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Marcel E. Salive, MD, MPH
National Center for Health Services Research and Health Care Technology Assessment Rockville, Md

Gordon S. Smith, MB, ChB, MPH; T. Fordham Brewer, MD, MPH
The Johns Hopkins University School of Hygiene and Public Health Baltimore, Md

JAMA. 1989;262(24):3403.

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In Reply.—

We agree with Dr Wiggs that homosexual rape in prison may be a significant risk factor for inmate suicide. However, our data sources (prison census and death investigation information, as well as death certificates) included no information for either the completed suicides or the prison population on the incidence of homosexual rape. Differences between self-reported lifetime prevalence of sexual assaults in prison (up to 9%) and those reported to prison authorities (a handful each year)¹ suggest that underreporting of such activities is substantial. This consequently restricts the ability to conduct such studies, even with information from prison authorities on reported rapes. There is a need for more detailed followup to investigate risk factors for prison suicide, including its relationship to prison rape. . . . [Full Text PDF of this Article]

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