HIV antibody screening of blood donations in the United Kingdom

Views and experiences of men who have sex with men on the ban on blood donation: a cross sectional survey with qualitative interviews

OBJECTIVE

To explore compliance with the UK blood services' criterion that excludes men who have had penetrative sex with a man from donating blood, and to assess the possible effects of revising this policy.

DESIGN

A random location, cross sectional survey followed by qualitative interviews.

SETTING

Britain.

PARTICIPANTS

1028 of 32,373 men in the general population reporting any male sexual contact completed the survey. Additional questions were asked of a general population sample (n=3914). Thirty men who had had penetrative sex with a man participated in the qualitative interviews (19 who had complied with the blood services' exclusion criterion and 11 who had not complied). Main outcome measure Compliance with the blood services' lifetime exclusion criterion for men who have had penetrative sex with a man.

RESULTS

10.6% of men with experience of penetrative sex with a man reported having donated blood in Britain while ineligible under the exclusion criterion, and 2.5% had donated in the previous 12 months. Ineligible donation was less common among men who had had penetrative sex with a man recently (in previous 12 months) than among men for whom this last occurred longer ago. Reasons for non-compliance with the exclusion included self categorisation as low risk, discounting the sexual experience that barred donation, belief in the infallibility of blood screening, concerns about confidentiality, and misunderstanding or perceived inequity of the rule. Although blood donation was rarely viewed as a "right," potential donors were seen as entitled to a considered assessment of risk. A one year deferral since last male penetrative sex was considered by study participants to be generally feasible, equitable, and acceptable.

CONCLUSIONS

A minority of men who have sex with men who are ineligible to donate blood under the current donor exclusion in Britain have nevertheless done so in the past 12 months. Many of the reasons identified for non-compliance seem amenable to intervention. A clearly rationalised and communicated one year donor deferral is likely to be welcomed by most men who have sex with men.

Regression analysis of group testing samples

This paper develops a general regression methodology that relates the group testing responses to individual covariate information. It can be used to study samples from a group testing procedure and to deal with a wide range of regression problems. A detailed illustration of the methodology is provided for a group testing procedure proposed by Gastwirth and Hammick. To demonstrate the utility of the method, simulation studies are performed on an HIV antibody testing data set published by Nusbacher et al.

Safety trial of heated factor VIII concentrate (8Y)

Seventeen previously untreated boys with haemophilia A were treated with high purity heat treated factor VIII concentrate (8Y) for up to 36 months. Liver function tests were assessed monthly. No boy's serum has been shown to contain HIV antibodies and no increases in alanine transaminase activity have been detected. In only one patient was a single rise in aspartate transaminase activity noted, and this was without a corresponding rise in alanine transaminase. A second patient's serum contained hepatitis B core antibody transiently. It was thought likely in both cases that the abnormalities reflected intercurrent infections rather than disease associated with transfusion. The physical treatments used in the production of 8Y seem to inactivate the agent(s) responsible for non-A, non-B hepatitis and HIV transmission by transfusion of factor VIII has been abolished. There are, however, problems associated with conducting safety trials in young haemophiliac patients.