These are related to the mandated rights of inmates to health care, the confidential nature of medical information, security concerns, the suitability of inmates as research subjects, and sexual activity and drug abuse among inmates in correctional settings. Strategies for dealing with AIDS in correctional institutions must confront reduction of disease transmission as well as the medical needs of those already infected. Strategies to this end include education to reduce risk behaviors and anxiety about the disease, mass screening of inmates, segregation of inmates, and expanded medical services (primary care, specialty services, and skilled nursing care). Confidentiality concerns, high costs, false negatives, and difficulties inherent in segregating seropositive inmates provide arguments against mass screening, although voluntary screening of pregnant inmates appears justified. Decisions to segregate are basically correctional rather than medical policy decisions. Educational efforts are likely to be most effective. These coupled with distribution of condoms and programs for reducing sexual tension and discouraging coercive sexual behavior provide the best means for reducing the transmission of AIDS.