Noncompliance to blood donor selection criteria by men who have sex with men – Complidon 2017, France

Abstract

Background and objectives In France, blood donation deferral for men who have sex with men (MSM) was reduced from permanent to 12 months in July 2016. Assessing noncompliance (rate and reasons) with this criterion is important to maintain a high level of viral safety in blood products. Materials and methods An anonymous online survey (Complidon) of a sample of blood donors was conducted in 2017. Data were post-stratified to be representative of all those who donated blood between July 2016 and December 2017. A multivariable analysis was performed to assess factors associated with noncompliance. Results Among male donors, 0Á73% [95% CI: 0Á63-0Á83] reported having sex with men in the 12 months preceding their donation. Factors associated with noncompliance were as follows: young age, a low educational level, concerns about privacy, and better knowledge of donor selection criteria and the window period than compliant men. More than half of noncompliant MSM donors (57Á6% [95% CI: 50Á6-64Á3]) felt that sexual orientation should not be a criterion for donation, 47Á2% [95% CI: 40Á4-54Á0] did not disclose their male-to-male sexual relations in order to avoid being excluded from donating, 40Á5% [95% CI: 34Á0-47Á4] reported using condoms and 21Á8% [95% CI: 16Á7-27Á9] had the same male partner for at least 12 months. Conclusion Complidon showed that compliance with blood donation criteria in MSM was high, but not optimal, especially among younger men. HIV residual risk did not increase after the implementation of 12-month deferral. Data from Complidon helped French policymakers to assess the additional HIV risk posed by increased access to blood donation for MSM.

HIV transmission network analysis allows identifying unreported risk factors in HIV‐positive blood donors in France

“…To evaluate BD compliance with the main selection criteria, an anonymous online survey (Complidon) was undertaken in from September to November 2017 with 108,000 BDs in France. This study showed that the overall noncompliance rate was 3.6% of BDs who did not report at least one deferral criterion regarding sexually transmitted infections, drug use, or tattoo/piercing upon their last donation 11 . Regarding infectious risks, 0.73% of male donors reported sex between men within the last 12 months before donation, and 1.9% of BDs reported a multiple sexual partnership 11 .…”

“…In addition, as shown by Complidon, MSM might not reveal their true mode of HIV transmission during the postdonation interview for various reasons. They might report either no risk factors or make up another more accepted risk factor 11 . Using HIV sequences from a French cohort of primary HIV infections (ANRS CO6 PRIMO cohort) with detailed sociodemoepidemiological data and from French BDs diagnosed with HIV‐1 over 16 years of surveillance, we applied a network inference approach to estimate risk factors in BDs who did not report their true potential mode of contamination during postdonation interview or in BDs for whom no data were available.…”

“…This study showed that the overall noncompliance rate was 3.6% of BDs who did not report at least one deferral criterion regarding sexually transmitted infections, drug use, or tattoo/piercing upon their last donation. 11 Regarding infectious risks, 0.73% of male donors reported sex between men within the last 12 months before donation, and 1.9% of BDs reported a multiple sexual partnership. 11 The most frequent reason for MSM not being compliant was that they believed no criteria for donation should be based on sexual orientation (57.6%).…”

“…11 Regarding infectious risks, 0.73% of male donors reported sex between men within the last 12 months before donation, and 1.9% of BDs reported a multiple sexual partnership. 11 The most frequent reason for MSM not being compliant was that they believed no criteria for donation should be based on sexual orientation (57.6%). Furthermore, many noncompliant MSM in Complidon reported consistently using condoms to protect their sexual relations (40.5%), and/or having the same partner for at least 12 months (21.8%), and/or having only sexual intercourse once with a man in the year preceding their most recent donation (11.6%).…”

Donor screening question alternatives to men who have sex with men time deferral: Potential impact on donor deferral and discomfort

“…Other countries are also considering ways to permit low‐risk MSM to donate and are involved in extensive research and consultation to find the best way to balance safety, sufficiency, and fairness 15–18 . Further research is required to identify criteria to better distinguish between low‐ and high‐risk activities in ways that lend themselves to donor screening questions.…”