Changes in the drug-taking behaviour of drug users after imprisonment vary according to the type of drug being taken. Prisoners were much more likely to continue to use heroin than either cocaine or amphetamines while in prison. Heroin was most likely to be used by those who had been using heroin during the immediate pre-imprisonment period, and particularly by the two-thirds of heroin users who considered themselves dependent. In view of the high prevalence of prior use of these drugs by individuals currently imprisoned, continuing attention is required to study of their behaviour and of the impact of interventions that may be introduced during or following their incarceration.

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Background Tattooing has, for more than a century, been recognized as a potential source of transmission of pathogens such as syphilis and hepatitis B. With the advent of HIV and other viruses such as hepatitis

A random sample of 1009 adult male prison inmates from 13 prisons covering short-, medium- and long-term establishments across England and Wales was interviewed about sexual behaviour, drug use and tattooing, inside and outside prison. We report here on their same-sex sexual activity. Thirty-seven men reported having engaged in sexual activity with a man during adulthood. Twenty-two men reported having had sex with a man in prison. Indirect support for this prevalence rate was given by sexually transmitted disease rates and prisoners' estimates of same-sex sexual activity occurring in prison. Twenty out of the twenty-two inmates had engaged in same-sex sexual activity previously outside prison. Two men had sex for the first time in prison (uncoerced). Approximately one-quarter of men who had same-sex sexual activity in prison reported having been coerced into having sex at some point. Same-sex sexual activity appears to be less frequent in the UK prison system as a whole than has previously been suggested.

A random sample of 1009 adult male prison inmates from 13 prisons covering short-, medium- and long-term establishments across England and Wales was interviewed about sexual behaviour, drug use and tattooing, inside and outside of prison. We report here on their heterosexual behaviour. Inmates had had a high number of sexual partners compared to population samples. The majority of sexual partners were casual and there were high levels of sexual involvement with injecting drug users and with prostitutes. Prisoners engaged in more risky sexual practices than did the general population and used condoms infrequently. A high number of prisoners had also injected drugs. Inmates reported a high frequency of past sexually transmitted diseases.