2237. Validity of Self-Reported HCV Status Among Justice-Involved Persons Living with HIV

Background The prevalence of hepatitis C virus (HCV) and human immunodeficiency virus (HIV)-1 co-infection among justice-involved persons is high and HCV health literacy is low. The validity of self-reported HCV status in this population has important implications for HCV testing and education programs inside correctional facilities and in the community after release, yet its assessment is limited. Methods HIV-positive justice-involved persons from the District of Columbia were enrolled into a study evaluating a health intervention for improved HIV treatment adherence and linkage to community-based HIV care. Participants completed a comprehensive baseline assessment that included self-reported HCV status, which we compared with lab-confirmed status among self-reported HCV(+) and HCV(−) participants. Overall agreement between reported and lab-confirmed status for all participants was assessed using Cohen’s Kappa statistic. Banked plasma specimens were tested for HCV antibody (Ab); Ab-positive or equivocal specimens were tested for HCV RNA levels. Results Of 110 participants, 103 were available for HCV testing and were included in analyses. Twenty participants (19%) self-reported being HCV(+) of which 11 (55%) were HCV Ab(+), all of who were HCV RNA(+). Nine participants reported being HCV(+) but were HCV(−) [8 were HCV Ab(−) and one had an equivocal Ab result which was HCV RNA(−)]. Among the 83 participants not reporting HCV infection, 80 were HCV Ab(−), one had an equivocal Ab result [HCV RNA(−)], and two (both women) were HCV Ab(+) and HCV RNA(+). Overall, self-report and lab results had a moderate agreement (Cohen’s Kappa = 0.60) and lab-confirmed prevalence of RNA(+) was 13%. Conclusion The validity of self-reported HCV status among justice-involved persons living with HIV was moderate. Only one-half of persons who reported HCV infection were confirmed to be HCV infected. In addition, two women (2.4%) who did not report HCV infection were found to be infected. These findings support the need for expanded HCV-specific testing, counseling and education among justice-involved persons, with focused attention on justice-involved women who may be at particularly high risk for undiagnosed HCV. Disclosures All authors: No reported disclosures.