analyst. The finished summary consisted of narratives within each domain area, basic background information about the participant and her circumstances, and the thoughts, reactions, associations, and interpretations--indicated by italics and placed within brackets--of the two analysts. This summary and the transcription were then read by the entire group prior to each 1-hour meeting devoted to discussing an individual participant's interview. Detailed notes were taken at meetings to record additional input and interpretation offered by other members of the qualitative team.

The 13 correctional officer interviews were analyzed over the course of two 1-hour meetings. Rather than preserve individual narratives, as had been the goal in the women visitors' interviews, we chose to combine the correctional officer interviews and examine recurring themes and implications for intervention development. Detailed notes were taken at each meeting to record additional input and interpretation offered by other members of the qualitative team. At the end of the 22 weeks devoted to analyzing the formative interviews with women visitors and correctional officers, we held two wrap-up sessions in which we discussed prominent themes that emerged in the interviews and preliminary intervention ideas.

RESULTS

Sample

Twenty women with incarcerated male partners who were within fewer than 12 months until release from custody participated in qualitative interviews. Their ages ranged from 18 to 52, with an average age of 29. Nine participants were African American, 5 were White, 4 were Hispanic, and 2 did not specify their ethnicity. Fourteen of the participants had children and 1 was pregnant with her first child at the time of the interview. Three of the partnerships were cross-ethnic, with the man always being African American but the woman being Latina or White. The remaining relationships were intraethnic, with the possible exception of 5 participants who did not provide ethnic identification for themselves and/or their partners. In 12 of the relationships the woman was 2 to 20 years younger than her incarcerated partner (with an average of 7.5 years), and in 5 of the relationships the women were 3 to 4 years older than their partners (3 participants did not specify the age of their partners). (3) The majority of the participants were struggling to make ends meet on low incomes (obtained through government aid and/or low-wage jobs), although several indicated that they lived comfortably due to higher wage work, and one was proud of the "good money" her management occupation provided her.

Of the 13 correctional officers working directly with visitors at San Quentin State Prison who participated in the qualitative interviews, 11 were male and 2 were female. According to interviewer estimates, their ages ranged from the early 20s to early 50s, and 7 were White, 4 were African American, 1 was Hispanic, and 1 was of unidentified ethnicity.

The Penitentiary Place: Visiting Rooms and Regulations

Four types of visits take place at San Quentin: noncontact (during which the prisoner and his visitor are separated by glass and talk through a speaker system), Death Row (held in small cubicles containing the prisoner and his visitors), contact (held in cafeteria-style rooms in which prisoners and their visitors can walk around or sit next to each other), and family visits (overnight stays arranged for prisoners and their legal wives or other nuclear relatives that take place in specially designated trailers). Family visits are the only sanctioned forum for sexual interaction. There are six separate settings for visits with distinct amenities and levels of supervision. The higher security inmates must visit in enclosed spaces, while the lowest security prisoners enjoy "the Ranch," which has an outdoor area as well as a less-monitored indoor space. There is also a hierarchy of privilege for visiting rights within the different levels of security, determined by the behavior of the incarcerated partner while he is in prison. Inmates with behavioral infractions are restricted to noncontact visits, whereas inmates with clean records who meet certain criteria (e.g., have a scheduled release date, have not been convicted of domestic violence) are permitted private, overnight visits with their legal spouse or nuclear relatives within the prison grounds up to every 6 to 8 weeks, depending on availability.

Prison visiting programs are predicated on the idea that the maintenance of social relationships is beneficial both as a reward system for controlling inmate behavior and as a means of increasing the likelihood of successful postrelease reentry into the community. These seemingly straightforward purposes give rise to conflicting expectations of how visitors are to be treated and what is to occur in visiting areas, in particular the contact visiting areas. In our interviews, San Quentin correctional officers spoke of their duty to maintain a "family atmosphere" in the visiting rooms and of their mindfulness of the presence of children. They emphasized their beliefs that visitors must be decorous and "respectful of other inmates' families" when visiting, and they interpreted the strict rules governing physical contact (one kiss and hug allowed at the beginning and end of the visit with no physical touching other than holding hands in sight of the officers permitted during the visit) as essential to maintaining this environment. Comments about the continual need to enforce these rules and the perception that visitors are perpetually attempting to thwart them arose often in the correctional officer interviews.

Officers generally believe that rule enforcement during the initial screening processes that occur when visitors first enter the prison sets the tone for how strictly people will expect to be held to regulations throughout their time in the correctional facility. Once a woman has had her identification checked to verify that she is legally permitted to enter the prison, a correctional officer reviews her garments and possessions and determines whether or not her clothing complies with the institutional requirements governing fabric types and colors (visitors are not permitted to wear anything resembling inmate or officer attire, such as blue denim or camouflage) and "appropriate" dress: no exposed shoulders or midriffs, no hemlines more than 2 inches above the knee, no low necklines, no see-through fabrics. All of the visitor interview participants regardless of age or ethnicity found the dress-inspection process to be humiliating and expressed dissatisfaction or even explicit anger over the procedures that they considered to be demeaning, illogical, or unpredictably enforced. Seven of the 13 officers interviewed specifically commented on their difficulties implementing regulations that they felt were vague, constantly changing, and widely subject to individual interpretation. Four of these officers criticized their coworkers for being too relaxed in their application of the rules, while 1 acknowledged being "a little lenient" due to sympathy for the women, another struggled with a desire to bend the guidelines for regular or particularly stressed visitors, and 1 confessed to simply feeling overwhelmed by having "so many [rules] to follow."

Visitors whose attire is deemed inappropriate must change their clothing or forfeit their visit for that day. The initial inspection process may entail visitors being told to contort their bodies if officers suspect that the garments will shift and reveal too much in the course of the visit. One participant described the rigors she routinely endures:

   I'm big on the bottom and my top is real small. So all my shirts
   fit me kinda weird. So the officers in the front [entry of the
   prison] they'll say, "Raise your arms above your head. Higher!
   Higher!" And then, "Bend over and touch your toes."

The officers' concerns about sexual expression in the visiting room lead to policies of vigilant--and, many visitors feel, excessive--policing of any hint of sexual suggestion. Women reported feeling that they are regarded with high suspicion as being wild creatures who cannot be trusted to control their or their partners' sexual urges. African American women in particular described feelings of racial discrimination around the control of their bodies:

   I just feel they're just ridiculous with it.... I can understand
   sometimes the way you dress. I can understand that. But if one
   rule is going to apply for one visitor it should apply for the other
   ones. And I bad my incident you know. I wore white pants and the
   lady [correctional officer] didn't let me in with them. But the
   female before me she got in with hers. Why? And I've been trying
   to figure out what the hell? Why? She white and she don't
   have no body like a black person'? I mean what is the problem? ...
   Black people have a body and you know. I don't know what it
   was. That's what I took it at. Because my butt is a little bit
   bigger than hers you know. That's the only thing I could think of!
   ... And you know when [my husband] kissed me he said, "What's
   wrong?" And I told him, "They made me change." And he was
   like, "They made you change. What'd you had on?" I said, "I had
   on my white pants." And I said, "Right over there, she got white
   pants and they let her in." And he said, "Well you know why. It's
   the color of her skin." Maybe some people are racist up there. I
   don't know. But I felt it was the racist thing that day.

Visitors found this scrutiny and insinuations of their hypersexuality extremely hurtful and frustrating, and many insisted that they did not want to be sexual with their partners in the dirty, public space of the visiting room, but that they did consider some forms of contact--rubbing backs, caressing necks or cheeks, resting hands on knees or heads on shoulders--as wholesome acts entirely suitable and indeed inherent to the maintenance of family:

   With the prison thing it's just you know he's my husband and ... I
   can't touch him, you know. That really bothered me. It ain't
   like we bein' sexual you know and I know you can't do that--I
   wouldn't even do that in front of nobody. But just the point of me
   just layin' my head on his shoulder, it shouldn't be a problem....
   Maybe get the guards to ease up a little bit you know. I mean I
   understand you can't be doin' too much but I mean you can at least
   you know--like they say you only can kiss your man once. That's
   when you meet. Okay I mean [makes a "kiss" noise] a little peck
   throughout the visit, what's wrong with that? ... You're sittin'
   there all these hours and all you can do is hold his hand. And you
   sittin' straight up like this that is really uncomfortable.... And
   I mean what's wrong with kissin' your husband on the cheek
   throughout the visit'? Cause I don't see nothin' wrong with it!

   [On our wedding day the correctional officers] let us kiss for 10
   minutes and then we had to quit and walk away. And so it was
   very sweet and it was nice and it was exciting. But it was also
   very, very hard to see him in handcuffs and shackles and standard
   county uniform instead of you know slacks or something. And
   that was it. We could barely hold hands cause he was shackled.
   And we could only kiss for a certain amount of time and then we
   had to back up and walk away and not see each other until later
   on that afternoon behind glass. So we didn't even get to touch
   each other after we already said, 'I do'. So it was very nice but it
   was very, very hard because nobody else got to even come in. Our
   son didn't even get to come in which was hard. He didn't even get
   to come in and see us get married. Cause he asked, "Can I be
   there?" "No you can't." My mom couldn't come in: his morn
   couldn't come in so it was just me, him, the witness, the sheriff
   and the preacher. That was it. [Laughs] Nobody else.

Another conflict in the interpretation of family and family-suitable activities is the requirement that couples present legal documentation of marriage to be eligible for overnight visits. Celibacy is forced upon women who are not legally married but who wish to remain monogamous with an incarcerated partner: One participant bluntly responded to the interviewer's question, "When [your partner] has been incarcerated how does that change your sex life?" by announcing "How does it change it? It stops." The kisses and hugs permitted at the beginning and end of visits are required to be conducted in full view of officers on the lookout for mouth-to-mouth exchanges of contraband who call out "That's enough!" when the designated time is over. For women who are willing to risk sanction and engage in physical expression in the public space of the visiting room, sexual contact is reduced to furtive groping or brief congress in a bathroom while under constant threat of discovery and exposure. Some correctional officers talk about policing intimacy and sexuality in the visiting room matter-of-factly, as a necessary part of their job. Others admit that they find this task uncomfortable: "People try to go into corners for their touchy-feely stuff, and it can be embarrassing to tell a grown person, 'You know better than that.'" Meanwhile, visitors claim that they are harassed by officers who impute sexual innuendo to women's behavior, whether or not this is intended:

   P: Say for instance like one day I was eatin' a popsicle. I guess I
   must have been eating it seductive and maybe I was. I don't--what
   you want me to do just bite it'? It's cold.... So the guard said you
   know walked over to him [my husband] and did like this [crooked
   his finger to call the prisoner to him].... And he just basically'
   told him, "Your wife can't be eating that popsicle like that." "How
   the hell I'm eating my popsicle?" So he said, "You can't eat the
   popsicle like that. If you're going to eat it eat it." I said,
   "Okay."

   I: He said that directly to you?

   P: No. My husband came back and said it to me. The guard didn't
   say nothin' to me.

   I: And what'd you say'?

   P: I said, "Well how in the hell am I supposed to eat my popsicle?"
   He said the guard said if you're gonna eat it eat it. [laughs]
   So I kinda laughed about that cause it didn't make no sense. And
   I kinda copped an attitude. "I'll just throw the goddamn thing
   away.

   I: And you didn't eat it?

   P: And I got an attitude about it. I gave it to my baby.... Yeah. I
   seriously caught a attitude about it and said, "You can't do nothing
   in this damn place."

Ways of Staying in Touch: The Romantic Imagination as Sacred "Place"

Prisons, by design, are unpleasant places. While some efforts may be made to make the waiting and visiting areas more accommodating, security concerns, budget allocations, and the "correctional" mission of the institution result in facilities akin to other governmental buildings servicing the poor and socially marginalized, such as welfare offices. As one woman complained, "It's sorta cruddy lookin'. You know, and then when it's wet, it's very nasty. I don't even let my daughter sit down out there, you know? Looks like somebody urinated all over the place, you know, and so they need to improve that condition." Literally confined to overcrowded and constantly surveilled rooms for their courtship, women and their incarcerated partners carve out alternative "places" for romantic interaction using letters, drawings, and fantasy. Seventeen participants described writing and receiving often-daily letters from their loved ones as a primary vehicle for communication--one that ultimately substitutes for physical contact:

   It was letters upon letters upon letters ... And 1 think he wrote
   me 45 letters and I wrote him 55 in that short period of time [one
   month]. We were writing constantly back and forth ... we
   weren't able to touch or see each other. But we just kind of like
   we fell in love over that.

   And then you know we write letters back and forth and sometimes
   we start talkin" about fantasies and sex and all that. And then
   that get me aroused and I'm like, "'Dang it! Dang it!"

   And that's our limits is in writing to each other. Cause all we
   get is a kiss and a hug [during visits]. There's no intimacy
   whatsoever. So that's out the window. But being romantic with each
   other he knows how to draw. He draws me roses. Instead of going
   out and buying me a dozen roses and sending them to the house
   he draws me a dozen roses and sends them to the house.... He
   draws me pictures with hearts with a rose through it and clouds in
   the ocean and everything. He draws me how he feels and what he
   wishes he could give me.

Women described understanding their partners in ways that no one else does, speaking of the men as dual beings who have an external front for others (e.g., the gangster, the criminal) and an internal "sweetness" and "goodness" that only the women can see. It is the latter side that blossoms in letters sent from prison, when inmates express abundant love and devotion, claiming that they have recognized the error of their ways and promising to reform upon release. These letters reinforce women's beliefs that their partners have untapped potential and desires to be "good men" who will care for the women, provide for their children, and do whatever it takes to stay out of prison. The intensive written communication that occurs during the incarceration period creates a curious "space" of closeness that anchors even relationships that participants report were foundering when the couple was together in the community:

   I think the strain that's been put on us has made us closer, which
   when--a lot of relationships that I've had there's not good
   communication. And I think the situation that we're in now we don't
   have a choice but to communicate in ways and learn how to read
   each other. And I think we've done that. And I think that's what's
   really different is we're more friends. Because we don't have sex.
   We don't you know cuddle all day or anything like that. So we're
   friends. And I think that you really have to be friends in order for
   your relationship to work you really have to be friends and I think
   we've got that down. It's a good thing in a way that he is there [in
   prison] because it's brought us closer.

In addition to statements about being closer to these incarcerated men, women also praised their mates for being "there" for them. This indicates a peculiar dislocation of place: If a man living behind bars in a correctional facility is there for someone, then obviously "there" refers to an emotional place and not a location. This is particularly salient when a man is transferred from facility to facility: He may serve a 3-year sentence in four different prisons, but he has been "there" for her throughout their romance. Furthermore, the knowledge that men are guaranteed to be in a particular place--even if that place is far outside the home--gives women a sense of heightened emotional proximity to their partners and a strengthened confidence in the sexual monogamy of their relationships:

   It's like, kind of a way for the woman to kind of control [her
   partner]. Like 'Oh, now you're in prison. So now I know were you
   are. And know when you're gonna call me. I know that you're
   gonna call me. I can go visit you anytime I want to.' ... I'd be
   like,
   'Oh yeah, I know where my man is at all times.' And it'd be like
   a joke, but it'd be serious, too, you know, in this sick way.

It becomes apparent that for women with incarcerated partners, "there"--in all its iterations and geographical locations--is the "place" of the relationship. A compelling example of this is the case of those who met men once the latter were already behind bars. For these couples, their entire courtships have transpired in monitored and restricted spaces owned and controlled by the state, and yet women described in rich romantic detail events that had occurred through fantasy (such as synchronizing activities and pretending to do them together) and rituals of inclusion (like setting a place for a partner at the dinner table at home). In addition, some men decide to have their wives' or girlfriends' names tattooed on them while they are incarcerated, as if bridging the distance between bodies by inscribing the women onto their flesh, making the male bodies the place of the female as well.

Photos also play a part in this interweaving of spaces to create the communal romantic place. At the prison, each visiting area has a wall painted with an idyllic picture that inmates and visitors must use as the backdrop for any photos they have taken. Women often display these photos proudly in their homes or in their wallets, and one imagines thousands of photos spread throughout the state featuring men wearing the same clothes and standing against the same wall--a very generic and static place--with smiling women nestled next to them, the couple absorbed in the private, intimate universe they have created. Conversely, when a man is released into the community these photos can serve as reminders of the specific place of the prison: One woman reported keeping a photo of her husband taken while he was incarcerated on her keyring even after he had returned home so that she could flash it at him as a warning whenever she feared he was heading toward trouble--a gesture perfectly symbolizing the inescapability of the penal place haunting men on parole.

From Place to Place: The Transformation of Intimacy

When relationships are created and maintained in fictional, imaginative places, release from prison into the hardships of reality is particularly problematic. For those who spend large portions of their lives behind bars--whether as inmates or as visitors--there can be a bifurcation of the home place. This is demonstrated by the comments of two women, one of whom explained that for her recidivist stepfather "[the prison] was his home. Home was his second home," and another who mused that after her many hours of visiting "[the prison] is like a--a home away from home."

The transmutation of place is further complicated by the conditions of parole, under which people's residences and vehicles can be searched by police or parole agents without need for advance warning or a warrant. Parolees in a sense are "mobile penitentiaries," transporting the mandates of correctional control wherever they go and thus involuntarily transforming their domestic environments into sites of potential punitive surveillance. This is particularly distinctive in California, a state that places a greater percentage of its offenders on parole (95% vs. the national average of 82%) and where 67% of incoming prisoners are parolees being returned to custody for violating the conditions of their release, compared to the national average of 35% (Little Hoover Commission, 2003). While some parole violations suggest deliberate illegal behavior (e.g., a positive drug test), others are "technical violations" resulting from the failure to meet an administrative condition, like missing a scheduled meeting with a parole officer. Of the 15 participants who said that their partners were currently incarcerated on parole violations, 10 women attributed their partners' reincarceration to what they felt were unfair or unnecessary parole conditions. Among them, 3 specified that the men's arrests had resulted from the authorities finding kitchen knives, which under parole strictures are deemed forbidden weapons, in the couple's home or car. Others said that their partners had failed to immediately report a change of address to their parole officers or had not remained at their official address when a job or housing opportunity arose elsewhere. Overall, participants described a sense of fatalism about and an associated preemptive forgiveness for their partners' likelihood of reincarceration, due to the arbitrary enforcement of stipulations the women perceived to be indiscriminate or illogical:

   And [my partner] says he does not want to come back [to prison]
   and he's not gonna come back. And I said, "I understand sometimes
   you can't prevent it." Because you know being on parole, they can
   violate you for anything. You could look at an officer wrong and
   he'd say, "Come on, I'm taking you." That's how parole is.

The stress for a couple of having their daily life under scrutiny and their home and vehicles opened to search onsite by the authorities is typically compounded by a shock of readjustment to living together in physical proximity. Paradoxically, the intimate place created during a man's imprisonment is reliant upon aspects of the physical space of the correctional facility that keep men housed, fed, and segregated from their partners and the temptations or dangers of the streets. As explained above, carceral relationships are often characterized by a heightened romantic discourse, and the bulk of the promises made during the incarceration period become untenable once a man is in the community and faces the difficulties of finding a job, avoiding criminal acquaintances, resisting substance use, and otherwise enacting the "manhood" he has developed in his letters:

   It was hard [when we lived together before my husband's most
   recent arrest] .... His drinking [made life hard]. His drinking and
   me being pregnant and you know, the money. I didn't want him
   buying beer because we had to save money and the baby was
   about to be born.

   [I didn't realize that my husband was using drugs again] until the
   kids started saying, "Well we made our own dinner." Or I'd come
   home [from work] and it's midnight and he'd be sleeping and the
   kids would be making sandwiches, so I knew he didn't make anything
   for them. Lame excuses. "I was too tired." And I had phoned
   his job at one point and they said, "No, he hasn't been working
   here for about a week."

Likewise, while the couple now may enjoy unimpeded sexual contact, they must also contend with issues of distrust and jealousy that may have been exacerbated by their separation. In instances when men are prone to violence, this can trigger cycles of domestic abuse. One participant described foreseeing such problems during a prison visit:

   When I went to go visit him he always asks me a question did I
   mess with [have sex with] anybody after him, because I was his
   I mean he was my first [lover] .... And when I went to go see him
   I was holding his hand and I was like, "No, I haven't been messing
   with anybody." ... And he kinda bent my finger back and I'm
   kinda like, you know I never had that happen before. So I was like
   you know, "You're tripping." And you know I kinda--that's when
   I felt threatened a little bit like you know. And I'm thinkin' to
   myself could it grow into something where you know he probably
   could start hitting me and stuff like that.

The intensified romance of separation, the heightened sexual tension of interdiction, and cultural scripts urging women to support men and demonstrate loyalty result in a curious form of intimacy that reaches its zenith when male partners are held apart geographically but are emotionally available. When the man's promises of redemption are not supported by social-service programs for job placement, drug treatment, or domestic violence counseling, this intimacy quickly disintegrates upon his return home. Yet the perceived injustice and arbitrariness of parole violations prevent women from feeling that they can accurately gauge their partners' behavior: When the ostensible reasons for which the men most often are returned to prison do not involve "new" wrongdoing but rather the failure to meet an administrative condition, women are inclined to offer forgiveness, empathy, and support. Thus they complete the cycle, renewing their commitment to their relationships and reentering the place of romance across the penitentiary walls.

Implications of the Carceral Place for HIV-Prevention Research

The romantic scripts that are created during a man's imprisonment center on ideals of a hard-working, loyal, "good" woman waiting for her man, who is using his time behind bars to reflect on the error of his ways. Couples invest great emotional energy in the belief that they are each "cleaning up" any past mistakes and that they will have a fresh start with one another upon the man's release from prison, a conviction often buttressed by mutual assurances that there are no new sexual or needle-sharing partners in the picture. Confusion regarding correctional HIVtesting policies complicates this matter: 50% of the participants believed that all prisoners at San Quentin underwent mandatory HIV testing, when in fact California state prisons implement voluntary testing only. Meanwhile, 18 of the 20 participants said they had been tested for HIV at least once, with the majority reporting that they were tested frequently (every 6-12 months). Their own high rates of testing and their interpretations of HIV testing and risk in prison imbued women with a sense of security regarding their personal risk:

   P: I know that I've never caught anything from him on the streets
   or in here [in prison] and I get tested all the time.... So that's
   why
   I guess I don't worry about it too much because we've been
   together as long as we have and I haven't had anything [any
   STDs]. But then he also tells me too, you know like the stuff that
   is happening in here. What the guys do to, you know, with each
   other and stuff? And he always is like, "I have an imagination. I
   can look at a magazine and do whatever." so I, I don't even worry
   about that. Not in here.
   I: So it feels like with him you feel there really isn't a risk?
   P: No, not at all. [pause] If there was gonna be a risk it would
   probably be [chuckles] him bein' out [of prison] and with a female
   type thing more than him bein in here!

The prohibition of sexual contact during incarceration also has several implications for the transmission of HIV and STDs. First, it may increase the probability that men will seek sexual outlet with other men while they are confined. Rates of men-with-men sex in prison are extremely difficult to document, and published reports of its frequency vary widely in their findings (Koscheski, Hensley, Wright, & Tewksbury, 2002). However, correctional officers and former prisoners consistently say that consensual sex is common among inmates. Second, the limitations on sexual contact during a man's incarceration heighten the anticipation of an erotic reunion upon his release: "Well, it's kind of like a privilege to be the first for a man who's getting out of jail.... It's like, okay, this man has been gone for umpteen months or whatever and I'm the first one he's been with so he's going to give all his loving to me." Indeed, women portray sex after a man's release from prison as exciting, meaningful, and all-consuming: "We [had] missed each other so we was like havin' sex like all day, all day." In addition, women speak of wanting to conceive children with their partners soon after the men return home, which, when combined with the built-up desires for physical closeness and sexual release and the beliefs that both parties have been tested for HIV and have abstained from risk while they were separated, makes using condoms highly unlikely. Of the 11 participants who said that they had used condoms at some point with their incarcerated partner, the majority were disinclined to do so after his release from prison:

   1: Okay. And when he comes out [of prison] what about condom
   use?
   P: Ahhh--No. I mean I he knows that we want to try for a baby.
   ... I'm, I'm ready not to use one [a condom]. I mean I trust--I
   know he hasn't been with any other girls while he's been in there
   [prison]. And I know that he hasn't been [having sex with men],
   that's not his thing. You know so I know--it's a good time to start
   [not using condoms]. We're starting our lives together and I trust
   him. He's been very willing up to this point to do what I asked as
   far as wearing a condom ...
   I: So in terms of risk in prison it sounds like you don't see any?
   P: I think it's pretty low risk as far as his situation.

The strict regulation of women's sexual expression and the mandate that they be legally married to have sanctioned sexual contact (family visits) with their partners affects women's feelings of self-efficacy. Visitors reported that they felt humiliated when correctional officers chastised them for "inappropriate" dress or behavior and were shamed or frustrated when their unions were not recognized as being legitimate. Women recounted stories of men proposing from jail or prison ("And then the day he got here he decided to send the letter with the proposal in it"), and some outwardly acknowledged that they wed their partners behind bars in order to obtain the marriage certificate required for family visits.

Most women, however, were ineligible for these visits because they remained unmarried or because of their partners' security or behavioral status. The majority of these women reported that they remained sexually abstinent due to their loyalty and love for their partners, affirming their traditional gender roles and suppressing their sexual needs for extended periods of time while muting their sexual expression so that their partners would not suspect them of going outside of their primary relationship. However, two participants recounted renewing their sexual relations with former lovers, men with whom they did not use condoms, and one of them reported contracting genital herpes from her secondary partner. Another woman turned to a new partner for sexual release during her husband's prior incarceration. She also exchanged sex for money with an acquaintance, an income-generating strategy she never had practiced previously. This woman stated that her husband was currently in prison because he had violently assaulted her after learning about her secondary relationship. Although the percentage of women with secondary partners among our participants was small (15%), the taboo nature of these behaviors and the selection bias of our sample of women visitors (who by definition were those actively visiting their partners) suggest that a higher proportion of women in the general population of partners of prisoners are potentially at increased risk of HIV and STDs through their rekindling of relationships with past partners, turning to new secondary partners, engaging in remunerated sex, and perhaps suffering jealousy-provoked domestic violence.

DISCUSSION

The Regulation of Sexuality in U.S. Society

Beyond the implications for our HIV-prevention intervention development, our research findings raise questions about the treatment of human sexuality, gender roles, and power relations in the United States. It is important to note that heavy restrictions on inmates' sexual behavior are not a universal aspect of prisons. During a field visit to a Brazilian prison, for example, the local warden explained to the first author of this study that the only limitations placed on inmates' physical contact with outsiders were those of space constraints: Prisoners signed up on lists for hour-long spots in private rooms, and any outsider who wished to join them therein--whether wife, girlfriend, or sex worker--was permitted to do so. The warden did not specify whether or not males were allowed to have private visits with other males, but the recent film Carandiru (based on a book written by a doctor who worked at the eponymous prison in Silo Paulo until its closure in 1992; Varella, 2000) depicts men-with-men sexual intercourse as routine and socially acceptable. When the researchers on the field visit explained the regulations against touching, hugging, and kissing in American facilities, it was difficult for the Brazilian warden to understand the relationship between these extreme restrictions and security, and he commented that attempts to remove sexuality from prison visiting were unrealistic and inhumane.

Like the visitors we interviewed, we are led to ask why and whether it is necessary to have such extreme limitations not only on sexual behavior itself, but also on any behaviors that might lead to sexual thoughts or feelings. We speculate that couched in terms of prison security concerns there is also a moral issue about sexuality in general, and more specifically the expression of sexuality by those who are not "deserving" of it (e.g., prisoners, and by association their romantic partners). The banning of intimate contact to the point where nonsexual touching and verbal innuendo are also restricted may be both a punitive device and a reflection of a view that touch is a luxury rather than a basic human need. At its extreme, this is expressed in the experience of super-maximum security prisons, in which inmates are held in total isolation and machines rather than humans perform tasks such as the opening and closing of doors and the delivery of food (King, 1999). Mediatized examples include the movies Monster k Ball and Dead Man Walking, which depict men condemned to death who are denied a last touch and kiss prior to their execution for the supposed reason of security. The strict regulation of women's apparel vis-a-vis presumed intent to engage in illicit sexual stimulation and behavior provides a more mundane example of the correctional ethos that human touch, and indeed human sexuality, are privileges rather than needs, while simultaneously enforcing paternalistic definitions of "good women" as passive and subordinate beings who need to be protected from conniving and exploitative men.

Summary

Given the steep increase in incarceration rates in the United States and the sharply disproportionate imprisonment of young men of color, the issues we have discussed in this paper will influence the development of heterosexual relationships of many already vulnerable and disenfranchised young men and women. One recalls the finding reported earlier that 22% of a general-population sample of urban African American women had a current sexual partner who had been incarcerated (Battle et al., 1995). Furthermore, elevated rates of recidivism due to technical parole violations exacerbate the susceptibility of women by making it difficult for them to set limits with their partners, whom they are inclined to view as wronged victims of a flawed and arbitrary criminal justice system. Our qualitative findings suggest that the dynamics of these relationships and the institutional constraints of criminal justice policy likely increase the risk of HIV and STD transmission as well as abusive romantic relationships. Therefore, understanding the carceral transformation of intimacy is extremely important from both public health and cultural perspectives: Only when we understand the relational dynamics happening across, behind, and in the shadow of the prison walls can we design effective interventions that reduce the risk of poor health outcomes and socially structured suffering.

(1) The United States correctional system includes jails (operated on a local level by counties and holding new arrestees awaiting trial, plus convicts sentenced to under 1 year of detention), state prisons (run by each state's department of corrections and containing felons serving over 1 year as well as parole violators), federal prisons (controlled by the Federal Bureau of Prisons and inhabited by offenders convicted of federal crimes), and community supervision under conditions of probation or parole.

(2) Gay and lesbian couples and heterosexual couples in which the female partner is incarcerated were not included in our research, and we do not know to what degree our findings apply to such couples.

(3) We have summarized the relevant patterns of age and ethnicity in the partnerships to ensure absolute anonymity. Due to human subject concerns we did not systematically collect individual demographic data on the incarcerated partners of our research subjects, but all of the women interviewed (except for 5) spontaneously communicated the age and ethnicity of their partners during the course of the interviews.

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Address correspondence to Megan Comfort, Center for AIDS Prevention Studies (CAPS), 74 New Montgomery St. Suite 600, San Francisco, CA 94105; e-mail: [e-mail].

The authors thank the study participants for their time and insights, our colleagues at Centerforce, and Shay Skye, Jax McKee-Shapter, and Magaly Pena. We also thank the reviewers and special-issue editor for their helpful feedback and suggestions. This project was funded by NINR RO1-NR08324-01. Comparative and background data were drawn from projects funded by NIMH/MH 42459, NIDA R01-DA10164, and the University-wide AIDS Research Program (UARP) at the University of California.