Prison health was transferred to the Ministry of Health in 1994. Each prison in France is now twinned with a public hospital and, according to UNAIDS, “conditions have improved noticeably since this transfer of responsibility.”

At the time, HIV prevalence in French prisons was about ten times that of the general population, while the prevalence of TB was three times the national average. In south-eastern France, 12.7% of prisoners tested HIV-positive in a 1994-95 survey.

In French prisons, condoms and lubricant are available, and are placed “in open containers in reception, the health care centre, and other locations where potential users…have the opportunity to take them unobserved.” (Shaw)

Conditions in French prisons continue to be under scrutiny. The publication in 2002 of the diary of a prison doctor shocked the French public and prompted parliament to vote unanimously to create a commission to investigate the living conditions of prisoners and working conditions of prison staff.

The book, “Médecin Chef à la Prison de la Santé”, was written by Dr Véronique Vasseur, who has worked in the Santé prison for seven years, the last six as head physician. She estimates that 5-10% of inmates are HIV-positive.

She found the cells filthy and infested with rats and lice. Drug dealing was rampant, with some guards also being involved. Rape was frequent, as were self-mutilations, suicides, and attempted suicides. The daily newspaper Le Monde carried out its own investigations and published reports on a number of documented cases of mistreatment, suicides, negligence, and rapes.

A high proportion of prisoners in French jails are remand prisoners. In July 2001, 57,844 people were in jail in France, of whom 20,143 were on remand. Prisoners awaiting trials and those condemned to less than one year's imprisonment are kept in prisons called "maison d'arrêt," which are the most overcrowded - on average 20% above capacity.

Dr Vasseur writes that at the Santé prison about a third of inmates are addicted to some drug, ranging from cocaine to concoctions such as water in which batteries had been boiled.

In 2002, the French government introduced a law Suspension de Peine whereby terminally ill prisoners could be released from prison if they presented no risk to society. Campaigners in France, such as Act Up Paris, say that three years after its passing the law has yet to make any significant impact, however..

At the end of 2004 the Ministry of Justice had granted 156 prisoners Suspension de Peine, a “ridiculously low number” according to Act Up Paris, given the number of seriously ill prisoners including those with AIDS diagnoses. In January 2005 the French government introduced the proviso that prisoners given the release on compassionate grounds could have the order revoked without recourse to medical opinion, for example if they failed to pay outstanding fines.