Participants in the discussion included correctional health care professionals, all of whom had extensive experience and expertise in the area of HIV disease management in correctional settings. They determined that circumstances under which HIV- positive inmates receive care, along with complex and rapidly evolving standards of HIV care, combine to present unique challenges to correctional health care professionals. Challenges faced in individual correctional settings may vary but generally include the need for an HIV surveillance system, the complexity and considerable expense of currently recommended therapeutic regimens, the development of routine mechanisms such as education and counseling to encourage all inmates who are at risk for HIV infection to undergo HIV testing or to disclose an already known HIV-positive status, the need to engage security staff in multidisciplinary team efforts to ensure optimum clinical outcomes for each patient, attention to the unique needs of female inmates who have high rates of HIV-related morbidity and mortality, the importance of overcoming barriers to implementing National Institutes of Health guidelines for the use of ART, and the development of relationships with HIV-positive inmates that are based on trust and communication in culturally appropriate terms. Standards of care for HIV-positive inmates should be the same as those for persons in non-correctional settings. With allowances made for the necessary restrictions imposed by security needs and limited resources, incarcerated individuals should receive HIV education, HIV counseling and testing, and appropriate treatment.