BACKGROUND: Health policymakers are concerned about the proportion of peopl
e who say they are unwilling to receive a blood transfusion. This article e
xamines how social, cultural, and political factors affect the perceived ri
sk of transfusions.
STUDY DESIGN AND METHODS: Data were collected as part of a large national t
elephone survey of 1204 people conducted in the United States in 1997 and 1
998. The survey elicited images associated with blood transfusions and cont
ained questions about the perceived risk of the blood supply, sensitivity t
o stigma, worldviews, trust, and demographics.
RESULTS: The results showed that a substantial proportion of people do not
consider the US blood supply to be safe and say they would not accept blood
if hospitalized. The images evoked most frequently by the stimulus phrase
"blood transfusions" were related to AIDS or HIV. The people who tend to pe
rceive the greatest personal and public risk from blood transfusions are fe
male, nonwhite, and less educated, and they have not previously received a
transfusion. Sensitivity to stigma, mistrust, one's perceived inability to
control hazardous activities and technologies, and fatalistic and egalitari
an worldviews tend to be associated with heightened concern about the risk
of blood transfusions.
CONCLUSION: Risk perceptions need to be monitored to anticipate and deal wi
th problems of public acceptance. Risk management strategies should be tail
ored to the specific characteristics of individuals that are important dete
rminants of the perceived risk of transfusions.