In 2007, the HIV Legal Network (Legal Network) published Hard Time: HIV and Hepatitis C Prevention Programming for Prisoners in Canada, exploring health and harm reduction policies and practices in Canada’s provincial, territorial, and federal prisons. Then, as now, the Legal Network confirmed that everyone benefits from improved healthcare in prison, and that imprisonment is not a justification for the denial of healthcare. The Legal Network identified important gaps in policy and practice in the provision of healthcare, which fuel the transmission of HIV, hepatitis C (HCV), sexually transmitted and blood-borne infections (STBBIs), and other harms in prison and beyond. The Legal Network thus called for prison and health authorities to work together to improve healthcare in prison.
In 2023 and 2024, we conducted a fresh assessment of healthcare and harm reduction policies and practices in Canada’s provincial, territorial, and federal prisons. Through open-source research and access to information requests, we identified and analyzed more than 200 healthcare and harm reduction policies applicable to prisons across the country (see Appendix 1 for the policies). We conducted over 25 interviews with stakeholders, including formerly incarcerated individuals, people who work in or for prisons, and community organizations supporting the rights of people in prison.
In the nearly two decades since Hard Time, healthcare in prison has improved. Yet, significant gaps remain, which are particularly pronounced for Indigenous people, racialized people, gender-diverse people, and women. Until these gaps are addressed, STBBIs will pervade throughout the country. Prison and health authorities must act to promote and protect the health of all people, irrespective of their legal status.