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Background Hepatitis C virus (HCV) infection rates have increased among younger, rural persons nationally. We report on a preliminary sample of a study examining HCV acquisition risk factors among rural persons who inject drugs (PWID) or person who use opioids (PWUO) non-medically. Methods We used respondent-driven sampling (RDS) to recruit PWID/PWUO in southern, rural Illinois as part of a larger study on infectious disease rates among social networks of PWID and illicit opioid users. Participants were surveyed regarding drug and sexual risk behavior, healthcare access, stigma, and social networks, and underwent rapid screening for HCV (OraQuickÒ HCV Rapid Antibody Test) and other infections. Using R software, we generated descriptive statistics to characterize HCV prevalence. Results Between July 2018 and April 2019,135 current PWID/PWUO were recruited, screened, and surveyed (58.5% male; 82.2% white; mean age 40.1 years). HCV rapid tests detected antibodies (HCV+) among 53 of 112 screened (47.3%). HCV+ participants were more likely to be white (96.2% vs. 83.1%, P = 0.006) than HCV antibody negative (HCV-) participants and showed a bimodal age distribution with peaks in the 25–30 and 45–50 age ranges. Reported injection drug use and heroin use in the past 30 days was significantly more common among HCV+ participants (96.2% vs. 72.9%, P = 0.001, and 12.9 vs. 7.9 days, P = 0.024) While HCV+ participants less frequently used methamphetamine compared with HCV -participants, the use of that drug was still high in both groups (11.9 vs. 18.4 days of use in the past 30 days, P = 0.01). HCV+ participants reported fewer social network members than HCV- participants (2.2 vs. 3.0, P = 0.048). Conclusion In this analysis of a preliminary sample, HCV exposure was high; with those positive for HCV antibody showing a bimodal age distribution, high frequency of multiple drug use, and smaller social network size compared with HCV negative counterparts. Upon RDS-based enrollment completion and pending analysis we will further examine HIV RNA status as well as the specific associations between network size and other risk factors that may inform disease screening and treatment interventions. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]