1 december World AIDS Day

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CDJI Urges Stronger Health Responses in Prisons, Detention Facilities and Post-Release Systems to Advance Global AIDS Commitments

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Madrid, Spain, 1 December 2025

Marking World AIDS Day 2025, the Centre for Development and Justice International (CDJI) calls on governments and national authorities to reinforce efforts to prevent and address HIV in prisons, police detention, pre-trial facilities, juvenile institutions, migrant centres, psychiatric establishments and probation systems, noting that sustained progress towards global AIDS targets requires comprehensive attention to all persons deprived of liberty and those transitioning back to community life.

Current evidence indicates that HIV prevalence in prisons remains significantly higher than in the general adult population. Millions of individuals pass through various stages of the criminal-justice system every year, often for short periods, creating continuous movement between closed settings and communities. This underscores the importance of ensuring continuity of care and access to essential prevention and treatment services in all relevant environments.

“Health protection cannot stop at the prison gate” – CDJI President

Azamat Shambilov, President of CDJI, states:

“If health protection ends at the prison gate, we are not advancing towards the global objective of ending AIDS – we are allowing avoidable gaps to persist. Individuals who spend time in detention return to their communities shortly thereafter. Their health and dignity must be upheld at every stage of the justice pathway. Ending AIDS requires strengthened probation systems, coordinated institutional responses and an integrated justice-health framework that ensures no individual is left without support.”

Persistent vulnerabilities across detention settings

People in detention frequently encounter conditions that heighten vulnerability to HIV, including limited access to prevention tools, irregular testing, interruptions in treatment during transfers or release, unsafe injecting practices, overcrowding, lack of privacy and pervasive stigma. These factors collectively undermine the effectiveness of national HIV responses and pose broader public-health risks.

Stigma – both within detention settings and during reintegration continues to deter individuals from seeking testing and treatment, and can impede access to employment, housing and services after release.

Essential HIV services remain unavailable in many countries

Despite longstanding international guidance, substantial gaps persist in the provision of HIV and harm-reduction services in closed settings. According to UN assessments across 189 countries:

condoms are available in 57 countries;
opioid-substitution therapy is offered in 56;
needle and syringe programmes operate in 11;
HIV testing is available in 79;
antiretroviral therapy is provided in 88.

These figures indicate ongoing challenges in meeting the principle of equivalence of care for people deprived of liberty.

The post-release period demands structured, coordinated support

CDJI emphasises that the period immediately following release often presents one of the highest risks of treatment interruption and reduced access to essential services. Well-functioning probation systems play a central role in linking individuals to healthcare providers, supporting adherence to antiretroviral therapy, facilitating access to mental-health and drug-dependence services, and assisting with housing and employment.

However, the organisation notes that probation services can fulfil this role effectively only when supported by strong inter-agency cooperation among justice institutions, public-health authorities, social-protection agencies, local administrations and civil-society organisations.

Towards a modern, coordinated and rights-based response

To support Member States in advancing their AIDS commitments, CDJI highlights the importance of adopting a comprehensive and integrated approach that includes:

continuity of care from arrest through release;
integrated digital health information systems accompanying individuals throughout the justice pathway;
formal health–justice coordination mechanisms with shared accountability;
enhanced harm-reduction and health services across all closed settings;
gender- and age-responsive approaches, including for women, girls and children;
reintegration planning initiated prior to release;
structured cooperation with civil-society organisations;
comprehensive anti-stigma training for justice, prison and probation personnel;
community health navigators to support long-term adherence.

These measures reflect internationally recognised principles and offer practical avenues for strengthening national responses.

Way Forward

CDJI underscores that achieving global HIV commitments requires sustained attention to the health and rights of individuals across police custody, detention units, prisons, probation systems and community reintegration pathways. Gaps in any part of this continuum continue to affect national and global progress.

“No society can meet its AIDS-related commitments if people in detention are left behind,” Shambilov states. “Health must accompany every individual throughout the justice pathway and support their reintegration into community life.”

CDJI calls on national authorities, justice institutions, public-health bodies and civil-society partners to reinforce coordination, ensure continuity of care and uphold the principle that health protection and human dignity apply to all persons, without exception.

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