One of the biggest challenges correctional centres face is to manage behaviour that could be life threatening and potentially dangerous to their inmate populations. Although assaults and stabbings occur quite frequently it is the behaviour where there are in some cases consent involved that challenge the safe governance of inmates. Although consensual sexual intercourse, rape, tattooing and injecting drug use occur in corrections, it is strictly prohibited by the Department of Correctional Services (DCS). Notwithstanding the outlawed status of these activities, it seems like it occurs unabated anyway. These activities are a high-risk for the exposure and transmission of Sexually Transmitted Infections (STIs), also known as Sexually Transmitted Diseases (STDs), human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) during an offender’s period of incarceration. This study explores offender perspectives on the causes of STIs, HIV and AIDS in a South African correctional centre. Creswell’s dominant-less-dominant mixed methodology strategy was followed. By using a structured interview schedule 100 face-to-face interviews were conducted with male offenders comprising of child, juvenile and adult remand detainees, as well as juvenile and adult sentenced offenders. The research participants identified sexual intercourse (consensual and coerced) as the major contributory risk factor to their exposure to and transmission of STIs, HIV and AIDS. This article also presents an overview of studies by other scholars on sex, tattooing and drug use in correctional settings.