O'Brien Sheila F, Osmond Lori, Fan Wenli, Yi Qi-Long, Goldman Mindy
Canadian Blood Services, Ottawa, Ontario.
School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Transfusion. 2016 Jun;56(6 Pt 2):1598-602. doi: 10.1111/trf.13445. Epub 2015 Dec 31.
The deferral for men who have sex with men (MSM) changed from a permanent deferral since 1977 to a 5-year deferral on July 22, 2013, in Canada. We assessed the impact on safety and adequacy of the blood supply at Canadian Blood Services.
Human immunodeficiency virus (HIV) rates were monitored from January 1, 2010, to July 21, 2015. Risk factors were assessed in notification interviews. Anonymous online surveys of male whole blood donors assessed compliance before and after implementation.
HIV rates were 0.2, 0.5, and 0.51 per 100,000 donations in 2010 to 2012; they were 0.54 and 0.22 in the first and second years after implementation (p = 0.8). Of four male HIV-positive donors after implementation, three denied risk factors and one knew he had HIV. Before implementation 9669 of 19,437 (49.7%) donors participated in the survey, and after implementation, 6881 of 18,934 (36.3%). Before implementation 0.67% of male donors were noncompliant, and after implementation, 0.44%. There was no difference before versus after implementation in male donors with MSM history in the past 5 years (0.37% vs. 0.43%, p = 0.54). After implementation, eligible MSM donors increased (0.42% vs. 0.66%, p = 0.04), with approximately 500 more donors in 2014.
Implementation of a 5-year deferral for MSM had no impact on HIV rates in 2 years of postimplementation monitoring. Donor compliance improved after implementation due to MSM donors who were previously ineligible becoming eligible. There was no change in the percentage of male donors with recent male partners but there was a modest increase in eligible MSM in the donor pool.
在加拿大，男男性行为者（MSM）的献血延期政策自1977年起为永久延期，2013年7月22日改为5年延期。我们评估了这一政策对加拿大血液服务中心血液供应安全性和充足性的影响。
监测2010年1月1日至2015年7月21日期间的人类免疫缺陷病毒（HIV）感染率。在通知访谈中评估风险因素。对男性全血捐献者进行匿名在线调查，评估政策实施前后的依从性。
2010年至2012年每10万次献血中的HIV感染率分别为0.2、0.5和0.51；政策实施后的第一年和第二年分别为0.54和0.22（p = 0.8）。政策实施后4名HIV阳性男性捐献者中，3人否认有风险因素，1人知道自己感染了HIV。政策实施前，19437名捐献者中有9669人（49.7%）参与了调查，实施后，18934名捐献者中有6881人（36.3%）参与。政策实施前0.67%的男性捐献者不符合要求，实施后为0.44%。在过去5年中有男男性行为史的男性捐献者中，政策实施前后没有差异（0.37%对0.43%，p = 0.54）。政策实施后，符合条件的男男性行为者捐献者增加（0.42%对0.66%，p = 0.04），2014年捐献者增加了约500人。
对男男性行为者实施5年延期政策在实施后两年的监测中对HIV感染率没有影响。由于之前不符合条件的男男性行为者捐献者变得符合条件，政策实施后捐献者依从性有所提高。有近期男性伴侣的男性捐献者比例没有变化，但捐献者库中符合条件的男男性行为者略有增加。
