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[How to reduce the prevalence of HIV-positive blood donors]
G León1, T Hernández, A M Quiros
1Banco Municipal de Sangre del Distrito Federal, Caracas, Venezuela.
Insights
Despite improved screening, a high prevalence of HIV positive blood donors persists. Many accepted donors exhibited high-risk behaviors, including multiple risk factors and lack of awareness about HIV transmission, highlighting gaps in donor selection and education.
Area of Science:
- Infectious Diseases
- Public Health
- Hematology
Background:
- Despite policy changes and improved predonation questionnaires, a significant prevalence of Human Immunodeficiency Virus (HIV) positive blood donors remains a concern.
- Previous efforts to reduce HIV transmission through blood donation have not fully resolved the issue of accepting infected donors.
Purpose of the Study:
- To analyze the reasons for the acceptance of Human Immunodeficiency Virus (HIV) positive blood donors at a Counselling Clinic between January 1995 and December 1996.
- To identify high-risk behaviors and awareness levels among HIV positive blood donors to improve donor screening and public health interventions.
Main Methods:
- A study involving the interviewing of HIV positive blood donors who attended a Counselling Clinic.
- Data collection through forms assessing identification, donation history, HIV risk behaviors, awareness of serological status, willingness to donate, and understanding of transfusion risks.
- Screening using Abbott HIV1/HIV 3rd generation plus EIA and confirmatory assays with HIV-1 Western Blot.
Main Results:
- Out of 53,338 blood donors, 130 (0.24%) were confirmed HIV positive; only 18 attended the clinic.
- Predominant risk factors included homo/bisexual and promiscuous behavior (p = 0.0003), with 55.55% having multiple risk factors.
- A significant proportion of donors (27.77%) knew their status, 16.66% suspected it, and 55.55% were unaware, yet risk factors were similar across groups. Failure in predonation questionnaires and ignorance of high-risk group belonging were noted reasons for donation.
Conclusions:
- Increased public information on HIV transmission, risk factors, and prevention is crucial.
- Awareness campaigns targeting HIV positive individuals about the dangers of blood donation are necessary.
- Enhancing predonation questionnaires for clarity and considering advanced screening tests like the p24 antigen test are recommended to prevent HIV transmission.
Unlabelled:
Despite abolishing the policy of giving the results of the serological test as a way to promote blood donation, and also after improving the predonation questionnaire, we still have a high prevalence of HIV positive blood donors. In this paper we try to analyze, interviewing the HIV positive blood donors in our Counselling Clinic from January 1995 to December 1996, why they were accepted. We asked the HIV positive blood donors to fill a form with the following questions: identification, kind and frequency of blood donation, HIV high risk behaviour, awareness of predonation serological status, willingness toward blood donation, awareness of how dangerous the transfusion of HIV contaminated blood is. For the screening we used Abbott HIV1/HIV 3rd generation plus EIA, test and HIV-1 Western Blot Cambridge, Biotest, Worcester MA, for confirmatory assays. During the evaluation period, 53,338 blood donors were attended, 130 (0.24%) were confirmed HIV positive. Only 18/130 (13.84%) assisted to the Counselling Clinic. The mean age was 33.27 +/- 5.35 years old, all males, 15 singles and 3 with stable couples. 6/18 (33.33%) could have been discarded because of physical appearance or because of theirs jobs. "Voluntary Donation" was higher than in the control group (p = 0.0001). Homo/bisexual and promiscuous behaviour (p = 0.0003) were the predominant high risk factors, in this group 55.55% had more than one risk factor. The association with HBV and syphilis was high (p = 0.0001 and p = 0.0005). 5/18 (27.77%) knew they were HIV positive; 3/18 (16.66%) had the suspicion they were HIV positive and 10/18 (55.55%) did not know it; however the risk factors were the same in those groups. In the knew/suspicion group the main reasons for blood donation were: Performing the test once more, 6; failure in the predonation questionnaire, 1; family pressure, 1. In the group that ignored their HIV positivity: ignorance of belonging to a high-risk group, 6; lack of confidence in the interviewer, 3 and failure in the predonation questionnaire, 1. 61.11% knew that the HIV tests were performed on all blood donations and the the positive ones were discarded. No one had knowledge of the window period.
Conclusions:
1. It is necessary to spread more information to the general population about the ways of HIV transmission, the risk factors and its prevention. 2. To make aware all HIV positive or those that suspect they are the HIV positive how dangerous their blood donation could be. 3. Offering the general population a free HIV test and giving the appropriate counselling and support. 4. Improving the questionnaire, assuring that the blood donor could understand the real meaning of the questions and how important his/her truthfulness is. 5. To consider the implementation of the p24 antigen test as mandatory to all blood donations and all the new techniques to avoid HIV transmission. 6. To change the "related" blood donors to the true voluntary, altruistic, blood donor.