Donation Policy & Studies, Canadian Blood Services, 1800 Alta Vista Drive, Ottawa, Ontario, K1G 4J5, Canada.
Department of Pathology and Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Transfusion. 2022 Jan;62(1):125-134. doi: 10.1111/trf.16753. Epub 2021 Dec 1.
In Canada, the deferral for men who have sex with men (MSM) has been progressively reduced from a permanent deferral for MSM since 1977, to 5 years, 1 year, and, most recently, 3 months. We estimated human immunodeficiency virus (HIV) residual risk and compliance with the MSM time deferral after each change.
Four anonymous online compliance surveys were carried out before and after each change. HIV incidence and prevalence were monitored from 2010 to 2021. Residual risk was estimated using the incidence-window period model.
Human immunodeficiency virus prevalence, incidence, and residual risk did not change with incrementally shorter MSM deferrals. The residual risk per million donations post 3-month deferral was 0.05 (0.001-0.371). Men with temporally remote MSM history became eligible and, therefore, compliant as the deferral periods decreased (Cochran-Armitage p value = <.0001). However, the percentage of men with MSM history in the last 3 months with the indefinite deferral in place was similar to the percentage noncompliant, while the 3-month deferral was in place. MSM donors did not report high-risk behaviors for which they would otherwise be deferred in any survey. Following the change, an estimated 4467 MSM per year were eligible to donate, an increase from 2501 estimated eligible MSM donors following the change to the 1-year deferral.
With progressively shorter MSM deferral periods, HIV residual risk was unchanged. The proportion of male donors with deferrable MSM history remained low, while those with temporally remote MSM history became eligible, increasing the number of eligible MSM donors.
在加拿大，自 1977 年以来，男男性行为者（MSM）的延迟时间从永久性延迟逐渐缩短为 5 年、1 年，最近又缩短为 3 个月。我们在每次变更后估计了人类免疫缺陷病毒（HIV）的残留风险和 MSM 时间延迟的遵守情况。
在每次变更前后进行了四次匿名在线合规调查。从 2010 年到 2021 年，监测了 HIV 的发病率和患病率。使用发病率-窗口期模型估计残留风险。
随着 MSM 延迟时间的逐渐缩短，HIV 流行率、发病率和残留风险没有变化。3 个月延迟后，每百万次捐赠的残留风险为 0.05（0.001-0.371）。具有临时遥远 MSM 历史的男性成为合格且因此随着延迟期的缩短而遵守（Cochran-Armitage p 值<0.0001）。但是，在有无限期延迟的情况下，最近 3 个月内有 MSM 历史的男性的百分比与不合规的百分比相似，而 3 个月的延迟仍然存在。MSM 捐赠者在任何调查中都没有报告他们会因高风险行为而被推迟的情况。变更后，估计每年有 4467 名 MSM 有资格捐赠，比变更为 1 年延迟后估计的 2501 名合格 MSM 捐赠者有所增加。
随着 MSM 延迟时间的逐渐缩短，HIV 残留风险保持不变。具有可延迟 MSM 病史的男性供者比例仍然较低，而具有临时遥远 MSM 病史的男性成为合格供者，增加了合格 MSM 供者的数量。
