Human immunodeficiency virus test-seeking motivation in blood donors, São Paulo, Brazil

Background and Objective  Previous studies have shown that volunteer, community‐recruited donors have a higher prevalence of human immunodeficiency virus (HIV) infection in São Paulo, Brazil, than replacement donors. One hypothesis which may explain this unexpected finding is that some individuals d...

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Bibliographic Details
Published in:Vox sanguinis 2006-04, Vol.90 (3), p.170-176
Main Authors: Goncalez, T. T., Sabino, E. C., Murphy, E. L., Chen, S., Chamone, D. A. F., McFarland, W.
Format: Article
Language:English
Subjects:
Adult
blood donor selection
Blood Donors - psychology
Brazil
Female
Hepatitis B virus
Hepatitis C virus
herpes simplex type 2
Herpes simplex virus 2
HIV
HIV Infections - blood
HIV Infections - epidemiology
HIV Infections - psychology
HIV risk factors
HIV testing
Human immunodeficiency virus
Human T-lymphotropic virus
Humans
Intention
Male
Mass Screening - psychology
Risk Factors
Treponema pallidum
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Summary:Background and Objective  Previous studies have shown that volunteer, community‐recruited donors have a higher prevalence of human immunodeficiency virus (HIV) infection in São Paulo, Brazil, than replacement donors. One hypothesis which may explain this unexpected finding is that some individuals donate blood because they are seeking HIV testing. The objective of this study was to characterize test‐seeking blood donors and to determine whether they are at higher risk for HIV infection compared with other donors. Materials and Methods  Subjects presenting for blood donation were asked to participate in a study assessing their motivations (including test seeking) to donate, as measured by perceiving donation as a means to obtain infectious disease test results. Participants completed the standard blood bank predonation screening questions plus our additional survey, and were tested for HIV, hepatitis B virus (HBV), hepatitis C virus (HCV), human T‐cell lymphocytotrophic virus (HTLV) I/II, syphilis and Chagas’ disease. As a result of anticipated low statistical power to directly measure the association between test‐seeking motivation and HIV infection, we tested for herpes simplex virus type 2 (HSV‐2) as a marker of sexual risk for HIV. Our survey includes accepted donors as well as persons whose risk‐behaviour histories would result in their exclusion from donation according to routine screening procedures. Results  Of 1720 potential blood donors randomly selected and approached, 1600 (93·0%) participated. Overall, 141 (8·8%) were classified as test seekers; 15·6% of these were HSV‐2 positive. The proportion of test seekers was the same among community‐recruited and replacement donors. Test seekers had a higher prevalence of HSV‐2 [adjusted odds ratio (AOR) 1·66; 95% confidence interval (CI): 1·06–2·59] adjusting for age, gender and prior donation. The association was significant among community‐recruited blood donors whose previous donation was more than 1 year ago (i.e. ‘lapsed donors’) (AOR 2·55; 95% CI: 1·20–5·44). Test seekers were not more likely to be rejected from blood donation as a result of health reasons, self‐reported HIV risk‐related behaviour, or by their own confidential unit exclusion. We found no difference in HSV‐2 prevalence between persons accepted for donation (15·7%) and those rejected because of self‐reported sexual risk (16·7%). Conclusions  We did not detect a difference in the proportion of test seekers across different types of b
ISSN:0042-9007
1423-0410
DOI:10.1111/j.1423-0410.2006.00743.x