Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Blood Transfus. 2018 Jan;16(1):7-16. doi: 10.2450/2017.0109-16. Epub 2017 Mar 23.
The predominant mode of transmission of human immunodeficiency virus (HIV) in Europe is male-to-male transmission. Men who have sex with men (MSM) are deferred from donating blood in many countries, but nevertheless do donate blood. Based on data from 34 countries, we estimated the proportion of MSM screened for HIV in the context of a blood donation and identified individual factors associated with this HIV screening in order to propose possible public health interventions.
In 2010, the first European MSM Internet Survey (EMIS) collected self-reported data on HIV testing from >180,000 MSM in 38 European countries. Using logistic regression, demographic and behavioural factors associated with screening for HIV in blood establishments were identified. Stratified by European sub-region, we analysed the proportion of MSM screening in blood establishments by time elapsed since last negative HIV test.
Donor eligibility criteria for MSM vary across Europe with most countries using permanent deferral. The Western region had the lowest (2%) proportion of MSM screened in blood establishments and the Northeastern region had the highest (14%). Being <25 years old, not disclosing sexual attraction to men, never having had anal intercourse with a man, having a female partner, living in a rural area, and certain European sub-regions or countries of residence increased the likelihood of being screened in blood establishments.
In spite of deferral policies, MSM are screened for HIV in the context of blood donations. Gay-friendly testing services are rare in rural areas, and young men might be reluctant to disclose their sexual orientation. Recent developments, such as home sampling, might offer new testing possibilities for those not reached by established services yet wishing to know their HIV status. Donor selection procedures should be improved. Both interventions might help to further reduce the risk of transfusion-transmitted infections.
在欧洲，人类免疫缺陷病毒（HIV）的主要传播模式是男男性行为。许多国家都禁止男男性行为者献血，但他们仍会献血。基于来自 34 个国家的数据，我们估计了在献血背景下对男男性行为者进行 HIV 筛查的比例，并确定了与这种 HIV 筛查相关的个体因素，以便提出可能的公共卫生干预措施。
2010 年，第一届欧洲男男性行为者互联网调查（EMIS）收集了来自 38 个欧洲国家的 18 万多名男男性行为者的自我报告 HIV 检测数据。使用逻辑回归，确定了与在血液采集机构进行 HIV 筛查相关的人口统计学和行为因素。按欧洲次区域分层，我们分析了自上次 HIV 阴性检测以来，在血液采集机构中筛查男男性行为者的比例。
欧洲各国对男男性行为者的献血资格标准各不相同，大多数国家采用永久性拒绝。西部地区筛查男男性行为者的比例最低（2%），东北部地区最高（14%）。年龄<25 岁、不公开性取向、从未与男性发生过肛交、有女性伴侣、居住在农村地区，以及某些欧洲次区域或居住国，增加了在血液采集机构中筛查的可能性。
尽管有回避政策，但男男性行为者仍在献血时接受 HIV 筛查。在农村地区，对同性恋友好的检测服务很少，年轻男性可能不愿意透露自己的性取向。最近的发展，如家庭采样，可能为那些尚未被现有服务覆盖但希望了解自己 HIV 状况的人提供新的检测可能性。献血者选择程序应加以改进。这两种干预措施都可能有助于进一步降低输血传播感染的风险。
