Blood donors with antibody to the human immunodeficiency virus--the Natal experience.

The major incursion of human immunodeficiency virus type I (HIV-1) infection into the South African heterosexual population has been by southerly migration of the heterosexual HIV-1 epidemic from central Africa. Much important information can be obtained from blood donor seroprevalence data and cohort studies of those individuals infected during the early stages of the epidemic in South Africa. By the end of April 1989, over half a million blood donors in Natal had been screened and the presence of antibody to HIV-1 confirmed in more than 200. The majority of these anti-HIV-1 positive donors are young and single (many of them still at school), although a substantial proportion already have children of their own and a recent history of sexually transmitted disease is common. The Natal Blood Transfusion Service experience indicates that the heterosexual HIV-1 epidemic in Natal is essentially no different from the earlier stages of heterosexual epidemics elsewhere in Africa. There is still time for effective programmes to have a major impact on progression of the epidemic in South Africa, particularly if these programmes are directed at the young population in educational institutions.