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Background: Justice- involved populations experience high HIV and substance use disorder (SUD) prevalence, while simultaneously facing barriers to healthcare access, housing, and reentry support. The period following release from incarceration is particularly vulnerable, marked by increased risk of HIV/STI transmission and overdose. The Mobile Enhanced Prevention Support (MEPS) is a holistic intervention that combines peer mentorship, cash incentives, and a mobile application to promote HIV testing and prevention, harm reduction, and linkage to supportive services.  

Objective: The aim of this study is to characterize social determinants of health (SDoH) and the impact of the MEPS intervention on social and health outcomes amongst our study population of individuals recently released from incarceration.  

Methods: This study employed baseline and 6-month follow up data from a randomized control trial in Los Angeles evaluating the effect of the MEPS intervention. Participants, who were all within 12 months of release from incarceration, were recruited from local community based organizations (CBOs) and randomized into the control (n=103) or intervention (n=105) arm; 160 (77%) completed the follow-up 6- month survey assessing psychosocial outcomes and SDoH. Bivariate analyses, logistic, and linear regression models were used to examine baseline associations, change over time in SDoH. The p-value for statistical significance was ≤ 0.05.

Results: The study cohort identified Hispanic (42%), Black (26%), White (21%), Asian/Native Hawaiian/Pacific Islander (3%), and Other (7%). Most of the study participants identified as Bi/Pansexual (43%), followed by Gay/Homosexual (26%), Heterosexual (21%), and Other (9%). At baseline, a majority of participants reported their income being inadequate to meet basic needs (87%), housing instability at the time of their last incarceration (61%) and current housing instability (72%). At the 6-month follow-up, the intervention group demonstrated a significant reduction in recent housing instability from baseline (-18.6%). Logistical regressions on 6-month outcome data demonstrated significantly increased odds of preventative care utilization amongst those with a regular doctor at baseline (OR = 2.64), and those who have a regular doctor at baseline are more likely to have one at follow up (OR = 5.02); whereas those who had income that does not meet basic expenses were less likely to have a regular doctor at follow up (OR = 0.05).  

Conclusions:  Although the MEPS intervention group did not produce significantly greater improvements across most outcomes, participants across both groups demonstrated meaningful reductions in recent housing instability, and having a regular doctor at baseline emerged as a significant independent predictor of preventative care utilization at follow-up, highlighting the critical role of healthcare linkage in supporting successful reintegration among formerly incarcerated individuals. This data is a part of a longitudinal study across multiple years, demonstrating the necessity for future close follow up and identification of barriers that impact this population.