Structural-Level Approaches for HIV Prevention and Care in US Prisons

Given the vast potential to intervene in prison settings, this chapter provides the background and a corresponding case study as to how structural-level approaches might be used to prevent HIV acquisition/transmission in prison settings. A peer-based model that empowers inmates to be the change agents is described. The chapter offers a compelling case that peer education programs created, managed, and administered by incarcerated persons have significant and often unrecognized potential. It begins with an overview of HIV in US prisons, followed by a description of peer education programs and HIV prevention and World AIDS Day in Prison using three correctional facilities as examples. Implications and conclusions close out the chapter.