As of July 1987 223 inmates in 33 State facilities were under treatment for AIDS. Ten inmates were treated in a Special Needs Unit (SNU) at Sing Sing prison. The report finds that the policies and procedures for the SNU are inadequate or not enforced. There are no criteria for admission or discharge from the SNU, no organized quality assurance program, and no continuing medical education for SNU staff on HIV disease. Medical and nursing services are judged to be inadequate for caring for AIDS inmate-patients. The dietary and nutritional needs of the patients are not being met. However, dental and ministerial services were found to be of high quality. The report concludes that the New York State Department of Corrections, the third largest correctional system in the United States, is, in most respects, managed in a modern and innovative way. However, it has not yet developed an adequate medical system for caring for inmates with AIDS. The report contains 36 recommendations for developing an adequate health care delivery system for AIDS patients-inmates in the Special Needs Unit. Correspondence and agency responses are included in an appendix.