Failure of self‐disclosure of deferrable risk behaviors associated with transfusion‐transmissible infections in blood donors

Abstract

BACKGROUNDTo date, most studies on deferral of blood donors have focused on men who have sex with men (MSM) and/or injecting drug users. Few have examined deferrable risk behaviors relating to transfusion-transmissible infections (TTIs) in general. This study aimed to examine the prevalence of, and factors associated with, nondisclosure of TTI-related risk behaviors in donors.STUDY DESIGN AND METHODSChinese-speaking donors who had just given blood in Hong Kong were invited to self-complete an anonymous questionnaire. Practices of one or more of seven deferrable risk behaviors associated with TTI were inquired. Factors associated with noncompliance with self-disclosure were evaluated by logistic regression.RESULTSOver a 4-week study period in 2012, a total of 1143 donors were recruited. Overall, 0.2% gave a history of drug injection, 1.7% had had sex with sex worker(s), and 0.3% had had sex with a human immunodeficiency virus–infected partner, while none had been paid for sex. Some 1.5% of male donors reported having same-sex behaviors. Factors associated with noncompliance were male gender (odds ratio [OR] 31.1; 95% confidence interval [CI], 3.7-263.6), having multiple sex partners (OR, 89.7; 95% CI, 28.7-279.9), and previous history of temporary deferral (OR, 11.4; 95% CI, 2.5-53.3). If suspected noncompliance was included, the overall prevalence of nondisclosure of deferrable behaviors could be high at 6.5%.CONCLUSIONAlbeit uncommon, some donors fail to provide accurate answers to predonation screening questions and are not deferred appropriately. There is room for improvement to make deferral policy acceptable and understandable, so as to minimize the risk of TTI. Efforts are also needed to tackle the paucity of data on noncompliance of non-MSM donors.

Motivations for donating and attitudes toward screening policies in US blood donors with viral infection

“…We may have increased the validity of our measurement by defining a test‐seeking index, which combined the above question with other factors influencing donors' decision to donate blood. The test‐seeking rates reported here are not substantially different than previous reports in the general donor population or among donors with HIV infection, regardless of how test‐seeking information was obtained.…”

Non‐compliance to infectious disease deferral criteria among Hong Kong's blood donors

“…We found that the non-compliance rate of donors with deferrable non-MSM behavioural risk was 2Á6%, a figure somewhat higher than that of 1Á2% for MSM in male donors. The latter prevalence was similar to the result of a previous survey (1Á5%), we conducted in Hong Kong over 4 years ago [11], and comparable to <0Á5% to 3% in other overseas studies [10,12]. It is hard to compare the prevalence of MSM-unrelated deferrable risk between cities/countries as similar studies in the literature are limited.…”

Reasons for noncompliance in donor risk reporting regarding male‐to‐male sex

“…Moreover, adding an "unsure" option on the DHQ could provide donors the possibility to discuss their uncertainty with Blood Service employees and not be forced to choose between "yes" or "no." 31 It is possible that the ambivalence in definitions may also apply to a wider range of sexual (deferrable) behaviors. Our results also suggest that blood services need to explain better why it is important that donors are truthful in their answers.…”