Understanding noncompliance with selective donor deferral criteria for high‐risk behaviors in <scp>A</scp>ustralian blood donors

Lucky, Tarana; Seed, Clive R.; Waller, Daniel; Lee, June F.; McDonald, Ann; Wand, Handan; Wroth, Stephen; Shuttleworth, Glen; Keller, A. J.; Pink, Joanne; Wilson, David

doi:10.1111/trf.12554

Cited by 43 publications

(64 citation statements)

References 39 publications

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“…While considered as noncompliers under the current permanent deferral policy, their risk of TTI transmission should be infinitesimally small. Should a 12‐month deferral period be enforced, the noncompliance rate in this study would fall to 1% (six MSM without a partner in the past 12 months divided by 591 male donors), which is closer to the 0.23% noncompliance rate in Australia, where the deferral period is 1 year . Given that many MSM are keen to donate blood, time‐based deferral might expand the donor pool without increasing the risk of TTI, assuming that other settings remain the same.…”

Section: Discussionmentioning

confidence: 72%

“…Nevertheless, the donor deferral system is highly reliant on donors’ understanding and honesty. The system would become meaningless if donors do not disclose their risk behaviors truthfully—in other words, being “noncompliant.” In Australia, a study reported an overall noncompliance rate among donors of 1.65% for any one of the eight TTI risk–related deferrable categories . An earlier study on 50,162 allogeneic blood donors by Williams and coworkers also reported a nondisclosure prevalence of 1.9% among nine deferrable categories in the United States.…”

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confidence: 98%

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

Wong

Lee

Lee³

et al. 2015

Transfusion

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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.

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Section: Discussionmentioning

confidence: 72%

mentioning

confidence: 98%

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

Wong

Lee

Lee³

et al. 2015

Transfusion

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“…These questions partly left the risk assessment to the donor. However, recent studies confirmed that in post-donation interviews, the majority of HIV-positive donors did not realize they engaged in risk behavior [9,10,13]. Therefore, a precise definition of heterosexual risk behavior would be desirable.…”

Section: Discussionmentioning

confidence: 97%

Good Feasibility of the New German Blood Donor Questionnaire

Houareau

Deitenbeck

Sümnig

et al. 2017

Transfus Med Hemother

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Background: We assessed the effect of the uniform donor questionnaire (UDQ) on deferral rates in first-time and repeat donors. We focused on the introduced question about unprotected sexual contact with a new partner. Another goal was a stratified comparison of the deferral rates of the donor questionnaire (DQ) and UDQ. Methods: Data on donors and deferrals using the DQ and UDQ were collected at four blood establishments. The comparison included a 2-year period by questionnaire version. For the comparison of the questionnaires, an adjusted multinomial logistic regression was performed. Results: The analysis included 260,848 donations. First-time (FTD) and repeat donations (RD) showed higher deferral rates with the UDQ (FTD +5.4%, RD +1.4%). Deferral due to a new partner was 3.0% in first-time and 0.4% in repeat donors. The majority of these occurred in the youngest age groups. The most frequent deferral criterion was ‘disease' (5.1%). Conclusion: The regression revealed stronger predictors for deferral than the questionnaire version. Especially younger age carried a higher and independent risk for deferral. The additional deferrals of mainly young first-time donors due to a new sexual partner may identify those donors with potential heterosexual risk behavior who would otherwise not be identified.

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“…Still, a varying percentage of donors are identified with HIV and HCV infections with deferrable risks that were not detected or reported in the donor selection process [1,5,13,14]. Comparison of risk factors among infected blood donors and infected individuals from the general population is only rarely used to assess the effectiveness of blood donor selection procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Some risk factors are prone to nondisclosure due to personal risk perception [5], avoidance of social undesirability, legal consequences, or perceived lack of confidentiality [13] especially in the group of infected blood donors (e.g. sexual risk behavior and drug use).…”

Section: Discussionmentioning

confidence: 99%

Which Infectious Blood Donors Could Be Identified by the Donor History Questionnaire - Comparison of Blood Donors Infected with HIV or HCV with Notified Cases from General Population in Germany

Preußel

Offergeld²

2018

Transfus Med Hemother

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Background: Potential risks for transfusion-transmissible infections are identified by donor history questionnaires (DHQs), and donors with higher risks are deferred from donation. We assessed to which extent the currently used DHQs support the identification of infections among blood donors. Methods: Between 2006 and 2013, we analyzed data from notified HIV and HCV cases in the general population and positive blood donors in Germany. Logistic regressions were used to identify relevant infection risks. We estimated the possible effect of improved capture of risk factors for donor selection by calculation of population attributable fractions (PAF). Results: Risky sexual contacts - MSM as well as heterosexual contacts - were the most prominent infection risks among HIV-infected donors. Whereas MSM contacts were significantly less reported by donors than by cases from the general population, 58% of donors disclosed heterosexual risks compared to 26% of notified cases. The complete identification of heterosexual risk contacts might prevent acceptance of 53% of HIV-infected donors. HCV-infected donors were more likely to report heterosexual exposure, imprisonment, and piercing/tattoo than notified HCV cases. Improved recording of piercing/tattoo could prevent acceptance of 16% of HCV-infected donors. Conclusion: Donor selection should be improved with special attention to the identification of (hetero)sexual risk factors, invasive procedures (piercing/tattoo and imprisonment) applying well-designed DHQs, effective donor education, and confidential environment in all steps of the selection process.

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Understanding noncompliance with selective donor deferral criteria for high‐risk behaviors in Australian blood donors

Cited by 43 publications

References 39 publications

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

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

Good Feasibility of the New German Blood Donor Questionnaire

Which Infectious Blood Donors Could Be Identified by the Donor History Questionnaire - Comparison of Blood Donors Infected with HIV or HCV with Notified Cases from General Population in Germany

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