At international AIDS conferences the issue of HIV/AIDS in prisons has historically received little attention. A turning point may have come with the XV International Aids Conference 2004 held in Bangkok, Thailand. Before the official conference started, a one-day satellite meeting debated issues related to HIV/AIDS in prisons. At the conference itself, two oral sessions and a large number of poster presentations were dedicated to HIV/AIDS in prisons.

In addition, three United Nations agencies released an important policy briefing on reduction of HIV transmission in prisons. Although most activities focused on HIV prevention, delegates also debated the question of how HIV treatment, including antiretrovirals (ARVs), can best be made available to inmates.

At the Bangkok conference and afterwards, the latest figures on HIV epidemiology in countries such as Vietnam and Cambodia increasingly point to prisons and detentions centres as being the engine of the epidemic, driving into the wider community (Rich 1999). Two examples have been Thailand and Lithuania.

In Thailand the first wave of HIV infections was observed in 1988 among IDUs. The infection rate rose from a negligible percentage at the beginning of 1988 to over 40% by September of that year. This was fuelled in part by transmission of the virus as many IDUs moved in and out of prisons (Jurgens). A more recent study concluded that IDUs in Bangkok continue to be "at significantly increased risk of HIV infection through sharing needles with multiple partners while in holding cells before incarceration" (Buavirat).

In Lithuania, random checks undertaken in 2002 by the state-run AIDS Centre found that in Alytus Prison 263 prisoners tested positive for HIV antibodies. Tests at Lithuania's other 14 prisons, which house 11,700 convicts, found only 18 cases of HIV infection. Before the tests at Alytus prison, Lithuanian officials had listed only 300 cases of HIV infection in the whole country, or less than 0.01% of the population, the lowest prevalence in Europe. It is believed that the outbreak at Alytus prison was also due to sharing of drug injection equipment (Dapkus). In 2002 7,000 prisoners, 60% of the country’s total prison population went on hunger strike demanding better treatment for HIV prisoners.