Over the past 4 decades, the number of individuals in the criminal justice system has increased dramatically (over 500%) in the United States, which leads the world in incarceration. Much of this increase is due to harsher drug sentencing laws which disproportionately affect disadvantaged members of society, including those who are mentally ill, poor, homeless and racial/ethnic minorities. Chronic medical illness is more common among jail and prison inmates and yet access to medical care after release from incarceration is more limited than in the general population. Incarceration is also disruptive to families and communities and contributes to health disparities in infectious diseases, including tuberculosis, hepatitis, sexually transmitted infections (STIs) and HIV. Routine screening for STIs and HIV in the criminal justice system can identify many new infections in this high-risk population. Treatment for STIs and HIV in jails and prisons, and linkage to HIV services after release, has the potential to both improve individual outcomes and reduce transmission to others. Increased collaboration between the department of health and department of corrections, as well as partnerships between academic institutions and the criminal justice system, have the potential to improve outcomes in this vulnerable population.

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