HIV Prevention in Prisons

Sterile Syringes
The distribution of sterile syringes to inmates also has been discussed as a means of preventing HIV transmission but does not occur in any U.S. prison. A survey conducted in December 2000 identified 19 prison-based needle exchange programs in Europe.(60) Evaluations of these programs found decreased needle sharing and no newly identified cases of HIV, hepatitis B, or hepatitis C. The Swiss Hindelbank pilot project performed a 1-year study of the effects of a needle exchange program, observing that needles were not used as weapons and that fewer abscesses occurred among inmates.(61) As with condoms, syringes usually have been available through dispensing machines or prison health personnel.

Safer injecting practice information (including providing bleach for cleaning syringes)is included in the education and counseling programs of many correctional systems in Europe, whereas correctional systems in the United States do not systematically provide bleach. Half of 20 European countries’ prison systems surveyed provided disinfectant for injection materials in 1998.(62)

Methadone Maintenance
Although methadone maintenance treatment rarely is available to prisoners in the United States, it is offered to inmates in most Western European systems, some Eastern European systems, and Australia and Canada. Studies indicate reduced use of illicit injections among participants in these programs.(12,63)


Elizabeth Kantor, MD
University of California San Francisco

Dr. Elizabeth Kantor MD practices geriatric medicine and internal medicine in San Francisco, California.



  1. U.S. National Commission on AIDS. HIV Disease in Correctional Facilities. Washington: U.S. National Commission on AIDS; 1991.
  2. Harrison P, Beck AJ. Prisoners in 2004. Washington: U.S. Department of Justice, Bureau of Justice Statistics; October 2005.
  3. Maruschak L. HIV in Prisons, 2003. Washington: U.S. Department of Justice, Bureau of Justice Statistics; September 2005.
  4. Maruschak L. HIV in Prisons and Jails, 2002. Washington: U.S. Department of Justice, Bureau of Justice Statistics; December 2004.
  5. Hammett TM, Harmon P, Rhodes W. The Burden of Infectious Disease Among Inmates and Releasees from Correctional Facilities. In: The Health Status of Soon-to-Be-Released Inmates: A Report to Congress. Vol. 2. Chicago: National Commission on Correctional Health Care; March 2002.

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