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To examine a possible link between substance use and risky sexual behaviour, a cross‐sectional study was conducted among 357 inmates across four South African prisons involved in a pre‐release intervention programme for parolees. About 93% of the participants reported using alcohol and 52% used marijuana prior to imprisonment, while 56% reported previous occurrence of sexually transmitted infections (STIs). Logistic regression analyses explored the impact of substance use on intention to reduce risky sexual behaviour. Age and inconsistent use of condoms were positively associated with having an STI prior to incarceration, while reported alcohol and marijuana intake had no effect. Never using condoms before was highly associated with lower intention to engage in preventive behaviours upon release. It can be concluded that inmates demonstrate high levels of substance use and engagement in risky sexual behaviours. Targeted pre‐release substance abuse interventions are essential to reduce the burden of disease amongst offenders.

To inform future intervention programmes, the purpose of this paper is to explore the psychosocial and contextual determinants of intention to reduce risky sexual behaviour amongst inmates in South African prisons.

A cross sectional study using interviewer administered questionnaires was conducted with 357 inmates across four prison facilities in South Africa that were involved in a pre‐release health education intervention for parolees in two provinces.

About 65 per cent of participants were first time offenders. Almost 50 per cent were unemployed prior to arrest and 66 per cent were married at time of incarceration. Self‐efficacy, general life skills efficacy and sexual communication were the strongest predictors of intention to reduce risky behaviour upon release. High intenders were significantly different from low intenders in their self‐efficacy, sexual communication, attitudes towards condom use and the perceived norm of sex being a non‐utilitarian transaction.

One of the key limitations is the low literacy levels amongst prison inmates. Data also relied heavily on self reports of behaviours that may have occurred prior to the participants being incarcerated.

It is concluded that the exploration of subpopulation specific behavioural determinants is a critical step in the development of effective, contextually‐relevant, health education interventions.