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

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. 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. 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%. 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. All authors: No reported disclosures.