Injection drug users who are already infected with HIV and other diseases and who stop using drugs while incarcerated still present a risk through possible unprotected sexual contacts with other inmates. Supply-side interventions to deal with these drug problems have reduced but eliminated injection drug use in correctional facilities. Demand-side interventions are not widely available or are not attractive treatment options to those who may benefit from them. Harm reduction is proposed as another approach to deal with drug problems. Harm reduction seeks to reduce the harm associated with drug use to the lowest possible level for any given individual by decreasing adverse health, social, and economic consequences of drug use. As an overall approach to drug problems, harm reduction focuses on providing various opportunities for incremental reductions in harmful behavior and acceptance of the fact that drug users are not always ready to completely eliminate drug use but may be ready to engage in other changes that can reduce both drug use and associated harm. Contextual and cognitive methods can be applied to reducing the harm of drug use and modifying behavior. Examples of harm reduction approaches to health problems in correctional settings are provided. 13 references