Another area where peer work is conducted is in prisons (correctional facilities).

Peer work is an additional supportive strategy in the provision of traditional health work in prison.  Peer work in prison links with outside society and aims to make bridges between the two during the period of detention.







Prison health
Prisons and correctional facilities are areas where many health issues come together:  substance use, mental and physical health problems, risk behaviour (injecting, tattooing, sexual activities) and communicable diseases.  These behaviours are not only highly concentrated in confined areas, but also closely interrelated.

In most prisons throughout Europe, drug use has become a substantial problem.  When entering the prison system, drug users frequently suffer from multiple health issues such as withdrawal symptoms, abscesses, infectious diseases and mental health problems. The prevalence of infectious diseases (HIV/AIDS, TB, viral hepatitis) in many prisons is higher than in the general population.

While during the past decade, risk reduction and prevention measures have been applied successfully in the community, in prisons, drug-free is still the predominant perspective.  Risk reduction strategies that are used outside prison are often regarded as undermining the measures taken inside to reduce the supply and use of drugs.

Proceeding from internationally acknowledged principles  (WHO, 1993 of equivalence - that healthcare measures successfully applied outside prison should also be applied inside prison.



Prison peer programmes

Examples of peer programmes targeting prison populations are:

  • Risk Reduction for Drug Users in Prisons
    This publication also includes information and training material on peer work.  Different professions can play an important role here:  general prison/correctional staff, prison guards, prison healthcare workers and probation officers. Furthermore, community services and drug users can also contribute.  Staff from drug treatment services can play an important role in training prison staff.  Drug users and/or former inmates themselves are also valuable in informing and supporting their peers to help them integrate and maintain healthy behaviours into their daily lifestyle in prison.
  • Prison programme AFEW
    An example of peer programmes in prison was delivered by AIDS Foundation East-West (AFEW)
    AFEW’s prison work in Eastern Europe has been exceptional and groundbreaking.  AFEW stimulates sound education on health and risk issues through professional education, peer counselling, and education among inmates.
    Their prison programming included embedded (in the prison) peer training programmes on prison health.  Inmates were trained to educate and support their fellow inmates/peers on infectious diseases, prevention methods and other health promotion issues.  ‘Good prison health is good public health’ is a principle that guides AFEW’s prison programming throughout the vast penal systems across the region.