The chronic mentally ill experience substantially higher rates of HIV infection than the general population. This paper examines the problems which confront the chronic mentally ill and society at large. Discussed are the questions of whether or not psychiatric patients should be excepted, due to their cognitive and behavioral impairments, from the protection of AIDS confidentiality laws. The question is raised that if some mentally ill are excluded, what will be the guiding criteria for exclusions? Also reviewed is the question of involuntary confinement of those infected with HIV and whether or not this is an appropriate way of controlling careless, high risk behavior. Likewise, society faces difficulties with the chronic mentally ill person's capacity to consent to HIV testing. Psychiatrically disabled people may suffer from diminished capacity and thus be unable to make competent decisions based on the HIV test counseling. Finally, although there has been considerable resistance to seeing mentally ill people as sexually active, psychiatric illness does not preclude sexual impulse. The Office of Mental Health drafted a policy on patient sexual activity which demands that condoms be available to psychiatric inpatients unless clinically contraindicated, but the type of condom availability warranted remains undefined. Contains 20 references. (Author/RJM)