People in prison in the United States experience alarmingly higher rates of HIV and substance use problems than people in the general population, with rates of HIV five times higher (Center for Disease Control and Prevention, 2012; Maruschak, 2015), and rates of substance use problems five to seven times higher (Karberg & James, 2005; Mumola & Karberg, 2006; NIDA, 2011). This disproportion in health problems is made more troubling by the high incarceration rate of people who are African American or Latino (Mauer & King, 2007), exacerbating health disparities between people who are White and people of color. One study found that the rise in imprisonment between 1970 and 2000 among Black men largely explained the greater HIV infection rates for Black men and women as compared with White men and women during the same time period (Johnson & Raphael, 2009).