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OMB No.: 1121-0311 Exp.: 01/31/2010 NATIONAL INMATE SURVEY Conducted by the Bureau of Justice Statistics and RTI International NOTICE: Public reporting for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the Director, Bureau of Justice Statistics, 810 Seventh Street, NW, Washington, DC 20531. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 1121-0311. 6. Are you currently being held in this facility for SECTION A any of the following: Please answer the question in the space provided or Mark x “Yes” or “No” for each item. Yes No mark your answer in the box, like this x. To protect A violent offense, such as physical or your privacy, do not put your name on this survey. c c sexual assault, rape, robbery, manslaughter, 1 2 attempted murder, or murder? 1. On what date were you admitted to this facility? A drug offense, such as possessing, selling, c c 1 2 If you cannot remember the exact date, please write or manufacturing drugs? down whatever you can remember, such as the year A property offense, such as burglary, c c and the month. larceny, auto theft, bad checks, fraud, 1 2 _________ / __________ / _________ forgery, or grand theft? c c Month Day Year Any other offense? 1 2 2. How old are you? 7. How long have you been in this facility? c Age: ______ Less than 1 week ....................................... 1 c At least 1 week but less than 1 month ...... 2 c 3. Are you of Hispanic, Latino, or Spanish origin? At least 1 month but less than 2 months .. 3 c 4 c At least 2 months but less than 6 months .. 1 Yes ............................................................. c 5 c At least 6 months but less than 1 year ....... 2 No ............................................................. c At least 1 year but less than 5 years ........... 6 c At least 5 years but less than 10 years........ 7 4. Which of these categories describes your race: c 10 years or more ........................................ 8 Mark x “Yes” or “No” for each item. Yes No c c White 1 2 8. Before you were admitted to this facility, had you c c Black or African American 1 2 ever spent time as an adult or juvenile in a prison, c c jail, or other correctional facility? American Indian or Alaska Native 1 2 c c c Yes ............................................................. 1 Asian 1 2 c 2 c c No ............................................................. Native Hawaiian or other Pacific Islander 1 2 9. Do you consider yourself to be: 5. What is the highest level of school you have c 1 completed? Heterosexual or ‘Straight’ .......................... c c Bi-sexual ................................................... 2 Less than a high school graduate .............. 1 c c Homosexual or Gay .................................. 3 High school graduate or GED .................. 2 c c Other ........................................................ 4 Some college ............................................. 3 c College degree or more ............................. 4 1 10. Before you entered this facility, had anyone ever These next questions ask aboutunwanted sex or physically forced, pressured, or made you feel sexual contact you have had with other inmates in this you had to have sex or sexual contact – that is facility. By unwanted, we mean sex or sexual contact unwanted touching of the genitals or butt, or that you did not want to happen. vaginal, oral, or anal sex? c → Yes .......................... 1 Continue to item 11 14. In the past 12 months, did another inmate use c → No .......................... 2 Go to item 12 physical force to make you do any of the following: Mark x “Yes” or “No” for each item. Yes No 11. Were you physically forced, pressured, or made to Touch their body in a sexual way or have c c 1 2 feel you had to have sex or sexual contact before your body touched in a sexual way? you were 18 years old, after you turned 18, or both? Give them a handjob or receive a handjob c c c 1 2 Before you were 18 .................................... 1 from them? c c c After you turned 18 ................................... 2 Have oral sex (blowjob) with them? 1 2 c 3 c c Both .......................................................... Have anal sex with them? 1 2 12. Before you entered this facility, were you 15. In the past 12 months, did another inmate, physically forced, pressured, or made to feel that without using physical force, pressure you or make you had to have sex or sexual contact while you you feel that you had to do any of the following: were an adult or juvenile in a jail, prison, or other correctional facility? Mark x “Yes” or “No” for each item. Yes No c Yes ............................................................. 1 Touch their body in a sexual way or have c c 1 2 c your body touched in a sexual way? No ............................................................. 2 Give them a handjob or receive a handjob c c 1 2 from them? 13. This question is aboutwanted or voluntary sex or c c Have oral sex (blowjob) with them? 1 2 sexual contact you have had with other inmates in c c this facility. In the past 12 months, did you do any Have anal sex with them? 1 2 of the following: x Mark “Yes” or “No” for each item. Yes No 16. In the past 12 months, how many times altogether Touch another inmate’s body in a sexual were you physically forced, pressured, or made to c c way or have your body touched in a sexual 1 2 feel like you had to have sex or sexual contact with way? another inmate? c → Give or receive a handjob from another c c 1 1 2 0 times .................... Go to SECTION B on page 4 inmate at this facility? c 1 time ..................... 2 Have oral sex (blowjob) with another c c c 1 2 3 inmate at this facility? 2 times .................... → c Continue to item 17 on page 3 3 – 10 times ............ 4 Have anal sex with another inmate at this c c 1 2 c } facility? 11 times or more .... 5 2 17. In the past 12 months, when you were physically 19. In the past 12 months, when you were physically forced, pressured, or made to feel that you had to forced, pressured, or made to feel that you had to have sex or sexual contact with another inmate, have sex or sexual contact with another inmate, did it ever happen during any of the following were you ever: times: Mark x “Yes” or “No” for each item. Yes No x Mark “Yes” or “No” for each item. Yes No c c Persuaded or talked into it? 1 2 c c Between 6:00 in the morning and noon? 1 2 c c Given a bribe or blackmailed? 1 2 c c After noon but before 6:00 in the evening? 1 2 Given drugs or alcohol to get you drunk c c 1 2 After 6:00 in the evening but before c c or high? 1 2 midnight? c c Offered protection from other inmates? 1 2 After midnight but before 6:00 in the c c 1 2 Trying to pay off or settle a debt that you c c morning? 1 2 owed? c c Threatened with harm or a weapon? 1 2 18. In the past 12 months, when you were physically c c Physically held down or restrained? 1 2 forced, pressured, or made to feel that you had to c c have sex or sexual contact with another inmate, Physically harmed or injured? 1 2 did it ever happen: x Mark “Yes” or “No” for each item. Yes No 20. In the past 12 months, when you were physically c c forced, pressured, or made to feel that you had to In your own cell, room, or sleeping area? 1 2 have sex or sexual contact with another inmate, In the cell, room, or housing unit of c c 1 2 did you ever: another inmate? x c c Mark “Yes” or “No” for each item. Yes No In a shower or bathroom? 1 2 c c c c Receive knife or stab wounds? 1 2 In the yard or recreation area? 1 2 c c c c Receive broken bones? 1 2 In a classroom or library? 1 2 c c Receive anal tearing? 1 2 In a workshop, kitchen, or other c c 1 2 c c workplace? Have your teeth chipped or knocked out? 1 2 c c 1 2 c c In a closet, office, or other locked room? Receive internal injuries? 1 2 c c 1 2 c c On the stairs? Get knocked unconscious? 1 2 c c 1 2 Somewhere else in the facility? Receive bruises, a black eye, sprains, cuts, c c 1 2 c c scratches, swelling, or welts? Off facility grounds? 1 2 3 21. In the past 12 months, when you were physically 23. In the past 12 months, did a facility staff person forced, pressured, or made to feel that you had to use physical force to make you do any of the have sex or sexual contact with another inmate, following: did you report it to any of the following people: Mark x “Yes” or “No” for each item.

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