The correctional facility at Framingham houses about 3,500 women who are serving State and county sentences as well as those awaiting trial. Health problems are more common than among male prisoners, and some pregnant women have tested positive for HIV. Inadequate facilities, staffing, and equipment, together with inappropriate health care systems, practices, and policies all severely limit the institution's ability to deliver good health care services to the inmates. Changes needed include a case management approach to HIV, upgrading of all medical facilities to comply with community standards, establishment of an HIV clinic and other appropriate clinics at the Framingham facility, improvement of HIV testing and counseling, and enforcement of nondiscriminatory policies affecting prisoners with HIV infection. Footnotes.