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Quiner C, Bruhn R, Grebe E, Di Germanio C, Kessler D, Reik R, Williamson P, Hampton D, Fayed R, Anderson SA, Williams AE, Glynn SA, Busch MP, Stramer SL, Custer B. Recently acquired infection among HIV-seropositive donors in the US from 2010-2018. Transfusion 2020; 60:2340-2347. [PMID: 32860262 DOI: 10.1111/trf.16032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/03/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Monitoring of transfusion-transmissible infections in the blood supply is essential for blood safety, as the donor population is not static, and changes in policy, donor behavior, or other factors could increase the risk of recipient infection. We assessed patterns of recently acquired HIV infection in US blood donors, including before and after the implementation of the 12-month deferral for men who have sex with men (MSM). STUDY DESIGN AND METHODS A large convenience sample of donations from donors testing HIV-1 nucleic acid testing (NAT) and serology-reactive were further tested with the Sedia HIV-1 Limiting Antigen enzyme immunoassay. Samples were analyzed across available demographic and donation data to provide an assessment of recently acquired HIV infection in US blood donors from 2010 to 2018. RESULTS Overall, 317 of 1154 (27.5%; 95% confidence interval, 24.9%-30.1%) donations from HIV NAT and serology-reactive donors had recently acquired HIV infection. There was no evidence of change in the percentages of recent HIV infection by year over the study period, either in all donors or in male donors, including after the MSM policy change. In multivariable logistic regression analysis, donors aged 24 years or younger were over 2.7 times more likely and repeat donors 2.2 times more likely to have recently acquired HIV infection compared to donors aged 55 years or older and first-time donors, respectively. CONCLUSION Patterns of recently acquired HIV infection varied by demographics but not over time. These findings suggest no impact of the MSM policy change on recently acquired HIV infection in US blood donors.
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Affiliation(s)
- Claire Quiner
- Vitalant Research Institute, San Francisco, California, USA
| | - Roberta Bruhn
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Eduard Grebe
- Vitalant Research Institute, San Francisco, California, USA
| | | | | | - Rita Reik
- OneBlood, St. Petersburg, Florida, USA
| | | | - Dylan Hampton
- Vitalant Research Institute, San Francisco, California, USA
| | - Rahima Fayed
- American Red Cross Scientific Affairs, Gaithersburg, Maryland, USA
| | | | - Alan E Williams
- U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Simone A Glynn
- National Heart, Lung and Blood Institute, National Institutes of Health, Rockville, Maryland, USA
| | - Michael P Busch
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
| | - Susan L Stramer
- American Red Cross Scientific Affairs, Gaithersburg, Maryland, USA
| | - Brian Custer
- Vitalant Research Institute, San Francisco, California, USA.,Department of Laboratory Medicine, University of California San Francisco, San Francisco, California, USA
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2
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Factors that contribute to blood donation behavior among primary healthcare users: A structural approach. Transfus Apher Sci 2019; 58:663-668. [DOI: 10.1016/j.transci.2019.08.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 11/20/2022]
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3
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Levi JE. Comment to: Test seeking: are health care professionals referring people to the blood centers for infectious markers testing? Hematol Transfus Cell Ther 2019; 41:197-198. [PMID: 31383586 PMCID: PMC6732407 DOI: 10.1016/j.htct.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
- José Eduardo Levi
- Instituto de Medicina Tropical da Universidade de São Paulo (IMTSP - USP), São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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4
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Zucoloto ML, Gonçalez T, Custer B, McFarland W, Martinez EZ. Comparison of the demographic and social profile of blood donors and nondonors in Brazil. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:330-336. [PMID: 30159946 DOI: 10.1111/hsc.12650] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 06/16/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
Population-based studies on blood donation prevalence and its association with sociodemographic and behavioural factors are scarce, but remain the best approach to assess correlates of donation, including those which could be the target for donor recruitment campaigns. This study describes the population of primary healthcare users from the public system in a medium-sized Brazilian municipality to investigate the association of blood donation practice with other sociodemographic factors. A stratified, representative sample of primary healthcare users at 12 healthcare facilities in Ribeirão Preto, São Paulo, Brazil, were invited to participate. Analysis focused on demographic and psychosocial factors including, sex, age, marital status, socioeconomic status, educational level, health insurance, self-perception of health, religious beliefs, and blood donation history. Blood donors, self-defined ineligible donors, and never donors were compared. Multiple correspondence analysis (MCA) was used to assess positively and negatively associated variables in the dataset. MCA was conducted on respondents' age and monthly household income to assess dimensionality of other questionnaire responses. Of a total of 1,055 study participants, 79.7% were females and the mean age was 40.6 years. Blood donation practice was reported by 246 participants (23.3%), 669 (63.4%) had never donated, and 140 (13.3%) reported being unable to donate blood. Graphical presentation of the MCA showed that male, older age groups, those who have health insurance, and with higher socioeconomic and educational level are more likely to donate blood. Poor or average self-perception of health, lower socioeconomic status, and divorced or widowed marital status were associated with self-defined inability to donate blood. Thus, our results are useful to understand the multifactorial nature of blood donation behaviour. Our findings provide guidance for targeted recruitment campaigns focused on relevant contextual factors. The focus on reducing barriers to blood donation according to sociodemographic groups can be a relevant strategy to expand the donor base.
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Affiliation(s)
- Miriane L Zucoloto
- Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
| | | | - Brian Custer
- Blood Systems Research Institute, San Francisco, California
- University of California San Francisco - UCSF, San Francisco, California
| | - Willi McFarland
- University of California San Francisco - UCSF, San Francisco, California
| | - Edson Z Martinez
- Ribeirão Preto Medical School, University of São Paulo - USP, Ribeirão Preto, São Paulo, Brazil
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Moreno EC, Bruhn R, Sabino EC, Bolina-Santos E, Miranda C, Carneiro-Proietti AB, Lopes ME, Almeida-Neto CD, Loureiro P, Capuani L, Takecian PL, Custer B, Gonçalez TT. Test seeking: are healthcare professionals referring people to blood centers for infections marker testing? Hematol Transfus Cell Ther 2019; 41:229-235. [PMID: 31085151 PMCID: PMC6738480 DOI: 10.1016/j.htct.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022] Open
Abstract
Background Test-seeking is associated with HIV in Brazilian blood donors. This study sought to investigate the frequency with which three different donor groups: deferred donors, accepted donors who tested HIV positive [HIV (+)], and accepted donors who tested infectious disease markers negative [IDM (−)], came to the blood bank at the suggestion of a health care professional. Study design and methods Donors deferred for reporting high-risk behaviors and participants in an HIV risk factor case-control study completed a confidential audio computer-assisted self-interview (ACASI) that included two questions related to health care professionals and test-seeking. Results Of 4013 enrolled deferred donors, 468 (11.8%) reported a health care professional suggested donation as a way to be tested for infection. Of 341 HIV (+) and 791 IDM (−) participants, 43 (12.6%) and 11 (1.4%), respectively, reported a health care professional suggested donation as a way to be tested for infection. Physicians were the most frequently reported source of referral: [(61.5% of deferred, 69.1% of HIV (+), and 9.1% of IDM (−) donors)]. Conclusion HIV (+) donors and deferred donors were 10 times more likely to report test-seeking behavior by suggestion of health care professional than IDM (−) donors. If true, efforts should be made to educate health care professionals and blood donors on how to safeguard the blood supply, emphasizing that HIV testing should be done at volunteer testing centers rather than at the blood centers.
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Affiliation(s)
- Elizabeth C Moreno
- Fundação Hemominas - Hemocentro de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Roberta Bruhn
- Blood Systems Research Institute, Epidemiology, San Francisco, CA, United States
| | | | | | - Carolina Miranda
- Fundação Hemominas - Hemocentro de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Maria Esther Lopes
- Fundação Hemorio - Hemocentro do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | - Paula Loureiro
- Fundação Hemope - Hemocentro de Pernambuco, Recife, PE, Brazil; Universidade Federal de Pernambuco (UFPE), Recife, PE, Brazil
| | - Ligia Capuani
- Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | | | - Brian Custer
- Blood Systems Research Institute, Epidemiology, San Francisco, CA, United States; University of California San Francisco(UCSF), San Francisco, CA, United States
| | - Thelma T Gonçalez
- Blood Systems Research Institute, Epidemiology, San Francisco, CA, United States.
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6
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Vahidnia F, Stramer SL, Kessler D, Gonçalez TT, Shaz BH, Leparc G, Krysztof DE, Dodd RY, Glynn SA, Custer B. Motivations for donating and attitudes toward screening policies in US blood donors with viral infection. Transfusion 2016; 56:2013-20. [PMID: 27351292 DOI: 10.1111/trf.13678] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 04/11/2016] [Accepted: 04/21/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Differences in motivating factors that contribute to the decision to donate blood between infected and uninfected donors may help to identify areas for improving donor education. STUDY DESIGN AND METHODS As part of a risk factor study, confirmed-positive donors (cases) based on serology-only (human T-lymphotropic virus [HTLV]) or serology and nucleic acid testing (NAT) or NAT-only (human immunodeficiency virus [HIV], hepatitis B virus [HBV], hepatitis C virus [HCV]), and serology-unconfirmed, NAT-negative false-positive donors (controls) were asked about motivations and opinions toward blood donation. "Test seeking" was inferred if a donor answered "yes" to "I wanted to get my test results" and one of the following: "blood center testing is confidential," "free," "more accurate than other test centers," or "tests will identify problems with my blood." Cases were compared to controls using descriptive and multivariable analyses. RESULTS Whether a case or control, the most common donation reason was "to help someone in need" (>90% in each group). After adjusting for demographic characteristics, test seeking was not significantly associated with infection status. Test seeking was more common in first-time, younger males and nonwhite, non-Hispanic donors. Of donors with HIV, 13% considered selection policies to be unfair, compared with 1, 2, 0.5, and 6% of donors with HBV, HCV, and HTLV and controls, respectively (adjusted odds ratio for HIV cases vs. controls, 3.9; 95% confidence interval, 2.3-6.7). CONCLUSIONS Most donors give to help those in need, including HIV-positive donors. Our results establish a baseline from which additional studies can be compared focused on alternate ways to reduce noncompliance and improved messaging to ensure that high-risk potential donors understand the reasons for blood donor screening policies.
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Affiliation(s)
| | | | | | | | | | | | | | - Roger Y Dodd
- American Red Cross, Holland Laboratory, Rockville, Maryland
| | - Simone A Glynn
- National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Brian Custer
- Blood Systems Research Institute, San Francisco, California.,University of California at San Francisco, San Francisco, California
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Moreno EC, Bolina-Santos E, Mendes-Oliveira F, Miranda C, Sabino EC, Cioffi JGM, Camargos V, Caiaffa W, Xavier CC, Proietti FA, de Freitas Carneiro-Proietti AB. Blood donation in a large urban centre of southeast Brazil: a population-based study. Transfus Med 2016; 26:39-48. [DOI: 10.1111/tme.12285] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- E. C. Moreno
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
| | - E. Bolina-Santos
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
| | - F. Mendes-Oliveira
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
| | - C. Miranda
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
| | - E. C. Sabino
- Instituto de Medicina Tropical; Universidade de São Paulo (USP); São Paulo Brazil
| | - J. G. M. Cioffi
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
| | - V. Camargos
- Departamento de Medicina Preventiva e Social; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - W. Caiaffa
- Departamento de Medicina Preventiva e Social; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
| | - C. C. Xavier
- Faculdade de Saúde e Ecologia Humana (FASEH); Vespasiano Brazil
| | - F. A. Proietti
- Departamento de Medicina Preventiva e Social; Universidade Federal de Minas Gerais; Belo Horizonte Brazil
- Faculdade de Saúde e Ecologia Humana (FASEH); Vespasiano Brazil
| | - A. B. de Freitas Carneiro-Proietti
- Research Division; Fundação Centro de Hematologia de Minas Gerais (HEMOMINAS); Belo Horizonte Brazil
- Faculdade de Saúde e Ecologia Humana (FASEH); Vespasiano Brazil
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Viga-Yurtsever S, Fraiji N, Lira E, Stefani MM, Kiesslich D. High rate of HIV infection in voluntary, first time, young male donors at HEMOAM, a reference blood bank in the Brazilian Amazon: 1992-2012 historical series. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/voxs.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S. Viga-Yurtsever
- Hematology and Hemotherapy Foundation from Amazonas State (HEMOAM); Manaus Amazonas State Brazil
| | - N. Fraiji
- Hematology and Hemotherapy Foundation from Amazonas State (HEMOAM); Manaus Amazonas State Brazil
| | - E. Lira
- Hematology and Hemotherapy Foundation from Amazonas State (HEMOAM); Manaus Amazonas State Brazil
| | - M. M. Stefani
- Tropical Pathology and Public Health Institute; Federal University of Goias; Goiania Goiás Brazil
| | - D. Kiesslich
- Hematology and Hemotherapy Foundation from Amazonas State (HEMOAM); Manaus Amazonas State Brazil
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