1 Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA.
2 Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Public Health Rep. 2019 Jan/Feb;134(1):36-46. doi: 10.1177/0033354918815182. Epub 2018 Dec 7.
In the United States, all men who have sex with men (MSM) were banned from donating blood from 1985 through 2015. In 2016, the guideline was amended such that men who had sexual contact with other men within the previous 12 months could not donate blood. We aimed to identify blood donation practices and their relationship with HIV risk and testing among young adult MSM (YMSM) at risk for having HIV.
In 2014, we recruited HIV-negative non-Hispanic black, Hispanic, and non-Hispanic white YMSM aged 18-24 from across the United States through social media platforms to complete an online survey. Among these YMSM who previously donated blood, we conducted a secondary analysis examining the relationship between having donated blood within the past 12 months and sexual risk behavior from recent condomless anal intercourse (CAI), HIV testing, and self-perceived risk of having an undiagnosed HIV infection.
Of the 2261 YMSM surveyed, 1104 (48.8%) had ever previously donated blood and 305 (13.5%) had donated blood within the past 12 months. Of the 305 blood donors, 50 (16.4%) had ever had CAI before their most recent blood donation. Among YMSM who donated blood, past-12-month blood donation was more likely among YMSM who never had CAI (adjusted odds ratio [aOR] = 1.84; 95% confidence interval [CI], 1.24-2.73) than among YMSM who had CAI and more likely among YMSM who believed it was not possible at all that they had an undiagnosed HIV infection (aOR = 1.57; 95% CI, 1.14-2.16) than among YMSM who believed there was any possibility of having an undiagnosed HIV infection; it was not related to past-12-month HIV testing.
YMSM donated blood frequently, suggesting that the deferral process in place did not prevent YMSM from donating blood. The current donor screening process should be reconsidered if it is to prevent YMSM from donating blood. Future research could identify screening questions that permit YMSM with a low risk of HIV infection to donate blood while maintaining the safety of the blood supply.
在美国，所有与男性发生性关系的男性（MSM）从 1985 年到 2015 年被禁止献血。2016 年，该指南进行了修订，规定在过去 12 个月内与男性发生过性关系的男性不能献血。我们旨在确定与 HIV 风险相关的献血行为以及在有 HIV 感染风险的年轻成年男男性行为者（YMSM）中进行 HIV 检测。
2014 年，我们通过社交媒体平台招募了来自美国各地的年龄在 18-24 岁之间的 HIV 阴性非西班牙裔黑人、西班牙裔和非西班牙裔白人 YMSM，以完成在线调查。在这些以前献过血的 YMSM 中，我们进行了一项二次分析，调查了过去 12 个月内献血与最近无保护肛交（CAI）、HIV 检测和自我感知的未确诊 HIV 感染风险之间的关系。
在接受调查的 2261 名 YMSM 中，有 1104 名（48.8%）曾有过献血经历，305 名（13.5%）在过去 12 个月内献血。在 305 名献血者中，有 50 名（16.4%）在最近一次献血前曾有过 CAI。在 YMSM 中，过去 12 个月内献血的可能性在从未有过 CAI 的 YMSM 中更高（调整后的优势比[aOR] = 1.84；95%置信区间[CI]，1.24-2.73），而在有 CAI 的 YMSM 中更高，在认为自己完全不可能感染未确诊 HIV 的 YMSM 中更高（aOR = 1.57；95%CI，1.14-2.16），而在认为自己有任何感染未确诊 HIV 的可能性的 YMSM 中更高；与过去 12 个月内的 HIV 检测无关。
YMSM 经常献血，这表明目前的暂缓献血程序并不能阻止 YMSM 献血。如果要防止 YMSM 献血，应重新考虑当前的献血者筛查程序。未来的研究可以确定筛查问题，使感染 HIV 风险低的 YMSM 能够献血，同时保持血液供应的安全性。
