Risk behaviors and rates of infection in the prison had increased substantially since a study undertaken 2 years earlier. Injection drug use in the prison had doubled, from 12 to 24 percent. Although the rate of HIV was still relatively low at 1.7 percent, it was many times that found in the general population and marked the prison as a public health disaster in process. The second article provides background information on transsexual and transgendered people in general and transsexual and transgendered youth and sex trade workers in particular, discusses the risk of HIV infection for transsexual and transgendered prisoners and summarizes the major issues confronting male-to-female transsexual and transgendered prisoners and makes recommendations regarding: prevention of HIV transmission; injection drug use and HIV; medical and support services; human rights and confidentiality; and aftercare. Notes