Joe Booth, 47, figures he’s only alive because one person out of dozens responded to letters he’d written begging for help. Serving time in a state prison near San Diego in 2009 for making a death threat against a man who defrauded his ailing mother, he was transferred to a cell with a prisoner who was serving life for a brutal rape.

Booth, who is openly gay, said that at the time he presented himself as “very effeminate,” with long red hair to his waist. On his first day in the new lockup, his cellmate caught a rat. As he was torturing the animal, he glared at Booth and told him that he had power over life and death. Booth took that as a threat and got an appointment with a prison psychiatrist to request a new cell.

The psychiatrist listened to his story and said she’d have him moved. But when he left the room, guards took him right back to the same cell (Booth speculates she was overruled). That night, as he was sleeping on the top bunk, his cellmate grabbed his ankle, yanked him onto the floor and raped him. The same happened each of the next three nights.

“I was looking for an exit, anything that would get me out,” Booth said of those four days. “I’d close my eyes tight and hope that when I opened them I’d be somewhere else.”

Every day, he begged guards and mental health staff to move him, but they laughed, figuring it was merely a “lovers’ quarrel,” he says. The fifth day, he decided to yell for help until he got a guard to pay attention. After an hour, one came over and got him switched into a solitary holding pen.

Booth felt suicidal. He needed medical care and wanted to file rape charges, but the guards at the prison paid him no mind. So he started writing letters — dozens in all — to every organization he could think of.

The only person who responded was a volunteer advocate at San Diego’s Center for Community Solutions, a local rape crisis center, which succeeded in scheduling a rape exam for Booth. When guards finally transported him to a local hospital for the exam, a volunteer was waiting for him in the exam room. She asked his name, touched his hand and said she knew he’d been raped and that it wasn’t his fault. “Getting in contact with that volunteer saved my life,” Booth said.

For inmates who are sexually assaulted, getting help from outside has been nearly impossible — until recently.