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.
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.,
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
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
2018 by SCITEPRESS Science and Technology Publications, Lda. All rights reserved
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,
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
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.
2.1 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
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
orientation AND in AND prison) AND
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
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
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
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.
3.1 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).
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
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).
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
Record title and abstract
Record screen
Record exclude title
and abstract (n= 66)
Full text article
assessed for
(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
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
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
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
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
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
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
INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research
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
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.
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.
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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INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research