DIRECT ORAL QUESTIONS TO BLOOD-DONORS - THE IMPACT ON SCREENING FOR HUMAN-IMMUNODEFICIENCY-VIRUS

Background: In December 1990, the Food and Drug Administration recomme nded that all United States blood centers implement a policy of asking prospective donors direct oral questions (DOQs) about human immunodef iciency virus (HIV) risk behaviors to increase the safety of the blood supply. Study Design and Methods:To evaluate the Impact of the DOQ po licy, HIV-related deferral and HIV seroprevalence data were analyzed a t four American Red Cross blood centers for the year before the policy change and the year after. An epidemiologic analysis with stratificat ion was conducted, including the calculation of odds ratios (OR) and 9 5-percent CIs. Results: Two of the four blood centers showed an overal l significant increase in HIV-related deferral after implementation of the DOQ policy: OR = 4.04, (95% CI = 3.41, 4.76); OR = 2.93, (95% CI = 2.67, 3.21). The increase in HIV-related deferral was higher for wom en. HIV seroprevalence decreased at all four centers, including the tw o that did not see an increase in HIV-related deferrals. Seroprevalenc e declined by 14 percent in the two centers with increases in HIV-rela ted deferral, which was neither significant nor attributable to DOQs. Conclusion: Given that HIV antibody screening cannot detect HIV-serone gative (but infectious) ''window-period'' donations, the deferral of a t-risk donors may offer some additional protection to the blood supply . However, evidence was not found of an increase in safety of the bloo d supply as measured by HIV seroprevalence.