Rapid participatory research and project development is possible within a t
ightly controlled social context such as a prison. Having gained access, ba
sed on trust and mutual respect, external agents may then facilitate signif
icant change. Given adequate support, incarcerated people with HIV/AIDS and
limited medical access may be able to develop mutual care, social support
and income-generating activities. In the Malaysian context, we estimated in
1998 that up to one-quarter of prisoners with HIV had indicators of signif
icant disease. We estimated that significant indicators remained unrevealed
among between one-half and two-thirds of these. Given prevailing condition
s, these would probably only be amenable to peer-based care.