HETEROSEXUALLY ACQUIRED HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION AND THE UNITED-STATES BLOOD-SUPPLY - CONSIDERATIONS FOR SCREENING OF POTENTIAL BLOOD-DONORS

The impact of heterosexual transmission of the human immunodeficiency virus (HIV) on the United States blood supply was assessed, and deferr al criteria that may exclude potential donors who are at high risk for heterosexually acquired HIV infection were evaluated. Interviews were conducted with 508 HIV-seropositive blood donors from May 1, 1988, to August 31, 1989 (Phase 1), and with 472 donors from January 1, 1990, to May 31, 1991 (Phase 2), at 20 blood centers. From Phase 1 to Phase 2, the overall HIV prevalence decreased from 0.021 to 0.01 8 percent ( p<0.001). HIV risk factors among HIV-1-seropositive donors were simila r during both study phases. Eleven percent of the men and 56 percent o f the women reported as their only risk that they had a heterosexual p artner who was at increased risk for HIV or was known to have HIV. The se percentages were similar during both study periods. During Phase 2, 13 percent of the men and 17 percent of the women with heterosexual t ransmission risk had a positive serologic test for syphilis, hepatitis B core antibody, or hepatitis C antibody. Among HIV-1-seropositive do nors reporting heterosexual risk, the median numbers of previous-year and lifetime sex partners for men were 2 and 30, respectively; for wom en, those numbers were 1 and 7, respectively. Thirty-one percent of th e men and 6 percent of the women reporting heterosexual transmission r isk also reported having had syphilis or gonorrhea within 3 years of d onation. It is concluded that the impact of heterosexual transmission of HIV infection on transfusion safety is not worsening at this time. Donor deferral based on reported numbers of sex partners or history of sexually transmitted disease is likely to have little benefit and wil l exclude a large number of HIV-uninfected donors.