Risk behaviors in volunteer blood donors who seroconverted for HIV, Abidjan, Côte d'Ivoire 1997 to 2005

Abstract

BACKGROUND: The residual risk of human immunodeficiency virus (HIV) transmission from blood products in the Abidjan National Blood Transfusion Center was estimated to be 1 in 5780 blood donations over the period 2002 through 2004. We aimed at describing risk behaviors in blood donors who seroconverted for HIV in Abidjan to improve the pre–blood donation selection. STUDY DESIGN AND METHODS: We investigated the behavioral profile of HIV seroconverters assessed before their HIV diagnosis, during the blood donation selection at the blood bank of Abidjan, and compared it to the profile documented after this HIV diagnosis, at enrollment in the PRIMO‐CI cohort. Since 1997, enrollment in this cohort is offered to every blood donor whose delay since HIV seroconversion was 36 months or less. RESULTS: Among the 418 blood donors who seroconverted for HIV between 1997 and 2005, 241 were enrolled in the cohort. Median age was 28 years and 63% were men. The median time between the last HIV‐negative test and the first positive test was 7 months. Since the last blood donation, 29% of donors reported unprotected sexual intercourse with multiple casual sexual partners, 55% unprotected sexual intercourse with one casual sexual partner, and 36% sharing of nail clippers. During the pre–blood donation questionnaire, 69% of HIV seroconverters had reported unprotected sexual intercourse since the last blood donation (vs. 89% reported after donation), and 7% had had multiple casual sexual partners (vs. 32%). CONCLUSION: Volunteer blood donors who seroconverted for HIV in Abidjan reported a high proportion of unprotected sexual intercourse with casual sexual partners.

Transfusion safety in francophone African countries: an analysis of strategies for the medical selection of blood donors

“…Such a rate of exclusion may be due to the high prevalence of African donor candidates having one or more risk factors or an erroneously noted risk factor. While certain risk factors (multiple partners, occasional partners, homosexuality) have been described in depth, 21,22 other risk factors attributed to routine practices in Africa have yet to be studied; such factors include religious scarification, traditional piercing in Sahelian populations, dental extractions, and bloodletting performed in North African countries. It appears that the epidemiology of infections transmissible by blood is not the same in all continents.…”

The Francophone Africa Blood Transfusion Research Network: a five‐year report (2007–2012)

“…Cette proportion, élevée si on la rapproche de celle des pays occidentaux, peut être due à la forte prévalence de candidats au don africains ayant un ou plusieurs facteurs de risque et/ou à l'identification erronée d'un risque inexistant chez le candidat au don. Si certains facteurs de risques, notamment sexuels (multipartenariat, partenaires occasionnels, homosexualité), ont été décrits en Afrique francophone [22], d'autres, associés à des pratiques traditionnelles sur le continent africain, n'ont pas encore fait l'objet d'investigations approfondies, comme la scarification et le piercing traditionnels dans certaines populations. Par ailleurs, sans qu'une raison particulière explique clairement cette irrégularité, la pratique de la sélection médicale est souvent intermittente ou partielle dans plusieurs pays du continent africain.…”

The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood

“…In Kenya, blood donations from high school students are preferred over adult samples due to the lower HIV infection prevalence within this population. However a study carried out using Stimmunology, an in vitro lymphocyte stimulation technique, has revealed a significant number of early, preseroconversion HIV carriers both among adult and teenage Kenyan populations 66,67. A mathematical model constructed to quantify transfusion risks across 45 Sub-Saharan African countries used 3 components: the risk of a contaminated unit entering the blood supply, the risk that the unit will be given to a susceptible patient, and the risk that receipt of the unit will lead to infection in the recipient.…”