Survey responses revealed that 3,661 AIDS cases had been confirmed among inmates in 45 State and Federal correctional systems as of October 1989. Thirty large city and county jail systems reported 1,750 cases of AIDS among inmates. The survey found 57 reported AIDS cases among Canadian inmates. In both the United States and Canada, no job-related cases of HIV infection or AIDS were reported among correctional staff. Cumulative total inmate AIDS cases in the United States increased by 600 percent since the first NIJ study in 1985 and by 72 percent since the fourth study in 1988. Between 1988 and 1989, the percent increase in total U.S. correctional cases (72 percent) exceeded the increase in cases in the population at large (50 percent). Studies performed by individual correctional systems suggested that demographic and risk factor patterns among prisoners with HIV infection and AIDS remained stable. Inmate cases were primarily male, blacks and Hispanics were overrepresented relative to the outside population, and intravenous drug use was the predominant exposure category. Little hard data exist on the extent of HIV transmission within correctional institutions, although data from several jurisdictions indicate a relatively low rate of transmission. Correctional policy issues and options related to HIV focus on education and training and HIV antibody screening and testing. The response of correctional administrators to the problem of AIDS is examined in terms of medical care, psychosocial services, housing and programming policies, and precautionary and preventive measures. It is pointed out that AIDS-related issues continue to produce substantial litigation involving correctional inmates and staff. 2 notes and 6 tables