The radical HIV prison activist movement has always been, in practice, an abolitionist movement. Set in Philadelphia in the early 2000s, this article centers the relationships through which leaders of ACT UP Philadelphia, the Philadelphia County Coalition for Prison Health Care, TEACH Outside, and Project UNSHACKLE worked to transform the social conditions for which prisons have been posited as the solution and to create a prison-free future in real time. Its pages unfold a three-part methodological toolkit for HIV prevention justice. First, harm reduction demands that one show up and provide relief, no questions asked. Second, mutual aid grounds the forging of new social relations that are more survivable than those produced by HIV stigma, mass criminalization, and organized abandonment. Third, transformative justice offers both a vision and a practice for challenging criminalization in all its intimate, communal, and structural forms, and building a racially just and strategic HIV movement.