Sriamporn Koson Tony, Consedine Nathan S, Saxton Peter J W
Department of Social and Community Health, School of Population Health, University of Auckland, Auckland, New Zealand.
Department of Psychological Medicine, School of Medicine, University of Auckland, Auckland, New Zealand.
Transfusion. 2025 Sep;65(9):1586-1591. doi: 10.1111/trf.18352. Epub 2025 Jul 21.
Blood service providers use deferral policies to reduce the risk of transfusion-transmitted infections, but policy effectiveness depends on donors' honesty in disclosing risk behaviors. Identifying specific social factors within men who have sex with men (MSM) may provide insight into noncompliance with sexual behavioral deferral criteria.
We identified a sample of 136 recent blood donors from a large behavioral surveillance survey of MSM in New Zealand. Univariate analyses were used to identify factors associated with self-reported noncompliance before a two-step hierarchical regression assessed whether MSM-related social factors added to the prediction of noncompliance, compared to only considering background characteristics.
Incorporating the MSM-related social factors significantly enhanced the model fit, explaining 23.2% additional variance in noncompliance (Nagelkerke R = 0.331, p = .002). Only MSM who were more open about their sexuality had increased odds of noncompliance (Odds ratio 5.25, 95% Confidence Interval 1.78-15.48, p = .003). Full-time employment remained a predictor of lower noncompliance in the final model (OR 0.19, 95% CI 0.05-0.69, p = .012).
This exploratory evidence suggests that blood service providers should consider the broader social context, particularly openness about sexuality, in understanding noncompliance with time-based sexual behavior donor deferral criteria. This "outness" in MSM donors likely reflects confidence in making disclosure decisions based on their perceived HIV risk, challenging the notion that noncompliance necessarily arises from discomfort or lack of knowledge about policies. Future research should explore the gap between perceived risk and policy understanding to better address MSM donors' complex decision-making processes.
血液服务机构采用延期献血政策以降低输血传播感染的风险，但政策的有效性取决于献血者在披露风险行为时的诚实度。识别男男性行为者（MSM）中的特定社会因素可能有助于深入了解其不遵守性行为延期标准的情况。
我们从新西兰一项针对MSM的大型行为监测调查中确定了136名近期献血者作为样本。在进行两步分层回归之前，使用单变量分析来识别与自我报告的不遵守行为相关的因素，该回归评估了与仅考虑背景特征相比，与MSM相关的社会因素是否增加了对不遵守行为的预测。
纳入与MSM相关的社会因素显著提高了模型拟合度，解释了不遵守行为中另外23.2%的方差（Nagelkerke R = 0.331，p = 0.002）。只有那些对自己的性取向更为开放的MSM不遵守行为的几率增加（优势比5.25，95%置信区间1.78 - 15.48，p = 0.003）。在最终模型中，全职工作仍然是不遵守行为较低的一个预测因素（优势比0.19，95%置信区间0.05 - 0.69，p = 0.012）。
这一探索性证据表明，血液服务机构在理解不遵守基于时间的性行为献血者延期标准的情况时，应考虑更广泛的社会背景，特别是性取向的开放性。MSM献血者的这种“出柜”可能反映了他们基于自身感知的HIV风险做出披露决定的信心，这对不遵守行为必然源于对政策的不适或缺乏了解这一观念提出了挑战。未来的研究应探索感知风险与政策理解之间的差距，以更好地应对MSM献血者复杂的决策过程。
