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Prison inmates generally lack access to clean needles and condoms while incarcerated because both drug use and sex are illegal in prisons. This inmate at a correctional facility in Rahway, New Jersey, unsuccessfully lobbied prison administrators in 1985 for sterile-needle and condom distribution behind bars.

As of the early 1990s, 33 percent of inmates in the federa prison system were African American, and 20 percent were Latino; the vast majority were men. Overall, the prison population is composed disproportionately of individuals in some of the highest HIV/AIDS-risk categories: poor people, injecting drug users (IDUs), and people of color. In 1993, over 93 percent of New York State prisoners with AIDS were IDUs. HIV/AIDS rates are higher in correctional facilities than in the general population, owing to this greater concentration of individuals participating in high-risk behavior.