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Wright I, Gahagan J. Improving gay, bisexual and transgender inclusion in blood and plasma donation policies and programmes in Canada: A qualitative study. Vox Sang 2024; 119:656-663. [PMID: 38616552 DOI: 10.1111/vox.13636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND AND OBJECTIVES An increasing number of blood operators around the world, including those in Canada, have removed time-based deferral periods for gay, bisexual and other men who have sex with men and replaced them with sexual behaviour-based questions for all donors. While this marks a significant shift in screening approach, what remains unclear is how members of two-spirit, lesbian, gay, bisexual, transgender and queer (2S/LGBTQ+) communities view blood operators' initiatives to be more inclusive. As such, this study was conducted to assess the awareness of donor screening changes and other initiatives among members of 2S/LGBTQ+ communities and to explore their recommendations for blood operators' work with these communities. MATERIALS AND METHODS Semi-structured qualitative interviews (n = 15) were conducted with 2S/LGBTQ+ people across Canada. Data were analysed using open inductive coding methods. RESULTS Reported here are the key results on recommendations for blood operators. Three themes were identified from the data: (1) the need for increased communications with 2S/LGBTQ+ communities surrounding changes to donor policies and guidelines; (2) the need for trans-inclusive policy and procedures; and (3) the need for culturally responsive and equity-informed staff training at donor centres. CONCLUSION Results suggest that blood operators should consider 2S/LGTBQ+ communities when developing blood and plasma donation policies, screening procedures and staff training. Increased consultation with these communities is desired, and further research specific to the experiences of transgender blood donors is needed.
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Affiliation(s)
- Isaac Wright
- Research Office, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Jacqueline Gahagan
- Research Office, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
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2
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Goldman M, Lewin A, Renaud C, O'Brien SF. Implementation of sexual risk behavior donor screening in Canada. Transfusion 2024; 64:1254-1261. [PMID: 38757763 DOI: 10.1111/trf.17878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND The two Canadian blood suppliers, Canadian Blood Services and Héma-Québec, removed the time-based deferral for men who have sex with men and adopted criteria assessing sexual risk behaviors. We report the impact of these changes on the safety and adequacy of the Canadian blood supply. STUDY DESIGN AND METHODS Since 2022, all donors are asked if (1) they have had a new partner and (2) more than one sexual partner in the last 3 months. Donors answering yes to either question are asked if they had anal sex in the last 3 months; if yes, they are deferred for 3 months. We followed HIV rates for the 18 months before and 14 (Héma-Québec) or 18 months (Canadian Blood Services) post-implementation and interviewed HIV-positive whole blood donors. We assessed the number and characteristics of whole blood donors answering yes to the two first questions with or without deferral. RESULTS There were four HIV-positive donations out of 1,492,355 donations pre-implementation and four out of 1,447,772 post-implementation (0.27/100,000 vs. 0.28/100,000, p = 1.00). Post-implementation, one HIV-positive donor was non-compliant with multiple criteria, no risk factors were identified in the others. 3.2% of donors answered yes to questions (1) and/or (2); 0.17% were deferred for a new partner and/or more than one partner and anal sex. Deferral rates were highest in first time, younger donors, and similar in males and females. CONCLUSION Implementation of sexual risk behavior donor screening resulted in unchanged HIV rates to date and a manageable deferral rate.
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Affiliation(s)
- Mindy Goldman
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Antoine Lewin
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, Québec, Canada
| | - Christian Renaud
- Medical Affairs and Innovation, Héma-Québec, Saint-Laurent, Québec, Canada
- Department of Microbiology, Infectious Diseases and Immunology, University of Montreal, Montreal, Québec, Canada
| | - Sheila F O'Brien
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
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3
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Vieites Y, Ferreira CM, Goldszmidt R, Andrade EB. Stigmatizing deferrals disproportionally reduce donor return rates: Evidence from Brazil. Vox Sang 2024; 119:606-611. [PMID: 38425028 DOI: 10.1111/vox.13607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/25/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND AND OBJECTIVES Prior research has shown that temporary deferrals negatively influence donor return rates, but it remains unknown the extent to which these effects vary across reasons for deferral. We investigate whether deferrals differ in their degree of perceived stigmatization and, if so, how being deferred for stigmatizing (vs. non-stigmatizing) reasons affects subsequent donation behaviour. MATERIALS AND METHODS We examined whether reasons for deferral vary on their perceived level of stigmatization through an online survey (n = 400). Furthermore, we used a dataset encompassing 25 years of donation records from the state-run blood collection agency (BCA) from Rio de Janeiro, Brazil, to investigate how stigmatizing (vs. non-stigmatizing) reasons for deferral affected return rates of 82,648 donors over a 60-month follow-up period. RESULTS Being deferred for sex- and drug-related reasons was perceived as much more stigmatizing than other reasons for deferral (odds ratio = 3.14, 95% confidence interval [CI]: 2.33-4.25). Controlling for multiple observables, prospective donors were less likely to return to the BCA when deferred for stigmatizing (vs. non-stigmatizing) reasons (adjusted hazard ratio = 0.87, 95% CI: 0.83-0.93). CONCLUSION Donors perceive deferrals motivated by sex- and drug-related reasons as particularly stigmatizing, which is negatively associated with donor return rates. BCAs may want to pay special attention when communicating stigmatizing reasons for deferral to prospective donors.
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Affiliation(s)
- Yan Vieites
- Brazilian School of Public and Business Administration, Fundação Getulio Vargas (FGV-EBAPE), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudio M Ferreira
- Brazilian School of Public and Business Administration, Fundação Getulio Vargas (FGV-EBAPE), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael Goldszmidt
- Brazilian School of Public and Business Administration, Fundação Getulio Vargas (FGV-EBAPE), Rio de Janeiro, Rio de Janeiro, Brazil
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Woo H, Fisher W, Kohut T, Haw J. Qualitative analysis of Canadian blood and plasma donors' views on expanding donor screening eligibility for gay, bisexual, and other men who have sex with men. Transfusion 2024; 64:85-92. [PMID: 38041576 DOI: 10.1111/trf.17606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND In many countries, sexually active gay, bisexual and other men who have sex with men (gbMSM) continue to be screened based on their sex or gender and the sex or gender of their sexual partner. However, there is growing support that screening based on specific sexual behaviors that pose risk of transfusion transmissible infection is a better approach to donor screening. STUDY DESIGN AND METHODS This paper reports results from Phase 1 (qualitative) of a mixed-methods study on Canadian blood and plasma donors' views on expanding eligibility for gbMSM by changing to sexual behavior-based screening. Semistructured interview data with 40 donors (whole blood = 20, plasma = 20; male = 21, female = 18, nonbinary = 1; mean age = 46.2; 10% participation rate) in Canada were analyzed using a thematic approach. RESULTS All participants, except one, supported the change as they anticipated that at least one of three outcomes would be achieved: increasing blood supply, enhancing equity, and improving or maintaining the safety of blood supply. One donor who was more skeptical of the change questioned the scientific evidence for the change and indicated mistrust of state institutions. The discussion considers implications for blood operators' communication strategies that can be used to reduce donor discomfort with the changes to donor screening. CONCLUSION In a nonrandom, purposive sample of 40 Canadian blood and plasma donors, most participants held favorable views regarding expanding the eligibility of gbMSM donors based on sexual risk behavior. Understanding donors' views on increasing eligibility may inform Canadian Blood Services and other blood operators as they develop their communications plans.
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Affiliation(s)
- Hyunjin Woo
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - William Fisher
- Department of Obstetrics and Gynaecology, Western University, London, Ontario, Canada
- Department of Psychology, Western University, London, Ontario, Canada
| | - Taylor Kohut
- Department of Psychology, Western University, London, Ontario, Canada
- Institut de Recherche en Sciences Psychologiques, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Jennie Haw
- Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
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Goldman M. MSM and blood donation: shifting to individualized risk assessment. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2023; 2023:294-298. [PMID: 38066878 PMCID: PMC10727087 DOI: 10.1182/hematology.2023000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Deferring donors at higher risk for transfusion transmissible infections is an important part of ensuring blood safety. The deferral for gay, bisexual, and other men who have sex with men (gbMSM) was implemented in the 1980s in many countries, since they were identified as a high-risk group for AIDS/HIV. With the introduction of increasingly sensitive HIV antibody testing, augmented by nucleic acid testing, the window period for HIV infection-when a donor may be infectious but have negative test results-has shrunk dramatically. In Canada, this has led to progressively shorter deferral periods for gbMSM, decreasing from a permanent deferral for sex with another male since 1977 to a 5-year, 12-month, and eventually 3-month deferral period. These time-based deferrals maintained safety; however, they are seen as stigmatizing by many and still result in the deferral of sexually active gbMSM. More recently, several countries have moved to a donor screening approach based on assessing sexual risk behaviors in all donors. This article outlines research supporting changes in policy, current eligibility screening policies in several countries, and preliminary results postimplementation of new eligibility policies in Canada in September 2022.
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Affiliation(s)
- Mindy Goldman
- Medical Affairs & Innovation, Canadian Blood Services, and Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, ON, Canada
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6
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Caffrey N, O'Brien SF, Walsh GM, Haw J, Goldman M. Evolving the gay, bisexual and other men who have sex with men time-based deferral to sexual risk screening for all donors: The contribution of Canadian research programmes. Vox Sang 2023; 118:605-615. [PMID: 37191161 DOI: 10.1111/vox.13443] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND AND OBJECTIVES In Canada, the time deferral for gay, bisexual and other men who have sex with men (gbMSM) to donate blood has gradually decreased. In September 2022, this deferral was replaced with sexual behaviour-based screening for all donors. We investigate how data from targeted research programmes addressed knowledge gaps to support this change. MATERIALS AND METHODS We conducted a scoping review describing the Canadian literature available before the research programmes relating to (1) behavioural indicators of HIV risk and (2) attitudes to blood donation among gbMSM, current donors and the general population. We summarize the targeted research programmes, their outputs and impact to date. RESULTS For question 1, five projects met inclusion criteria. For question 2, three articles met inclusion criteria. Knowledge gaps identified were insufficient evidence of HIV incidence in gbMSM who met other donor eligibility criteria and scant data on opinions and views of blood donation and screening criteria for sexual risk behaviours. The research programmes funded 19 projects at 11 different research sites involving over 100 individual researchers/collaborators resulting in 19 peer-reviewed publications to date. Leveraging existing gbMSM cohorts yielded relevant HIV incidence data to inform safety modelling studies. Findings indicated that sexual behaviour-based screening was acceptable to gbMSM and donors, and donor discomfort around specific questions could be mitigated with clear explanations. CONCLUSION Targeted research programmes filled critical knowledge gaps and informed a change to gender-neutral, sexual behaviour-based screening for all donors. Findings supported successful implementation of these changes with research-informed staff training.
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Affiliation(s)
- Niamh Caffrey
- Donation Policy & Studies, Canadian Blood Services, Calgary, Alberta, Canada
| | - Sheila F O'Brien
- Donation Policy & Studies, Canadian Blood Services, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Geraldine M Walsh
- Innovation and Portfolio Management, Canadian Blood Services, Vancouver, British Columbia, Canada
| | - Jennie Haw
- Donation Policy & Studies, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Mindy Goldman
- Donation Policy & Studies, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada
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7
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Fisher WA, Kohut T, Woo H, Haw J. Alternatives to blood donor deferral of gay, bisexual, and other men who have sex with men: Acceptability of screening the sexual risk behavior of all blood donors. Transfusion 2023; 63:531-540. [PMID: 36637350 DOI: 10.1111/trf.17241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Blood operators screen donors to reduce the risk of transfusion-transmitted infections (TTIs). Many are evolving screening procedures from those that defer all who have had a sexual interaction with gay, bisexual, or other men who have sex with men (gbMSM) to an approach that assesses individual donors' recent sexual risk behavior with any partner. STUDY DESIGN AND METHODS A representative sample of current blood donors (N = 1194) was recruited online and randomized to complete either the existing (at the time of the study) Canadian Blood Services' donor questionnaire (DQ) that screens out those with recent gbMSM sexual experience, a modified donor questionnaire (MDQ) that assesses individuals' recent sexual behavior with any partner, or an MDQ that assesses individual sexual behavior with any partner and explains why these questions are asked. Respondents were asked for their perceptions concerning difficulty, comfort, and acceptability of these screening questionnaires. RESULTS Across experimental conditions, current donors regarded screening questionnaire difficulty to be low; discomfort in responding was minimal; screening questionnaires were perceived to be relatively inoffensive and justified, and very few donors would cease donating if the screening questionnaire they responded to became the one in general use. Some minor sex differences were observed, and in some cases, perceptions of the MDQ with explanation were somewhat more positive than those of the DQ and MDQ without explanation. DISCUSSION An individual risk behavior screening approach appears to be acceptable to current blood donors as an alternative to screening out all who have recently engaged in gbMSM sexual interactions.
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Affiliation(s)
- William A Fisher
- Department of Psychology and Department of Obstetrics and Gynaecology, Western University, London, Ontario, Canada
| | - Taylor Kohut
- Department of Psychology, Western University, London, Ontario, Canada
- Institut de Recherche en Sciences Psychologiques, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Hyunjin Woo
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jennie Haw
- Donation Policy and Studies, Canadian Blood Services, Ottawa, Ontario, Canada
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
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8
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Haw J, Holloway K, Goldman M. How do we forecast tomorrow's transfusion? Applying social science approaches to meet tomorrow's transfusion needs: Blood donors and donation. Transfus Clin Biol 2023; 30:47-51. [PMID: 36372196 DOI: 10.1016/j.tracli.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Jennie Haw
- Medical Affairs & Innovation, Canadian Blood Services, Canada, 1800 Alta Vista Drive, Ottawa, ON K1G 4J5, Canada; Department of Health Sciences, Carleton University, 1125 Colonel By Drive, Ottawa, ON K1S 5B6, Canada.
| | - Kelly Holloway
- Medical Affairs & Innovation, Canadian Blood Services, 67 College Street, Toronto, ON M5G 2M1, Canada; Institute of Health Policy Management and Evaluation, University of Toronto, 155 College Street, Suite 475, Toronto, ON M5T 3M6, Canada.
| | - Mindy Goldman
- Medical Affairs & Innovation, Canadian Blood Services, Canada, 1800 Alta Vista Drive, Ottawa, ON K1G 4J5, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, 451 Smyth Road, Suite 2044, Ottawa, ON K1H 8M5, Canada.
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9
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Lambert G, Cox J, Fourmigue A, Dvorakova M, Apelian H, Moodie EEM, Grace D, Skakoon-Sparling S, Moore DM, Lachowsky N, Jollimore J, Lal A, Parlette A, Hart TA. HIV incidence and related risks among gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver: Informing blood donor selection criteria in Canada. Transfusion 2022; 62:2555-2567. [PMID: 36197064 PMCID: PMC10092181 DOI: 10.1111/trf.17127] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/25/2022] [Accepted: 09/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND An individualized behavior-based selection approach has potential to allow for a more equitable blood donor eligibility process. We collected biological and behavioral data from urban gay, bisexual, and other men who have sex with men (GBM) to inform the use of this approach in Canada. STUDY DESIGN AND METHODS Engage is a closed prospective cohort of sexually active GBM, aged 16+ years, recruited via respondent-driven-sampling (RDS) in Montreal, Toronto, and Vancouver, Canada. Participants completed a questionnaire on behaviors (past 6 months) and tested for HIV and sexually transmitted and blood-borne infections at each visit. Rate ratios for HIV infection and predictive values for blood donation eligibility criteria were estimated by RDS-adjusted Poisson regression. RESULTS Data on 2008 (study visits 2017-02 to 2021-08) HIV-negative participants were used. The HIV incidence rate for the three cities was 0.4|100 person-years [95%CI:0.3, 0.6]. HIV seroconversion was associated with age <30 years: adjusted rate ratio (aRR) 9.1 [95%CI:3.2, 26.2], 6-10 and >10 anal sex partners versus 1-6 aRR: 5.3 [2.1,13.5] and 8.4 [3.4, 20.9], and use of crystal methamphetamine during sex: 4.2 [1.5, 11.6]. Applying the combined selection criteria: drug injection, ≥2 anal sex partners, and a new anal sex partner, detected all participants who seroconverted (100% sensitivity, 100% negative predictive value), and would defer 63% of study participants from donating. CONCLUSION Using three screening questions regarding drug injection and sexual behaviors in the past 6 months would correctly identify potential GBM donors at high risk of having recently contracted HIV. Doing so would reduce the proportion of deferred sexually active GBM by one-third.
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Affiliation(s)
- Gilles Lambert
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada.,Institut National de Santé Publique du Québec, Montréal, Québec, Canada
| | - Joseph Cox
- Direction Régionale de Santé Publique de Montréal, Montréal, Québec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Alain Fourmigue
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Milada Dvorakova
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Herak Apelian
- Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
| | - Erica E M Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - David M Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nathan Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.,School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada.,Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Jody Jollimore
- Community-Based Research Centre, Vancouver, British Columbia, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
| | - Abbie Parlette
- Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Trevor A Hart
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, Toronto Metropolitan University, Toronto, Ontario, Canada
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10
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Castillo G, Vesnaver E, Gibson E, Butler-Foster T, Goldman M, Hill NE, Rosser A, Lapierre D, Rubini KA, MacDonagh R, Miguel G, Palumbo A, MacPherson P, Randall T, Osbourne-Sorrell W, O'Brien SF, Bridel W, Otis J, Greaves M, Al-Bakri TB, Reid M, Labrecque M, Germain M, Orvis S, Clapperton AT, Devine D, Presseau J. Staff perspectives on barriers and enablers to implementing alternative source plasma eligibility criteria for gay, bisexual, and other men who have sex with men. Transfusion 2022; 62:1571-1582. [PMID: 35834537 PMCID: PMC9544875 DOI: 10.1111/trf.17000] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/12/2022] [Accepted: 05/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Canadian Blood Services introduced new eligibility criteria that allows some sexually active gay, bisexual, and other men who have sex with men (gbMSM) to donate source plasma, marking a significant change from time-based deferral criteria. We aimed to identify potential barriers and enablers to implementing the new criteria from the perspective of donor center staff. STUDY DESIGN AND METHODS We conducted Theoretical Domains Framework-informed interviews with staff from two source plasma donation centers in Canada. RESULTS We completed 28 interviews between June 2020 and April 2021. Three themes representing eight domains captured key tensions. Valuing inclusive eligibility criteria: staff support inclusive criteria; many were concerned the new criteria remained discriminatory. Investing in positive donor experiences: staff wished to foster positive donor experiences; however, they worried gbMSM donors would express anger and disappointment regarding the new criteria, staff would experience unease over using stigmatizing criteria and convey nonverbal cues of discomfort, and recurring plasma donors may behave inappropriately. Supporting education, training, and transparency of eligibility criteria: participants believed providing in-person training (i.e., to explain criteria rationale, address discomfort, practice responding to donor questions) and ensuring donors and the public were well-informed of the upcoming changes would improve implementation. DISCUSSION Participant views emphasize the importance of supporting staff through training and transparent communication to optimize the delivery of world-class equitable care for a new cohort of donors who have previously been excluded from plasma donation. Findings inform which staff supports to consider to improve implementation as policies continue to shift internationally.
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Affiliation(s)
- Gisell Castillo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Elisabeth Vesnaver
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Emily Gibson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | | | - Mindy Goldman
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada.,Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Canada
| | - Nolan E Hill
- Centre for Sexuality, Calgary, Canada.,Local Advisory Group, Calgary, Canada
| | | | - Don Lapierre
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada
| | | | | | | | - Amelia Palumbo
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Paul MacPherson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Medicine, The Ottawa Hospital, Ottawa, Canada.,Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Canada
| | | | | | - Sheila F O'Brien
- Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Canada
| | | | - Joanne Otis
- Department of Sexology, Université du Québec À Montréal, Montreal, Canada
| | | | | | | | | | - Marc Germain
- Héma-Québec, Medical Affairs, Quebec City, Canada
| | | | | | - Dana Devine
- Canadian Blood Services, Vancouver, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, Canada
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada
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