Objective: To examine the health of prisoners and ex-prisoners in Fiji, including risk behaviours, service access and HIV status.

Methods: Longitudinal study of 198 men and women recruited prior to release from prison in Fiji, interviewed in the weeks preceding release, and again 1 and 4 months post-release. Dried blood spot samples taken at baseline were tested for HIV.

Results: Eighty percent of participants completed at least one follow-up interview. The prevalence of HIV was low (1%), despite evidence of widespread STI and BBV risk behaviours. A history of risky substance use was normative and more than a third reported high psychological distress prior to release. Fewer than one in four reported accessing health care within a month of release from prison.

Conclusions: The health needs of this population are significant but differ in important ways from those of incarcerated populations in other countries. Further research is needed to inform evidence-based care for prisoners and ex-prisoners in Pacific Island nations.