Risk factors for human immunodeficiency virus infection among Brazilian blood donors: a multicentre case–control study using audio computer‐assisted structured interviews

Abstract

Background Although risk factors for HIV infection are known, it is important for blood centers to understand local epidemiology and disease transmission patterns. Current risk factors for HIV infection in blood donors in Brazil were assessed. Methods A case-control study was conducted at large public blood centers located in four major cities between April 2009 – March 2011. Cases were persons whose donations were confirmed positive by enzyme immunoassays followed by Western Blot confirmation. Audio computer-assisted structured-interviews (ACASI) were completed by all cases and controls. Multivariable logistic regression was used to estimate adjusted odds ratios (AORs) and associated 95% confidence intervals (CIs). Results There were 341 cases, including 47 with recently-acquired infection, and 791 controls. Disclosed risk factors for both females and males were sex with an HIV-positive person (adjusted odds ratio (AOR) 11.3, 95% CI [4.1, 31.7]) and being an IVDU or sexual partner of an IVDU (AOR 4.65 [1.8, 11.7]). For female blood donors, additional risk factors were having male sex partners who also are MSM (AOR 13.5 [3.1, 59.8]), and having unprotected sex with multiple sexual partners (AOR 5.19 [2.1, 12.9]). The primary risk factor for male blood donors was MSM activity (AOR 21.6 [8.8, 52.9.]). Behaviors associated with recently-acquired HIV were being a MSM or sex partner of MSM (13.82, [4.7, 40.3]), and IVDU (11.47, [3.0, 43.2]). Conclusion Risk factors in blood donors parallel those in the general population in Brazil. Identified risk factors suggest that donor compliance with selection procedures at the participating blood centers is inadequate.

HIV Genotypes and Primary Drug Resistance Among HIV-Seropositive Blood Donors in Brazil

“…Detailed results of risk factor interviews for these infected donors relative to a group of matched non-HIV-infected controls are reported elsewhere 10 .…”

“…9 A case control study comparing HIV seropositive and seronegative blood donors was designed to understand risk exposures and motivations to donate blood among HIV seropositive relative to matched seronegative control donors. 10 A blood sample was also collected from all enrolled HIV seropositive blood donors to characterize HIV genotype and drug resistance.…”

“…If consent was obtained, a questionnaire about HIV risk factors and motivations for donation was administered through a computer audio system (ACASI). 10 For consenting HIV-seropositive subjects, we performed genotype and drug resistance testing on plasma samples obtained at the time of counseling which were rapidly processed and frozen in order to optimally preserve HIV RNA; in contrast the index donation samples was used to define recent infection status (see below), since that sample would best represent the stage of seroconversion and hence duration of infection at the time of the original seropositive donation.…”

“…The HIV risk factors were chosen based on their statistically significant relationship (p<0.05) with HIV infection in the HIV Risk Factor Study 10 . In addition to the unadjusted relationships shown in Tables 2 and 4, we applied stepwise logistic regression modeling, conditioned on hemocenter, with entry into the model set at p<0.20 and p<0.05 to stay in the model.…”

Contribution of the Retrovirus Epidemiology Donor Study (REDS) to research on blood transfusion safety in Brazil

“…All responded to a questionnaire in an audio computer-assisted structured interview (ACASI) an innovative technology that allows more privacy and interview standardization, eliminating the potential interviewer bias. All respondents can both read text onscreen and listen to pre-recorded questions and answer options and then record his/her responses using a touch screen and/or keyboard 20 . A total of 341 cases (107 had recently acquired HIV infection) and 791 controls completed all study procedures.…”