Primary HIV prevention interventions in prisons and upon release

Publication Summary

The purpose of this paper is to review HIV/AIDS prevention interventions in prisons in Canada and worldwide that aim to reduce transmission. Four systematic reviews, six randomized control trials and 13 observational studies are examined that evaluate HIV risks and interventions among inmates from 2002 to 2007. In particular, voluntary counselling and testing, needle exchange, distribution of condoms and bleach, tattooing and methadone maintenance programs are examined. Further, sexual education and peer-based HIV prevention programs that include pre- and post-release outcomes are assessed.


Voluntary counselling and testing programs raise awareness, provide education, dispel myths, reduce levels of HIV-related discrimination, and detect those in need of care and treatment

  • Evidence shows that needle exchange programs in prisons stabilize or decrease the level of drug use, reduce needle sharing, and stabilize or reduce HIV transmission
  • There is no evidence that prison-based needle exchange programs have serious, unintended negative consequences
  • Methadone maintenance programs in the U.S., France, and Australia facilitated re-entry in the community, reduced re-incarceration risk, and heroin use declined significantly
  • Condom distribution programs raise awareness and reinforce HIV prevention messages, and reduce HIV transmission rates
  • Peer education models in correctional environments appear to be educationally effective for HIV prevention