[How to reduce the prevalence of HIV-positive blood donors].

UNLABELLED: Despite abolishing the policy of giving the results of the serological test as a way to promote blood donation, and also after improving the predonation questionnaire, we still have a high prevalence of HIV positive blood donors. In this paper we try to analyze, interviewing the HIV positive blood donors in our Counselling Clinic from January 1995 to December 1996, why they were accepted. We asked the HIV positive blood donors to fill a form with the following questions: identification, kind and frequency of blood donation, HIV high risk behaviour, awareness of predonation serological status, willingness toward blood donation, awareness of how dangerous the transfusion of HIV contaminated blood is. For the screening we used Abbott HIV1/HIV 3rd generation plus EIA, test and HIV-1 Western Blot Cambridge, Biotest, Worcester MA, for confirmatory assays. During the evaluation period, 53,338 blood donors were attended, 130 (0.24%) were confirmed HIV positive. Only 18/130 (13.84%) assisted to the Counselling Clinic. The mean age was 33.27 +/- 5.35 years old, all males, 15 singles and 3 with stable couples. 6/18 (33.33%) could have been discarded because of physical appearance or because of theirs jobs. "Voluntary Donation" was higher than in the control group (p = 0.0001). Homo/bisexual and promiscuous behaviour (p = 0.0003) were the predominant high risk factors, in this group 55.55% had more than one risk factor. The association with HBV and syphilis was high (p = 0.0001 and p = 0.0005). 5/18 (27.77%) knew they were HIV positive; 3/18 (16.66%) had the suspicion they were HIV positive and 10/18 (55.55%) did not know it; however the risk factors were the same in those groups. In the knew/suspicion group the main reasons for blood donation were: Performing the test once more, 6; failure in the predonation questionnaire, 1; family pressure, 1. In the group that ignored their HIV positivity: ignorance of belonging to a high-risk group, 6; lack of confidence in the interviewer, 3 and failure in the predonation questionnaire, 1. 61.11% knew that the HIV tests were performed on all blood donations and the the positive ones were discarded. No one had knowledge of the window period.

CONCLUSIONS: 1. It is necessary to spread more information to the general population about the ways of HIV transmission, the risk factors and its prevention. 2. To make aware all HIV positive or those that suspect they are the HIV positive how dangerous their blood donation could be. 3. Offering the general population a free HIV test and giving the appropriate counselling and support. 4. Improving the questionnaire, assuring that the blood donor could understand the real meaning of the questions and how important his/her truthfulness is. 5. To consider the implementation of the p24 antigen test as mandatory to all blood donations and all the new techniques to avoid HIV transmission. 6. To change the "related" blood donors to the true voluntary, altruistic, blood donor.