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Background Among patients enrolled in HIV care and treatment in rural Mozambique, 30% abandon treatment within a year. A cluster randomized controlled trial assessing the impact of couple-based vs. individual treatment for concordant couples on viral suppression (the HoPS+ trial) hypothesizes that harnessing family support will improve patient outcomes. Individuals with high levels of empathy will likely provide greater social support for treatment retention and adherence. This study validates a locally tailored version of the interpersonal reactivity index (IRI)—cognitive empathy (CE) and affective empathy (AE)—among expectant parents living with HIV in Zambézia province, Mozambique. Methods Using baseline data from 558 participants from the HOPS+ trial, we used a maximum likelihood exploratory factor analysis with a promax oblique rotation to assess the culturally relevant questions from the IRI. We examined discriminant and construct validity through analysis of subscale relationships by sex, age, education, and depression and intra-person reliability over time with an interclass correlation model (n = 119). Results Our participants live in 6 districts and receive health care at 24 health facilities. The median age was 25 (IQR: 22 to 30), 50% were female, and 44% were single. Participants had a median of 5 years of formal education (IQR: 2–7). Half of them report their occupation as “farmer” and 17% screened positive for depression. On a scale of 0–4, the median baseline CE score was 2.6 (IQR: 1.9–3.2) and the median baseline AE score was 1.9 (IQR: 1–2.6). Males (2.6 vs. 2.4, P < 0.01), participants who finished primary school (2.7 vs. 2.5, P < 0.01), and older participants (2.6 vs. 2.5, P = 0.04) had higher CE scores, while depressed participants had higher AE scores (2.3 vs. 1.8, P < 0.01). We found moderate stability over time (CE ICC: 0.63, AE ICC: 0.54) in a subset of 119 study participants. Conclusion While depression is associated with 12.5% higher AE scores, older participants, males, and those high levels of education had higher scores on the CS scale. This preliminary work will inform future work on the HoPS+ trial and guide future interventions aimed at increasing retention in and adherence to treatment in people living with HIV. Disclosures All authors: No reported disclosures.

1683. Empathy Scale Validation Among Expectant Seroconcordant Couples Enrolled in HIV Care and Treatment in Zambézia Province, Mozambique