Rapid HCV RNA Testing and LInkage to Care

• The goal of this study is to simplify the HCV testing process using combined rapid screening and confirmation in order to reduce early barriers and improve linkage to care among a vulnerable high-risk homeless population. The investigators are partnering with Albuquerque Health Care for the Homeless (AHCH) to conduct rapid testing and provide counseling, test results, and referrals directly on site.
• After Rapid HCV testing the investigators will randomize participants to 1) counseling and referral to a provider, or 2) Rapid RNA testing plus counseling and referrals to a provider.

The study's primary is to to assess linkage to care, which is the percent of subjects who are evaluated by a provider specifically for HCV infection in both groups. Linkage to care will be determined via medical chart abstraction 30 days after testing. The investigators hypothesize that there will be a 30% absolute difference in linkage to care between study arms, with a higher percent of participants in the combined rapid testing group being linked to a provider for evaluation relative to the control group (rapid anti-HCV alone).

• The study's second aim is exploratory in nature and sequentially follows the first aim. The investigators will also assess HCV Cascade of care in both group, and by medical chart abstraction (up to 36 weeks after study entry) to determine the number and proportion of individuals who achieved sustained virologic response (SVR12), which is a marker for cure.
• The study's third aim is a qualitative inquiry into the use of supportive services by participants during treatment. Such services may include social work, case management, patient navigation, participation in support groups, etc. The investigators will review medical charts for this information. The investigators are interested to see if more individuals in one study arm will access one or more of these supportive services compared to the other study arm.