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N ATIONAL I NMATE S URVEY
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 xxxx-xxxx.
6. How long have you been in this facility?
SECTION A
Please answer the question in the space provided or
mark your answer in the box, like this ⌧. To protect your
privacy, do not put your name on this questionnaire.
1. On what date were you admitted to this facility?
If you cannot remember the exact date, please write
down whatever you can remember, such as the year
and the month.
_________ / __________ / _________
Month
Day
Year
2. How old are you?
Age: ______
3. Are you of Hispanic, Latino, or Spanish origin?
Yes .................................................................... 1
No .................................................................... 2
4. Which of these categories describes your race?
Mark one or more.
White................................................................
Black or African American ..............................
American Indian or Alaska Native ..................
Asian ................................................................
Native Hawaiian or other Pacific Islander ......
1
2
3
4
5
A violent offense, such as physical or sexual
assault, rape, robbery, manslaughter, attempted
murder, or murder?
A drug offense, such as possessing, selling, or
manufacturing drugs?
A property offense, such as burglary, larceny, auto
theft, bad checks, fraud, forgery, or grand theft?
Any other offense?
1
2
3
4
5
6
7. This question is about wanted or voluntary sex or
sexual contact you have had with other inmates in
this facility. Since you arrived at this facility, did you
do any of the following:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Touch another inmate’s body in a sexual way or
have your body touched in a sexual way?
1
2
Have oral sex with another inmate at this facility?
1
2
Have vaginal sex with another inmate at this
facility?
1
2
Have anal sex with another inmate at this facility?
1
2
These next questions ask about unwanted sex or sexual
contact you have had with other inmates in this facility. By
unwanted, we mean sex or sexual contact that you did not
want to happen.
8. Since you arrived at this facility, did another
inmate use physical force to make you do any
of the following:
5. Are you currently being held in this facility for
any of the following:
Mark ⌧ “ Yes” or “No” for each item.
Less than 1 month............................................
At least 1 month but less than 6 months ........
At least 6 months but less than 1 year ............
At least 1 year but less than 5 years..................
At least 5 years but less than 10 years ..............
10 years or more................................................
Yes
No
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
1
2
Touch their body in a sexual way or have your
body touched in a sexual way?
1
2
1
2
Have oral sex with them?
1
2
1
2
Have vaginal sex with them?
1
2
1
2
Have anal sex with them?
1
2
Continue to next page
1
9. Since you arrived at this facility, did another inmate,
without using physical force, pressure you or make
you feel that you had to do any of the following:
Mark ⌧ “ Yes” or “No” for each item.
Touch their body in a sexual way or have your
body touched in a sexual way?
Yes
No
1
2
Have oral sex with them?
1
2
Have vaginal sex with them?
1
2
Have anal sex with them?
1
2
10. Since you arrived at this facility, how many times
altogether were you physically forced, pressured,
or made to feel like you had to have sex or sexual
contact with another inmate?
0 times ......................
1 - 2 times ................
3 - 5 times ................
6 - 10 times ..............
11 or more times ......
1 Go to SECTION B, page 3
2
3
Continue to item 11
4
5
11. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did it ever happen during any of the
following times:
Mark ⌧ “ Yes” or “No” for each item.
Between 6:00 in the morning and noon?
Yes No
1 2
After noon but before 6:00 in the evening?
1
2
After 6:00 in the evening but before midnight?
1
2
After midnight but before 6:00 in the morning?
1
2
12. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did it ever happen:
Mark ⌧ “ Yes” or “No” for each item.
In your own cell, room, or sleeping area?
Yes No
1 2
13. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, were you ever:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Persuaded or talked into it?
1
2
Given a bribe or blackmailed?
1
2
Given drugs or alcohol to get you drunk or high?
1
2
Offered protection from other inmates?
1
2
Threatened with harm or a weapon?
1
2
Physically held down or restrained?
1
2
Physically harmed or injured?
1
2
14. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did you ever:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Receive knife or stab wounds?
1
2
Receive broken bones?
1
2
Receive anal or vaginal tearing?
1
2
Have your teeth chipped or knocked out?
1
2
Receive internal injuries?
1
2
Get knocked unconscious?
1
2
Receive bruises, a black eye, sprains, cuts,
scratches, swelling, or welts?
1
2
Receive some other injury?
1
2
15. Since you arrived at this facility, when you were
physically forced, pressured, or made to feel that
you had to have sex or sexual contact with another
inmate, did you report it to any of the following
people:
In the cell, room, or housing unit of another inmate? 1
2
In a shower or bathroom?
1
2
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
In the yard or recreation area?
1
2
A correctional officer?
1
2
In a classroom or library?
1
2
An administrative staff person?
1
2
In a workshop, kitchen, or other workplace?
1
2
A medical or healthcare staff person?
1
2
In a closet, office, or other locked room?
1
2
An instructor, teacher, or counselor?
1
2
Somewhere else in the facility?
1
2
A volunteer?
1
2
Off facility grounds?
1
2
Some other facility staff person?
1
2
2
Continue to next page
SECTION B
These next questions are about wanted or unwanted sex
or sexual contact you have had with staff at this facility.
By staff, we mean the employees of this facility and
anybody who works as a volunteer in this facility.
16. Since you arrived at this facility, have you willingly
had sex or sexual contact with any staff at this
facility?
Yes .................................................................... 1
No .................................................................... 2
17. Since you arrived at this facility, did a facility staff
person use physical force to make you have sex or
sexual contact with them?
Yes .................................................................... 1
No .................................................................... 2
18. Since you arrived at this facility, did a facility staff
person, without using physical force, pressure you
or make you feel that you had to have sex or sexual
contact with them?
Yes .................................................................... 1
No .................................................................... 2
19. Since you arrived at this facility, how many times
altogether have you had any type of wanted or
unwanted sex or sexual contact with staff at this
facility?
0 times ......................
1 - 2 times ................
3 - 5 times ................
6 - 10 times ..............
11 or more times ......
1 Go to item 28 on page 4
2
3
Continue to item 20
4
5
21. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did any single
incident ever involve more than one facility staff
person?
Yes .................................................................... 1
No .................................................................... 2
22. Since you arrived at this facility, when you had
sex or sexual contact with facility staff, did it ever
happen during any of the following times:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Between 6:00 in the morning and noon?
1
2
After noon but before 6:00 in the evening?
1
2
After 6:00 in the evening but before midnight?
1
2
After midnight but before 6:00 in the morning?
1
2
23. Since you arrived at this facility, when you had
sex or sexual contact with facility staff, did it ever
happen:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
In your own cell, room, or sleeping area?
1
2
In the cell, room, or housing unit of another inmate? 1
2
In a shower or bathroom?
1
2
In the yard or recreation area?
1
2
In a classroom or library?
1
2
In a workshop, kitchen, or other workplace?
1
2
In a closet, office, or other locked room?
1
2
Somewhere else in the facility?
1
2
Off facility grounds?
1
2
24. Since you arrived at this facility, when you had sex
or sexual contact with facility staff were you ever:
20. Which of the following types of sex or sexual
contact did you have with a facility staff person?
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Persuaded or talked into it?
1
2
Given a bribe or blackmailed?
1
2
Given drugs or alcohol to get you drunk or high?
1
2
Offered protection from other inmates?
1
2
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
You touched a facility staff person’s body in a
sexual way or had your body touched in a sexual
way.
1
2
You had oral sex.
1
2
Threatened with harm or a weapon?
1
2
You had vaginal sex.
1
2
Physically held down or restrained?
1
2
You had anal sex.
1
2
Physically harmed or injured?
1
2
Continue to next page
3
25. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, was it ever with
the following:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Male facility staff?
Female facility staff?
1
1
2
2
26. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did you ever:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
Receive knife or stab wounds?
Receive broken bones?
Receive anal or vaginal tearing?
Have your teeth chipped or knocked out?
Receive internal injuries?
Get knocked unconscious?
Receive bruises, a black eye, sprains, cuts,
scratches, swelling, or welts?
Some other injury?
1
1
1
1
1
1
2
2
2
2
2
2
1
2
1
2
27. Since you arrived at this facility, when you had sex
or sexual contact with facility staff, did you ever
report it to any of the following people:
Mark ⌧ “ Yes” or “No” for each item.
Yes
No
A correctional officer?
An administrative staff person?
A medical or healthcare staff person?
An instructor, teacher, or counselor?
A volunteer?
Some other facility staff person?
1
1
1
1
1
1
2
2
2
2
2
2
4
END QUESTIONNAIRE
These last two questions are about your experience with
this questionnaire.
28. How upsetting did you find it to answer questions
about your own experiences with sex and sexual
assault in this facility?
Not upsetting at all .......................................... 1
Somewhat upsetting ........................................ 2
Very upsetting .................................................. 3
29. How accurate are the answers you gave in this
questionnaire?
Not very accurate .............................................. 1
Fairly accurate .................................................. 2
Very accurate .................................................... 3
After you have completed the survey, please put
it in the envelope and seal it before you turn it in.
Thank you!
| File Type | application/pdf |
| File Title | Natl Inmate Survey_PAPI_F_arrived.qxd |
| Author | Lee, Deborah M. (Debbie) |
| File Modified | 2007-01-23 |
| File Created | 2007-01-23 |