LAST APRIL, at a prison in upstate New York, Kim Ayala met with her therapist about the nightmares that had been disrupting her sleep. A tiny 46-year-old with a gravelly voice and an expansive demeanor, Ayala had been transferred from Rikers Island a few months earlier to serve out a sentence for grand larceny. But memories of the New York City jail — of her treatment at the hands of a medical staffer there — continued to trouble her.

Ayala was incarcerated in October 2013 at the Rose M. Singer Center, known as Rosie, the island’s only women’s facility. Not long after she arrived, she says, she had a medical evaluation with a physician assistant named Sidney Wilson. Ayala asked Wilson to prescribe her some Fluocinonide, a steroid cream used to treat skin conditions like eczema, which Rikers inmates used as a substitute for lipstick. “It keeps your lips pink,” Ayala says. “Even though you smoke you want your lips to remain pink.”

Wilson was friendly and chatty. “Do you have a rash?” he asked. Ayala said no, that she needed the cream for her mouth. Then, Ayala says the conversation took a turn. “What are you willing to do for it?” she says Wilson responded. “Show me something and tell me what you want me to do.”

On multiple occasions, Ayala says, Wilson would bring her gifts — candy, cigarettes, chicken wings — as long as she would agree to expose her vagina or allow him to touch her sexually. He prescribed her medications she says she didn’t need, including Baclofen, a muscle relaxant, and Gabapentin, a seizure medication, which Ayala says she sold to other inmates. (Her medical records confirm Wilson prescribed her these medications.) He shared details about his personal life with her, told her she was smart and beautiful, and promised to meet her on the outside after she was released.

“When you’re incarcerated, you’re almost at a loss,” Ayala says. “The physical attention, the fact that he’s a doctor, the fact that you can get things from the outside. … He could take advantage of women in that situation.”

It wasn’t until after she left Rikers that Ayala understood the full implications of Wilson’s conduct. Referred by her therapist, Ayala says she reported Wilson’s behavior to an investigator with the state’s Department of Corrections and Community Supervision (DOCCS) in April. “The lady said that it’s a crime, that he shouldn’t have did it,” Ayala says. “He had us while we were silent.”

Rikers Island

Inmate waiting to enter the common area at the Rose M. Singer Center, Rikers Island. New York City, November 21, 2011.

Photo: Clara Vannucci

Ayala is not the only inmate Wilson has allegedly preyed upon. Latricia Revell, Theresa Bradberry, and Audry Slayton, all former Rosie inmates, say that Wilson — one of about a dozen PAs serving at the facility — touched them sexually, often in exchange for items like prescriptions, cigarettes, candy or food. Jamie Turner, a current Rosie inmate, and a sixth former inmate who wants to remain anonymous, say that Wilson asked them to show him their breasts in exchange for prescriptions. (Turner says she declined to do so.)

Under New York State law, people under correctional control are legally incapable of consent, so a jail employee who makes sexual contact with an inmate could be guilty of sexual abuse. New York City Department of Correction rules prohibit staff members from “indulging in any undue familiarity with inmates.” Professionally, Wilson’s alleged behavior would constitute sexual misconduct, according to the state Department of Health.

Reached by phone in May, Wilson categorically denied the allegations. (When I contacted him again in August with additional details, he said he had no response.)

“Am I a sex maniac or something?” Wilson said when I first spoke with him. “I do not do any kind of exam — especially pelvic exam where I have to touch them in the private part — without a female chaperone there.” Wilson argued that female inmates can fabricate accusations against a male provider and authorities will believe them because they are women. He further charged that the accusations against him were likely retaliation for his refusal to prescribe inmates medications they wanted to use to get high. “I’m telling you, these ladies — they come to you for some type of drugs, and if you don’t give it to them, that’s it,” he said. “You’re on the black list.”

All six women say this version of events is untrue. Like Ayala, Latricia Revell reported her experience with Wilson to DOCCS in April after she was transferred from Rikers to state prison. The agency has referred the matter back to New York City’s Department of Investigation, which is looking into the allegations.

WILSON IS EMPLOYED by Corizon Health, the nation’s largest for-profit correctional health care provider. The company — along with its corporate predecessor, Prison Health Services — has been under contract with New York City to provide health care at Rikers since 2001.

Wilson has been removed from patient contact, though he continues to work for Corizon in an administrative capacity, according to the company. A spokesperson for the city’s Department of Health and Mental Hygiene (DOHMH), which oversaw Corizon while Wilson was seeing Rosie patients, said that while privacy laws prohibit the agency from commenting on individual cases, “We take all allegations of sexual abuse very seriously.”

A Corizon spokesperson told The Intercept that the company investigates “any reported impropriety or abuse.” He added, “It goes without saying that substantiated cases of sexual assault and abuse of inmates are inexcusable and punishable by termination and reporting to law enforcement.”

But correctional health care operations, whether private or government run, often struggle to recruit high-quality medical professionals as working conditions can be taxing and sometimes dangerous. In recent years, several Corizon employees around the country have been accused of sexual misconduct.

In Alabama, Corizon hired two doctors whose medical licenses had previously been suspended over allegations they had sexual contact with patients. A nurse employed by Corizon in Daytona Beach, Florida, was fired in 2012 after a prisoner claimed the nurse had sex with him and gave him money. (She denied the allegations.) The Justice Department has opened a criminal investigation into a former Corizon physician, Mark Walden, for the alleged sexual abuse of male inmates at two New Mexico prisons. Walden, who has faced multiple lawsuits filed by former inmates accusing him of molestation, has denied the claims.

And Wilson is not the only Rikers health care provider to be accused of sexual abuse. Dr. Franck Leveille, who had been employed on the island for over a decade, was arrested on charges of sexual abuse and criminal sexual conduct in 2010 after complaints by two inmates. According to court documents, he was released on bail and subsequently fled to Haiti.

In June, Mayor Bill de Blasio announced that the city will not renew Corizon’s contract when it expires at the end of this year, and will instead turn correctional health care over to the Health and Hospitals Corporation, which runs the city’s public hospitals. (HHC is overseeing Corizon employees and health care delivery until then.) But the change will not mean a new medical staff at Rikers. Doctors, nurses, and physician assistants who worked for the company will keep their jobs as long as they pass background checks and performance reviews.

Rikers Island

Wall postings at the Rose M. Singer Center asking inmates to report corruption and misconduct to the city’s Department of Investigation. Rikers Island, New York City, November 21, 2011.

Photo: Clara Vannucci

IN THE U.S., incarcerated people have a greater need for reliable medical care than perhaps any other population. Inmates are disproportionately poor and sick, and imprisoned women in particular experience even higher rates of mental illness, substance dependency, and past trauma. Yet they have little say in who will care for them, or what kind of treatment they’ll receive.

Forty-four percent of women under correctional control — either in prison, jail or on probation — report having been physically or sexually assaulted prior to incarceration, according to the most recent national data, published in 1999. Smaller-scale studies around the country have found that nearly all imprisoned women and girls have experienced physical or sexual abuse. “A traumatized person in that situation is going to have a certain behavior, will react a certain way, is very vulnerable to re-traumatization,” says Amy Fettig, senior staff counsel at the ACLU’s National Prison Project.

Kim Ayala says she was sexually abused by a family member from ages nine to 14, and her medical records note a history of mental illness dating back to this early abuse. “It traumatizes you so bad you end up in institutions,” she says. She’s been diagnosed with depression and schizophrenia and has been admitted to psychiatric facilities on at least four occasions. She has struggled with cocaine addiction and tried to kill herself several times — by overdosing, by cutting herself.

“She is a very fragile lady who needs to be handled with care and caution,” a Rikers mental health clinician wrote in a progress report last year. (Rikers medical staffers also consistently noted that Ayala’s thought processes were coherent and organized.)

Theresa Bradberry, who is 46, was also molested as a child. Bradberry, who has a pacemaker and needs regular medication for congestive heart failure, says Wilson’s advances started in early 2013, after she had an X-ray done of her pelvic area. Bradberry says that as Wilson showed her the film, he pointed to the faint outline of her hips and complimented her shape. Not long afterward, during another appointment, he touched her upper leg. He didn’t ask, she says, “he just did it.” Bradberry told Wilson he couldn’t do that kind of thing for free.

After a few visits, their interactions became an exchange. Bradberry says Wilson would ask her to go behind a small partition in the cubicle where he saw patients. “Pretend like I’m examining you,” he would say, but really, she says, “he was feeling on me.” Bradberry says she would let Wilson touch her breasts and vagina, and in return, he would give her candy and prescribe her skin cream.

Bradberry is now in prison upstate finishing out a sentence for illegal possession of a gun. The day I met her, she had on bright pink eye shadow and a bright pink shirt. She says her family never came to visit her at Rikers, and she didn’t have much money on her commissary account. “I feel like I sold myself cheap because I had no one,” she says. “It haunts me.”

Only recently did she join a prison therapy group for trauma victims; she says the counselor reminds her that it’s unacceptable for men to violate her, even if they compensate her. “People shouldn’t take advantage of other people’s weaknesses,” she says.

ALLEGED SEXUAL ABUSE by a staffer charged specifically with ensuring an inmate’s well-being is particularly insidious. But the coercive power that jail employees wield over Rosie inmates has been well-documented. In late May, the Legal Aid Society, the largest provider of legal services to the city’s poor, along with the private firm Cleary Gottlieb Steen & Hamilton, filed a class action lawsuit alleging serial rape and sexual abuse by guards at facility. Rosie ranks among 12 jails nationwide that have the highest reported rates of staff sexual misconduct. In a Justice Department survey conducted between 2011 and 2012, 5.9 percent of Rosie inmates said they’d been the victim of staff sexual abuse, compared to 1.8 percent of jail inmates nationally.

Actual rates of staff sexual misconduct are likely higher. “Sexual abuse in prison is widely underreported because prisoners fear retaliation from officers or other prisoners,” Fettig says. Both Ayala and Revell waited until they were out of Rikers and transferred upstate to report Wilson’s behavior, in part because they were afraid of a backlash. “I was afraid of the retaliation that may transpire from him, as he has access to my addresses and personal medical and mental health records,” Ayala wrote me in June. But it wasn’t just that. “I really loved Sidney and did not want to hurt him or have him lose his job,” she continued. “So I was torn, feeling used, and at the same time loving this man.”

This type of scenario has been allowed to persist because of what the Legal Aid class action calls “a culture of complacency” on the island, as well as a lack of regulation. The jail falls into a regulatory loophole in federal law pertaining to sexual abuse and harassment in correctional settings. States are penalized when their prisons fail to comply with the 2003 Prison Rape Elimination Act (PREA), which sets standards for tracking, preventing and responding to sexual abuse and harassment. But local jails are not subject to the same enforcement. (DOC says it is working on coming into compliance with PREA.)

The state has referred Ayala’s and Revell’s allegations to the city’s Department of Investigation, but for current Rikers inmates who file sexual misconduct complaints, there is little data indicating that DOC will act on their claims. The corrections department says it has “a zero tolerance policy with regard to sexual abuse.” But according to a statement the public advocate’s office submitted to the Board of Correction in May, DOC refuses to release any information regarding investigations of inmate complaints of sexual misconduct, or any data on rates of substantiation.

Partial view of Rikers Island Jail, NYC, NY. Nov 2009.

Partial view of Rikers Island, New York City, November 2009.

Photo: Clara Vannucci

“I SHOULD HAVE KNOWN,” Latricia Revell told me over the phone in June. “But now I’m like, hey, he wasn’t just doing it to me, he was doing it to other people too. I felt more stupid than anything. He violated me.”

Revell, who is 40, was incarcerated at Rikers a year ago on two charges of grand larceny. During a visit shortly after her arrival, she says “[Wilson] was taking my temperature and said I had nice lips.” He told her she could come visit him at the clinic whenever she wanted.

On one of her next visits, he kissed her — without asking. “Why’d you do that?” Revell asked him. She says Wilson replied that he couldn’t help it. When she told him she needed a gynecology appointment, Wilson said he could take care of that. Revell says the procedure was more sexual than clinical. “He was looking at me, you know what I mean?” she says. “I liked it at first because, you know, it was something to do.”

Over the course of the next four months, until she was transferred from Rikers, Revell says her visits with Wilson became “an every other day thing.” He’d bring her Popeyes chicken, cigarettes, gum, and candy. He would put his fingers inside her and give her oral sex. He told her about his sons, about his life outside of Rikers. He gave her his cell phone number and said he’d take care of her once she was out. “Sidney promised me so much,” Revell wrote me in a letter earlier this year. It wasn’t until months after she left Rikers that she says she learned he’d been making the same promises to other inmates.

“I thought I’d found someone with a good job,” she told me one morning in late June. Her head was wrapped in a yellow scarf, her pretty gap teeth bright white. “I thought he’d look out for me and my daughter. But now that I know — he’s a monster, he’s disgusting.”

This article was reported in partnership with The Investigative Fund at The Nation Institute, with support from the Puffin Foundation.

Photo: Rose M. Singer Center women’s restroom sign. Rikers Island, New York City, November 23, 2011.