Inmates call Ron Osorio "West Hollywood" because the words are printed on the cream-colored cloth bag he carries inside Men's Central Jail each Friday.
The bag is filled with 300 Lifestyle condoms. Osorio, who works for the nonprofit Center for Health Justice, has been visiting the jail almost weekly since 2001, when Los Angeles County Sheriff Lee Baca approved a small but groundbreaking program that allowed the health group to pass out prophylactics to inmates in a segregated unit for gay men.
"We go to the dorms and a guy hands out the bagged lunches. There's another guy that hands out the juice. . . . and I stand between those two as they go through the line. They get their lunch, they get a condom, and they get their juice," Osorio said.
Not all inmates take condoms, but Osorio talks to those who do about the risks of HIV/AIDS.
He tells them that, despite what he's handing them, it's forbidden to have sex in jail.
Osorio has distributed more than 43,655 condoms to inmates since the project began, but said that is not nearly enough.
The transfer rate of HIV/AIDS in jail continues to be high, he said, and the public is at risk because once released, inmates carry the diseases back to their communities.
Eight years after Baca first approved the program, the sheriff is pondering whether to expand it by doubling the number of condoms distributed to the 300 inmates within the segregated unit.
His decision comes as a yearlong pilot condom distribution program at the California State Prison at Solano enters its eighth month.
Health advocates say that a successful review of that program could lead to widespread distribution of condoms in prisons throughout the state.
It would be one of the most aggressive measures in the nation's jails and prisons to curb the spread of HIV/AIDS, experts say.
Sheriff's officials acknowledge that the virus is a prominent problem in the jails.
They spend about $2 million each year in federally refundable money on HIV/AIDS medication and identify about 65 new cases each month.
On average there are about 1,400 people in L.A. County jails with HIV each year, said Steve Whitmore, a spokesman for the Sheriff's Department.
'There's a paradox'
Osorio, who was incarcerated for 19 months beginning in 1999, said that consensual sex in prisons is common.
He said inmates often go to extreme and unsafe lengths for protection, using plastic wrap from their sandwiches, rubber gloves and empty candy wrappers during sex.
"One condom per week is not enough," Osorio said. "To believe they're doing it one time, come on."
According to a United Nations report published last year on HIV and AIDS in places of detention, about 1.9% of prisoners in the United States are known to be HIV-positive.
The report also says the issue is international and calls for more education, efforts to reduce the supply of drugs in institutions, and condom distribution as a way to combat the diseases.
Currently, only a few jails in the United States -- including some in San Francisco, New York City, Philadelphia andWashington, D.C. -- offer condoms to inmates. Condoms are also available in prisons in Vermont.
Providing condoms to inmates seems like a "no-brainer," said Mary Sylla, who founded the Center for Health Justice, a nonprofit organization based in West Hollywood that focuses on reducing HIV cases in prisons.
She said that when condoms are offered, inmates do take them and reports of unsafe sexual activity decline.
Despite calls by health groups, most efforts to expand distribution have stalled, and state bills -- including one in California -- that could have led to widespread distribution of the prophylactics have been continuously voted down, died in committee or were vetoed.
Distributing condoms in jails is often a taboo issue, and authorities say they must balance the public health issue with their pledge to uphold the law.
"Sex in jails is against the law, but there is a public health issue that needs to be considered," Whitmore said. "There's a paradox here."
Some prison officials worry that inmates will use the condoms to attack prison guards by filling condoms with urine or feces and throwing them at guards in what is known as "gassing."
Richard L. Tatum, state president of the California Correctional Supervisors Organization, said his group opposes condom distribution programs in jails and prisons because inmates could use them to smuggle drugs and other contraband.
He said the spread of HIV/AIDS and other diseases within incarcerated populations is a problem, not only because of sex but also because of tattooing and other activities.
He said educational programs, not condoms, are the answer.
But Whitmore said the condom giveaways have not proved to be a problem in Men's Central.
At the prison in Solano, where condoms are dispensed in a type of vending machine available to the general prison population, few problems have been reported, Sylla said.
"No place that has instituted condom distribution has then revoked it because of problems," said Nina Harawa, an assistant professor at Charles Drew University in South Los Angeles who researches HIV/AIDS in incarcerated populations.
Harawa said condoms are provided to prisoners in parts of Europe, the Middle East, Latin America and South Africa.
She said that the program at Men's Central "is an ideal example of how this can work successfully in the United States."
For Osorio, who is HIV-positive, the issue is personal.
He said he makes the trek to Men's Central Jail every Friday because condoms can save lives and money.
"How much money are we saving the state if we can keep one person from being infected?" he said.
"When they're in the jail system, you and I are paying for it," Osorio said. "That's what we need to understand."