The integrative policy was established when HIV infection was not known to be contagious. Compulsory screening was added in 1987, although it was prompted more by legal than by public health concerns. However, the availability of AZT treatment has made early diagnosis clearly beneficial to infected people. The compulsory testing has also helped relieve pressure on the government to segregate all HIV-infected inmates. Further health initiatives have included vaccination of correctional staff and voluntary testing for hepatitis B, voluntary chest x-rays to screen for tuberculosis, and the use of a standard protocol for HIV-positive inmates. Other issues needing attention include intravenous drug abuse, homosexual activity, nutrition and vitamin supplements, equitable access to appropriate health care in prison, confidentiality, motivating inmates to use counseling services, and occupational health among correctional health care personnel. 18 references