Lifetime HIV testing among three samples of adults with histories of incarceration in Southern California.

ABSTRACTJustice-impacted persons may inconsistently access HIV testing. This cross-sectional secondary analysis investigates lifetime HIV testing prevalence among adults with prior histories of incarceration in Southern California, United States, participating in health-focused programming (n = 3 studies). Self-reported demographic and lifetime HIV testing data were collected between 2017-2023; descriptive analyses were conducted. Across the three samples, at least 74% of participants were male; Latino and African American individuals accounted for nearly two-thirds of participants. Lifetime HIV testing ranged from 72.8% to 84.2%. Males were significantly more likely than females to report never being tested in two samples and accounted for >95% of those never tested. No statistically significant differences in testing were observed by race/ethnicity. Single young adults (ages 18-26) were less likely than their partnered peers to report testing. HIV testing is critical for ensuring that individuals access prevention and treatment. HIV testing among justice-impacted adults in this study was higher than in the general population, potentially due to opt-out testing in correctional settings. Nevertheless, these findings underscore the importance of implementing targeted interventions to reduce structural (e.g., health insurance, access to self-testing kits) and social barriers (e.g., HIV stigma) to increase HIV testing among justice-impacted males and single young adults.

Access to Healthcare Among Young Adult Probationers Participating in a Pilot Health-Focused Reentry Program.

Justice-involved adults experience disparities in healthcare access. This pilot study examines healthcare access among young adult probationers (n = 66) receiving 6-months of Service Navigation and Health Coaching support implemented between 2017 and 2021. Data are from baseline, 6-month follow-up and satisfaction surveys. Between baseline and follow-up, the proportion of insured young adult participants (66%-88%; p < .001) and those using healthcare services (36%-71%; p < .001) increased significantly; report of unmet physical healthcare needs decreased significantly (44%-26%; p = .003). Satisfaction data revealed increased self-efficacy, motivation, focus, and improved organizational, goal setting, and communication skills. The program improved healthcare access by increasing health insurance and recent use of healthcare services. Longitudinal studies are needed to assess maintenance of these outcomes and potential impacts on disparities in health status and access to care indicators. Integrating navigation and coaching supports to advance the well-being of justice-involved young adults is a promising mechanism to facilitate healthcare access.

Motivations for Seeking Laser Tattoo Removal and Perceived Outcomes as Reported by Justice Involved Adults.

The goal of this study is to describe reasons for desiring removal of unwanted tattoos and self-reported outcomes among justice-involved adults (JIA) receiving free laser tattoo removal in Southern California. Between 2016 and 2021, JIA completed voluntary anonymous surveys at baseline (n = 53) and follow-up (n = 113) visits. Descriptive analyses were generated for quantitative items. Themes were identified from open-ended questions. Patients were predominantly male (74%) and most (81%) reported tattoo-related discrimination. Adjusted multivariate analyses showed that a higher number of domains in which patients reported tattoo-related discrimination was associated with having more tattoos to remove and citing reasons for removal related to employment and stigma by association (e.g., gang membership and police interactions). At follow-up, 48% of patients felt they were treated better in their community, and nearly a quarter of patients (25%) reported greater confidence and self-esteem. JIA seek tattoo removal due to stigma and discrimination. While JIA reported diverse benefits, tattoo removal should likely be considered as one element of comprehensive programing that addresses JIA's diverse emotional, social, and economic needs. Longitudinal research is needed to clarify the long-term effects of tattoo removal for JIA.

Factors associated with COVID-19 vaccine intent among Latino SNAP participants in Southern California.

BACKGROUND: COVID-19 is significantly impacting the health and well-being of the country, particularly for ethnic minority populations and low-income groups. Our goal was to determine COVID-19 vaccination intent in a low-income, Latino population receiving aid from the Supplemental Nutrition Assistance Program (SNAP) in Southern California, and identify contributing factors and concerns. METHODS: A cross-sectional, mixed-methods survey was conducted among participants in the Southern California Nutrition Incentives Program (¡Más Fresco! More Fresh). Only Latino respondents were included in this analysis. Primary outcome was vaccine intent trichotomized into: "definitely/likely yes", "not sure/don't know", and "definitely/likely not." RESULTS: The majority of participants (n = 486) were female (93%), Spanish speaking (74%), with a median age of 40 years (IQR = 13). Approximately half (48%) reported they would get a COVID-19 vaccine, 39% were unsure, and 13% reported "definitely/likely not". In the multivariable multinomial logistic regression model, participants with a household member with a COVID-19 health risk factor were more likely to be unsure about getting the vaccine. Participants who were primarily English speaking, did not receive the influenza vaccine last season, and reported not reading or talking about COVID-19 were more likely to report not intending to receive the vaccine. Many respondents were concerned about "side effects and ingredients", and did not trust the vaccine development process, particularly with how fast it happened. CONCLUSION: Low-income Latinos in Southern California were generally hesitant to get a COVID-19 vaccine. Culturally sensitive vaccine promotion campaigns need to address the concerns of minority populations who experience increased morbidity and mortality from COVID-19.

Clients' Perspectives Regarding Peer Support Providers' Roles and Support for Client Access to and Use of Publicly Funded Mental Health Programs Serving Transition-Age Youth in Two Southern California Counties.

Peer providers are increasingly used by mental health programs to engage transition age youth (TAY, age 16-24) living with serious mental illness. This study elicited TAY clients' perspectives on peer providers' roles, responsibilities, and contribution to TAYs' use of mental health services. In 2019, six focus groups were conducted with TAY clients (n=24) receiving publicly funded mental health services in Southern California. Results from this analysis included four themes that illustrated the role of peers as perceived by TAY clients, including: 1) building client-peer provider relationships, 2) engaging with mental health services, 3) role-modelling recovery and supporting skill acquisition to instill hope and empowerment, and 4) peer roles and experiences specific to racial/ethnic concordance. These findings provide needed perspectives on the evolving role of peer providers in mental health services programming for TAY clients.

Overview of a Pilot Health-focused Reentry Program for Racial/Ethnic Minority Probationers ages 18 to 26 in Southern California.

There is a significant gap in reentry programming that is tailored to the needs of young adults ages 18 to 26 who are in a unique developmental life stage that involves ongoing maturity in their neurobiology, cognitive development, and social and financial transitions to adulthood and independence. This article describes the structure and approach of a 6-month health-focused reentry program designed for racial/ethnic minority young adult (YA) probationers in Southern California. The UCSD RELINK program includes service navigation and an optional psychoeducation health coaching program to build health literacy, problem-solving, and executive functioning skills relevant across multiple life domains. We describe participant characteristics and service needs at intake. Between 2017 and 2019, 122 YA probationers ages 18 to 26 responded to interviewer-administered baseline surveys. Participants needed basic services including housing, nutrition assistance, employment, and educational/vocational training. Depression and anxiety symptoms, Adverse Childhood Events, trauma, and unmet physical and mental health care needs were pervasive. Given the dearth of research on reentry programming for YA, this article documents the approaches taken in this multi-pronged health-focused reentry program to ensure that the program was tailored to YA reentrants' comprehensive needs. These data serve to concretely illustrate the range of needs and how YA reentrants view their own health and social needs in the context of multiple competing demands; such data may be useful for program planners and policymakers seeking to advance service delivery for YA minority reentrants.

Examining Equitable Online Federal Food Assistance during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Study in 2 Regions.

The USDA Supplemental Nutrition Assistance Program (SNAP) provides food and financial assistance to food-insecure individuals and families. In the midst of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, SNAP benefits evolved. Policy changes and federal legislation expanded SNAP eligibility, raised benefit levels, and introduced program waivers that enabled online ordering to reduce participants' exposure to community-acquired SARS-CoV-2. Although rapid expansion of SNAP benefits in the online space represents significant progress for federal food assistance, changes also introduced unforeseen partiality in how benefits and services were accessed and utilized, as illustrated by 2 populations and regions in the early months of the SARS-CoV-2 pandemic: low-income older adults in rural Alabama and low-income Hispanic adults in urban California. Opportunities exist to build on the recent progress in SNAP, while also ensuring continued inclusiveness of eligible persons. Efforts should be informed by evidence that supports equitable access to federal food assistance.