Prevalence and predictors of penile nodules in French Guiana's sole prison facility

Abstract

Purpose: Penile implants or nodules are objects inserted beneath the skin of the penis mostly for erotic purposes. The procedure is painful and there may be complications. It is often associated with prison. Our objectives were to describe the prevalence of penile nodules among inmates in French Guiana, and to study factors associated with this practice, notably psychiatric diagnoses.

Methods: The study was cross-sectional. All consenting new adult prisoners incarcerated between 01/01/2014 and 31/12/2014 at the penitentiary centre of French Guiana were included. The Mini International Neuropsychiatric Interview (MINI) was used to screen for psychiatric diagnoses.

Results: Of 492, 29.6% declared having penile nodules. The median number was 4 (IQR = 2-7). The number of nodules correlated with age. There was no statistical link between the presence of penile nodules and the reasonforincarceration. Multivariate analysis showed that persons <45years with prior incarcerations, with substance addiction, and those with a history of death in the family were more likely to have penile nodules. Those with psychosis and those with suicidal risk were less likely to have penile nodules. Prisoners speaking English or Maroon languages seemed more likely to have penile implants in the multivariate model.

Conclusions: Overall, 29.6% of arriving inmates had penile nodules. The practice was linked to drug addiction and was less frequent among those with psychosis and suicidal risk. Given the high HIV prevalence in prison, penile nodule may be an obstacle to condom-based prevention.

Fig 1. Distribution of the number of penile nodules among inmates in French Guiana.

Fig 2. Proportion of male inmates with penile nodules, by language spoken.

Fig 3. Principal component analysis showing the component loadings for psychiatric diagnoses and the presence of penile nodules.