Under mandated reforms in prison health care, inmates are not simply entitled to care equivalent to that delivered in the community; their status requires it. The prison environment, with a primary purpose of control and containment, is a threat to the physical, mental, and emotional well-being of inmates. This is of particular relevance to inmates who are HIV positive or who have AIDS. Despite recognition by the Home Office that these inmates should have the same level of medical attention as those outside prison who are HIV positive or who have AIDS, seropositive inmates have been subjected to inferior and unethical medical practices and forms of control. Because of problems that have arisen from the institutional management of these prisoners, their future treatment may be a test case by which the newly constituted Health Care Service for Prisoners may be judged. Ultimately, the effective restructuring of prison health care requires adequate Treasury funding accompanied by a fundamental change in the attitudes and behavior of those officers and managers who have traditionally applied the punishment rather than the medical paradigm to those in their care. 12 notes and 36 references