Donation Policy and Studies Group, Canadian Blood Services, Ottawa, Ontario, Canada.
Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.
Transfusion. 2022 Feb;62(2):355-364. doi: 10.1111/trf.16755. Epub 2021 Dec 8.
Blood operators are working to improve donor screening and eligibility for gay, bisexual and other men who have sex with men (gbMSM), and trans and nonbinary donors. Many consider screening all donors for specific sexual risk behaviors to be a more equitable approach that maintains the safety of the blood supply. Feasibility considerations with this change include ensuring donor understanding of additional sexual behavior questions and minimizing donor loss due to discomfort.
Qualitative one-on-one interviews were conducted with Canadian whole blood and plasma donors (N = 40). A thematic analysis was conducted to assess participants' understandings of the questions, examine their comfort/discomfort, and identify strategies to mitigate donor discomfort.
All participants understood what the sexual behavior questions were asking and thought the questions were appropriate. Themes related to comfort/discomfort include: their expectations of donor screening, social norms that they bring to donation, whether their answer felt like personal disclosure, knowing the reasons for the question, trusting confidentiality, confidence in knowing their sexual partner's behavior, and potential for the question to be discriminatory. Strategies to mitigate discomfort include: providing an explanation for the questions, forewarning donors of these questions, reducing ambiguity, and using a self-administered questionnaire.
While many blood operators and regulators view the move to sexual behavior-based screening for all donors as a significant paradigmatic shift, donors may not perceive additional sexual behavior questions as a significant change to their donation experience. Further research is needed to evaluate the effectiveness of strategies to mitigate donor discomfort.
血液中心的工作人员正在努力改进对男同性恋者、双性恋者和其他与男性发生性行为的男性（MSM）以及跨性别和非二进制的献血者的筛选和资格标准。许多人认为对所有献血者进行特定的性行为风险筛查是一种更公平的方法，既能保证血液供应的安全性，又能维护献血者的隐私。这一改变的可行性考虑因素包括确保献血者理解更多的性行为问题，并最大限度地减少因不适而导致的献血者流失。
对加拿大全血和血浆献血者（N=40）进行了一对一的定性访谈。采用主题分析法评估参与者对问题的理解、检查他们的舒适度/不舒适度，并确定减轻献血者不适的策略。
所有参与者都理解性行为问题的含义，并认为这些问题是合适的。与舒适度/不舒适度相关的主题包括：他们对献血者筛选的期望、他们带到献血中的社会规范、他们的回答是否感觉像个人披露、了解问题的原因、信任保密性、对了解性伴侣行为的信心，以及问题可能存在歧视的可能性。减轻不适的策略包括：解释问题、预先告知献血者这些问题、减少歧义以及使用自我管理的问卷。
虽然许多血液中心和监管机构认为将基于性行为的筛查扩大到所有献血者是一个重大的范式转变，但献血者可能不会将额外的性行为问题视为他们献血体验的重大变化。需要进一步研究以评估减轻献血者不适的策略的有效性。
