Date Published: January 11, 2013
Publisher: Public Library of Science
Author(s): Lorraine Yap, Tony Butler, Juliet Richters, Eva Malacova, Handan Wand, Anthony M. A. Smith, Luke Grant, Alun Richards, Basil Donovan, Patrick S. Sullivan. http://doi.org/10.1371/journal.pone.0053065
We report the prevalence of penile implants among prisoners and determine the independent predictors for having penile implants. Questions on penile implants were included in the Sexual Health and Attitudes of Australian Prisoners (SHAAP) survey following concerns raised by prison health staff that increasing numbers of prisoners reported having penile implants while in prison.
Computer-Assisted Telephone Interviewing (CATI) of a random sample of prisoners was carried out in 41 prisons in New South Wales and Queensland (Australia). Men were asked, “Have you ever inserted or implanted an object under the skin of your penis?” If they responded Yes: “Have you ever done so while you were in prison?” Univariate logistic regression and logistic regression were used to determine the factors associated with penile implants.
A total of 2,018 male prisoners were surveyed, aged between 18 and 65 years, and 118 (5.8%) reported that they had inserted or implanted an object under the skin of their penis. Of these men, 87 (73%) had this done while they were in prison. In the multivariate analysis, a younger age, birth in an Asian country, and prior incarceration were all significantly associated with penile implants (p<0.001). Men with penile implants were also more likely to report being paid for sex (p<0.001), to have had body piercings (p<0.001) or tattoos in prison (p<0.001), and to have taken non-prescription drugs while in prison (p<0.05). Penile implants appear to be fairly common among prisoners and are associated with risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of blood borne viruses and wound infection. Harm reduction and infection control strategies need to be developed to address this potential risk.
Penile implants are inert objects placed beneath the skin of the penis through an incision and are variously referred to as Yakuza beads, pearls, penile implants, penile beads, penile nodules, penile inserts, speed bumps, and penile marbles in the English literature –. Objects placed underneath the skin of the penile shaft may include ball bearings, plastic beads made from toothbrushes, glass, metal pellets, silicon, precious metals, marbles or pearls –. The practice is distinct from inflatable prostheses or semi-rigid bars to treat impotence.
The Sexual Health and Attitudes of Australian Prisoners (SHAAP) survey interviewed randomly sampled men and women prisoners in New South Wales (September 2006 to December 2006) and Queensland (September 2007 to June 2008) –. The survey utilised a computer-assisted telephone interview (CATI) format . To the best of our knowledge, this is the first time that this [CATI] approach has been used to screen a prisoner sample in an epidemiological survey.
Of the 2,018 male inmates surveyed, 118 (5.8%) reported that they had inserted or implanted an object under the skin of their penis. Of these, 87 (73%) had this done while they were in prison.
This paper is the first population-based epidemiological study to show the extent of penile implants among prisoners, and that most (73% of those with penile implants) report having had them inserted whilst in prison. This confirms case reports among clinicians who suggest that penile implants are not uncommon among incarcerated populations ––. In this study, the likelihood of having a penile implant increased with younger age, possibly suggesting that the incidence of the practice is increasing among prisoners. Having an Australian Indigenous background was not significantly associated with penile implants. Men with penile implants had a higher probability of using illicit drugs in prison, of being paid for sex, and having piercings and tattoos in prison, indicating riskier lifestyles than the average prisoner.
Penile implants appear to be fairly common among prisoners and associated with prisoners engaging in other risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of acquiring blood borne viruses and infections. More research needs to be conducted to understand the extent and impact of the practice and harm reduction strategies developed to address this risk.