Ae. Williams et al., ESTIMATES OF INFECTIOUS-DISEASE RISK-FACTORS IN US BLOOD-DONORS, JAMA, the journal of the American Medical Association, 277(12), 1997, pp. 967-972
Objective.-Individuals who do not respond accurately to questions abou
t infectious disease risk factors at the time of blood donation repres
ent a potential threat to the safety of the blood supply. This study w
as designed to estimate the prevalence of undetected behavioral and ot
her risks in current blood donors. Design.-Anonymous mail surveys to c
ollect demographic, medical, and behavioral information were administe
red to individuals who had donated blood within the previous 2 months.
Sampling weights were used in the analysis to adjust for differential
sampling and response rates among demographic groups to provide preva
lence estimates for the donor population. Setting.-Five geographically
and demographically diverse US blood centers. Participants.-A stratif
ied probability sample of 50 162 allogeneic blood donors. Main Outcome
Measures.-Estimated prevalence rates for risk behaviors that would ha
ve been a basis for deferral if reported at the time of the donor scre
ening interview (deferrable risk). Results.-Completed questionnaires w
ere received for 34 726 donors (69.2% of the sample). A total of 186 p
er 10 000 respondents (1.9%) reported a deferrable risk that was prese
nt at the time of their past donation, while 39 per 10 000 (0.4%) repo
rted this behavior within the 3 months prior to donation. Rates (with
95% confidence intervals [CIs]) of deferrable risk behaviors were 1.4
(95% CI, 1.2-1.6) times higher for men than women, 1.6 (95% CI, 1.3-2.
0) times higher for first-time vs repeat donors, 2.7 (95% CI, 2.0-3.6)
times higher for donors with reactive screening tests, and 7.6 (95% C
I, 3.6-15.8) times higher for donors who used the confidential unit ex
clusion option. Conclusions.-Despite the high degree of transfusion sa
fety in the United States today, a measurable percentage of active blo
od donors when assessed by anonymous survey report risks for human imm
unodeficiency virus and other infections not reported at the time of s
creening, suggesting the need for further refinements in the blood don
or qualification process.