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Some systems, like city and county jail systems, do not actively seek to identify and treat inmates with STDs. A study conducted by five reputable scholars analyzed "what factors" are important to the decision making process of women behind reporting sexual assault in prison "in an effort to inform or enhance the implementation of PREA. More specifically, around 29, prisoners reported an incident regarding another inmate, 34, prisoners reported an incident involving staff that worked at the facility, and 5, inmates reported an incident involving both. Some prisons separate known homosexuals, bisexuals, and transgender people from the general prison population to prevent rape and violence against them. A meta-analysis published in found a prevalence rate of 1. The results of the study showed that women who accepted rape myths were "

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Many reports of sexual abuse of either coerced vaginal or anal intercourse remain unreported. The test consisted of six questions on how often had the inmates felt nervous, hopeless, restless, depressed, effortless, and worthless in the past 30 days. The, "physical and psychological problems resulting from prison rape also make it difficult for former inmates to keep steady jobs or to assimilate back into the normal routines of life". People largely, deeply misunderstand the gravity of prison rape. The privatization of correctional facilities can be harmful to the public health, the incentive to screen and treat inmates at a cost is low. Some prisons separate known homosexuals, bisexuals, and transgender people from the general prison population to prevent rape and violence against them.

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To conclude, rates of staff sexual misconduct were highest in facilities where youth perceived the facility staff to be unfair However, the most recent research on women inmates indicates a change. Sexual assault victims deal with severe shame and fear, which plays a significant role in their decision to report the crime. Women that are transgender, "are [specifically] subject to high levels of police abuse, including profiling as sex workers and sexual exploitation and physical and verbal abuse from guards and male inmates while in detention". Juvenile Justice Information Exchange.

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