Background In Rhode Island, the Patient Protection and Affordable Care Act (ACA) has led to over 95% of the state’s population being insured. We evaluated insurance coverage and barriers to insurance use among patients presenting for services at the Rhode Island STD Clinic. Methods We analyzed factors associated with insurance coverage and utilization among patients presenting for STD services between July and December 2015. Results A total of 692 patients had insurance information available; of those, 40% were uninsured. Patients without insurance were more likely than those with insurance to be non-white (50% among uninsured, compared to 40% among insured; p = 0.014) and Hispanic or Latino/a (25%, compared to 16%; p = 0.006), and less likely to be MSM (27%, compared to 39%; p = 0.001). Of those with health insurance, 26% obtained coverage as a result of the ACA, and 56% of those were previously uninsured. Among uninsured individuals, barriers to obtaining health insurance included cost and unemployment. Among those with insurance, 43% reported willingness to use insurance for STD services. Barriers to insurance use included concerns about anonymity and out-of-pocket costs. Conclusions Despite expanded insurance access, many individuals presenting to the Rhode Island STD Clinic were uninsured. Among those who were insured, significant barriers still existed to using insurance. STD clinics continue to play an important role in providing safety-net STD services in states with low uninsured rates. Both public and private insurers are needed to address financial barriers and optimize payment structures for services.

Purpose of Review The review details recent literature reports regarding Hepatitis B Virus (HBV) and, in particular, Hepatitis B prevalence/incidence in incarcerated populations around the world. Furthermore, the review will summarize the national/international guidelines regarding HBV and look at diagnosis, vaccination, treatment, and linkage to care after release. Recent Findings HBV affects prisoners at a much higher rate than the general populations. Many who are at increased risk for HBV infection are also at increased risk for incarceration. Incarcerated settings also have higher rates of HBV transmission. Summary Incarcerated individuals should be immunized if they are not already immune to HBV. Increased access to safe injecting and tattoo paraphernalia, condoms, and personal hygiene equipment could reduce the spread of HBV and other blood-borne and sexually transmitted infections. Future research should focus on ways to prevent the spread of HBV and similar viruses in incarcerated settings in order to protect incarcerated individuals and the general public. Research on effective linkage to community HBV care following release is needed.