In Reply: The comments by Drs Binswanger and Wortzel and Dr Barton highlight the serious public health and socioeconomic problems associated with interruptions in health care among former inmates during their transition from prison or jail into the community. These include the development and transmission of resistant HIV infection, increased public health care expenditures, and criminal recidivism. The magnitude of the problem is illustrated by the size of the incarcerated population in the United States. In January 2008, more than 2.3 million adults were confined in the American penal system, representing the largest correctional population in the world.1 Additionally, this population has consistently exhibited rates of infectious disease, chronic illnesses, and psychiatric disorders that exceed those of the general population.2 Because the vast majority of US inmates eventually return to their home communities, the timely linkage to health care during the reentry period is critical.
Baillargeon J, Paar DP, Rich JD. Treatment for Individuals With HIV/AIDS Following Release From Prison—Reply. JAMA. 2009;302(2):147-148. doi:10.1001/jama.2009.921