Medical Affairs and Innovation, Canadian Blood Services, Ottawa, Ontario, Canada.
Department of Pathology & Laboratory Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Transfusion. 2024 Jul;64(7):1254-1261. doi: 10.1111/trf.17878. Epub 2024 May 17.
The two Canadian blood suppliers, Canadian Blood Services and Héma-Québec, removed the time-based deferral for men who have sex with men and adopted criteria assessing sexual risk behaviors. We report the impact of these changes on the safety and adequacy of the Canadian blood supply.
Since 2022, all donors are asked if (1) they have had a new partner and (2) more than one sexual partner in the last 3 months. Donors answering yes to either question are asked if they had anal sex in the last 3 months; if yes, they are deferred for 3 months. We followed HIV rates for the 18 months before and 14 (Héma-Québec) or 18 months (Canadian Blood Services) post-implementation and interviewed HIV-positive whole blood donors. We assessed the number and characteristics of whole blood donors answering yes to the two first questions with or without deferral.
There were four HIV-positive donations out of 1,492,355 donations pre-implementation and four out of 1,447,772 post-implementation (0.27/100,000 vs. 0.28/100,000, p = 1.00). Post-implementation, one HIV-positive donor was non-compliant with multiple criteria, no risk factors were identified in the others. 3.2% of donors answered yes to questions (1) and/or (2); 0.17% were deferred for a new partner and/or more than one partner and anal sex. Deferral rates were highest in first time, younger donors, and similar in males and females.
Implementation of sexual risk behavior donor screening resulted in unchanged HIV rates to date and a manageable deferral rate.
加拿大的两家血液供应商，加拿大血液服务中心和魁北克血液服务中心，取消了对男男性行为者的基于时间的延迟，并采用了评估性行为风险的标准。我们报告了这些变化对加拿大血液供应的安全性和充足性的影响。
自 2022 年以来，所有献血者都被问到（1）他们是否有新伴侣，以及（2）在过去 3 个月内是否有多于一个性伴侣。对任何一个问题回答“是”的献血者，都会被问到他们是否在过去 3 个月内有过肛交；如果是，他们将被延迟 3 个月。我们跟踪了实施前 18 个月和实施后 14 个月（魁北克血液服务中心）或 18 个月（加拿大血液服务中心）的 HIV 感染率，并采访了 HIV 阳性的全血献血者。我们评估了在不延迟和延迟的情况下，对前两个问题回答“是”的全血献血者的数量和特征。
在实施前，有 4 份 HIV 阳性的血液样本来自于 1492355 份捐赠，而在实施后，有 4 份 HIV 阳性的血液样本来自于 1447772 份捐赠（0.27/100000 对 0.28/100000，p=1.00）。在实施后，有 1 份 HIV 阳性的血液样本来自于一个不符合多项标准的献血者，而其他献血者则没有发现风险因素。有 3.2%的献血者对问题（1）和/或（2）回答“是”；有 0.17%的献血者因为新伴侣和/或多个伴侣和肛交而被延迟。延迟率在初次献血、年轻的献血者中最高，在男性和女性中相似。
实施性行为风险献血者筛查导致 HIV 感染率迄今保持不变，并且延迟率可以控制。
