AEGiS-13IAC: Prevalence rates and risk behaviors among U.S HIV positive blood donors.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Prevalence rates and risk behaviors among U.S HIV positive blood donors.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. ThOrC673)

Clark K, Finlayson T, Lavinghouse R, Busch M, Steketee R, Williams A
K. Clark, Center fo Disease Control, 1600 Clifton Road, M-S E46, Atlanta, GA 30333, United States, Tel.: +1 404 639 2085, Fax: +1 404 639 2029, E-mail: kjc4@cdc.gov

BACKGROUND: U.S. blood donors are screened by interview and laboratory tests. Though testing has improved, it is still possible to miss persons with early HIV infection, who are a risk to the blood supply.

METHODS: From 1988-98, we collected data on donations positive for HIV-1 antibody at 15 U.S. blood centers. We interviewed positive donors to determine HIV risk. We used a sensitive/less sensitive (S/LS) EIA test to discriminate recent from older infections on 1994-1997 samples.

RESULTS: Of 25,726,721 donations, 3,501 (.014%) tested positive for HIV-1 antibody. Overall positive rates decreased from .023% in 1988 to .005% in 1998 (p > .01). Rates decreased among men (.030% in 1988 to .008% in 1998, p > .01) and women (.012% in 1988 to .004% in 1998, p > .01). Of HIV positive donors, 2,127 (61%) were interviewed. Overall reported risk behaviors for men were male-to-male sexual contact (MSM) 47%, intravenous drug use (IDU) 8%, heterosexual contact (HET) 9%, and no identified risk (NIR) 36%; and for women were HET 45%, IDU 3% and NIR 52%. From 1988 to 1998, the frequency of HIV positive donations from males decreased significantly for all risk categories: MSM (.017% in 1988 to .003% in 1998), IDU (.002% to .0002%) and HET (.003% to .001%). Of men in 1998, 38% of the interviewed HIV positives acknowledged MSM risk and 5% IDU. Although the frequency of NIR decreased (.009% to .004%), this category accounted for half of the HIV positives in 1998. Using the S/LS EIA test 19% of all positive donors were recent and 81% older infections. Recent HIV infections were more frequent in donors who were under age 35, white, from southeastern U.S., and had MSM risk.

CONCLUSIONS: A combined strategy of deferral and testing has made the U.S. blood supply safer than ever. Though there has been significant progress in blood safety, further improvements are possible. Since a large number of HIV positive male donors are aware of their risk at donation, current deferral methods are not totally effective. Nearly 1 in 5 HIV-positive donors acquired infection within 4 months prior to donation.

Keywords: AEGIS, Prevalence, Blood Donors, Risk-Taking, HIV Infections, HIV Seropositivity, HIV Antibodies, United States, Tissue Donors, Human, Male, Female, Epidemiology, immunology
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