Donation Policy & Studies, Canadian Blood Services, K1G 4J5 Ottawa, ON, Canada.
Donation Policy & Studies, Canadian Blood Services, K1G 4J5 Ottawa, ON, Canada; Department of Pathology and Laboratory Medicine, University of Ottawa, K1H 8M5 Ottawa, Ontario, Canada.
Transfus Clin Biol. 2022 Aug;29(3):198-204. doi: 10.1016/j.tracli.2022.06.001.
Gay, bisexual and other men who have sex with men (gbMSM) were ineligible to donate blood in most countries since the 1980's. In Canada the deferral period has been incrementally decreased from lifetime to male-to-male sex in the last 3 months. Now a few countries have removed the deferral altogether. Risk models have been utilised to estimate the probability of an HIV positive donation being released into the blood supply and to inform incremental changes to the length of the deferral period. Here we use public health data to estimate the risk of HIV if the gbMSM deferral criteria were removed in Canada.
We calculate the risk reduction among heterosexuals based on responses to standard risk questions routinely asked of donors. We assume gbMSM will donate at the same rate as heterosexual males. We apply the same risk reduction principle to HIV incidence and prevalence among gbMSM in the general population to evaluate the HIV risk without gbMSM time deferral. We model three scenarios where risk reduction is varied by assumptions about incidence and compliance with deferral criteria.
The estimates for all scenarios were not significantly different to the currently observed scenario which predicts a residual risk of 0.02 HIV positive per million donations (95% CI: 0.000006-0.09).
The models predict that removing the gbMSM deferral criteria would result in HIV residual risk similar to currently observed.
自 20 世纪 80 年代以来，男同性恋、双性恋和其他与男性发生性关系的男性（男男性行为者）在大多数国家都没有资格献血。在加拿大，在过去的 3 个月中，从终身到男男性行为的延迟期已逐渐缩短。现在，一些国家已经完全取消了这种延迟。风险模型被用于估计 HIV 阳性献血进入血液供应的概率，并为逐步缩短延迟期提供信息。在这里，我们利用公共卫生数据来估计如果加拿大取消男男性行为者的献血延迟规定，HIV 的风险。
我们根据对献血者常规询问的标准风险问题的回答，计算异性恋者的风险降低率。我们假设男男性行为者将以与异性恋男性相同的速度献血。我们将同样的风险降低原则应用于一般人群中男男性行为者的 HIV 发病率和流行率，以评估没有男男性行为者时间延迟的 HIV 风险。我们对三种情景进行建模，其中风险降低率因对发病率和对延迟标准的遵守的假设而有所不同。
所有情景的估计值与目前观察到的情景没有显著差异，该情景预测每百万次献血中有 0.02 例 HIV 阳性的剩余风险（95%CI：0.000006-0.09）。
这些模型预测，取消男男性行为者的献血延迟规定将导致与目前观察到的相似的 HIV 剩余风险。
