People in prisons and other closed settings are disproportionally affected by HIV. In 2023, HIV prevalence among people in these settings was two times higher than among adults aged 15–49 years in the general population1. Lack of access to HIV treatment and prevention services in prisons and other closed settings remains a significant barrier to achieving social justice and equality and ensuring health for all people. Treatment coverage gaps are notable for people living with HIV in prisons and other closed settings. Among the 37 countries that reported on antiretroviral therapy coverage among people in prisons and other closed settings in recent years, only 18 countries reported above 95% coverage, and five countries reported less than 50%. HIV programmes are generally not available or tailored for women in prisons and other closed settings (1). A small but slowly increasing number of countries provide at least some HIV-related services in prisons and other closed settings.

P.4 At least 156 countries have laws criminalizing HIV exposure, nondisclosure or transmission or prosecutions based on general criminal laws; 152 criminalize the possession of small amounts of drugs; 170 criminalize some aspect of sex work; 63 criminalize same-sex sexual activity; and 16 criminalize transgender people. A significant percentage of people in prisons and other closed settings have been convicted of offences related to their own drug use, engagement in sex work, same-sex sexual activity or their gender identity (5)...