HPTN Bibliographic Record
McFarland W, Mvere D, Shamu R, Katzenstein D. Risk factors for HIV infection among first-time blood donors in Zimbabwe. Transfusion. 1998, 38: 279-84.
BACKGROUND: Factors associated with an increased likelihood of HIV infection among newly recruited blood donors in Zimbabwe are identified. Their feasibility as criteria for exclusion from donation is assessed. STUDY DESIGN AND METHODS: A self-administered survey including demographic and behavioral questions was completed by 1199 first-time, volunteer blood donors in Harare, Zimbabwe. Methods for subject recruitment and laboratory screening followed usual blood bank protocols. RESULTS: Fifteen percent of subjects were HIV positive. Factors significantly associated with HIV seropositivity at the p<0.05 level included recruitment venue, age, marital status, donor residence, residence of primary partner, occupation, history of sexually transmitted disease, and condom use. An exclusion strategy based on donor age, condom use, recruitment venue, sexually transmitted disease history, and residence of primary partner would exclude a large proportion of HIV-infected donors without substantial loss of uninfected donors. CONCLUSIONS: Exclusion of donors who are likely to be infected with HIV is a sound policy for improving blood safety and reducing operating costs worldwide. Identification of efficient donor selection criteria requires knowledge of the local epidemiology of HIV infection and the asking of questions that are likely to be answered accurately. PIP: Sub-Saharan Africa is the region of the world which is most severely affected by HIV infection and the AIDS pandemic. The region also has a disproportionately high level of transfusion-associated HIV transmission due to the high prevalence and incidence of HIV infection in the general population and the paucity of resources with which to fully implement effective prevention measures. Since 1985, Zimbabwe's National Blood Transfusion Service (NBTS) has screened all donated blood for HIV antibodies. First-time adult donors have the highest prevalence of HIV infection of all donor groups, with 10% of such donors in 1993 and 1994 being infected. New adult donors accounted for more than 50% of all HIV-positive donations even though they provided only 10% of donations overall. A self-administered survey including demographic and behavioral questions was completed by 1199 adult, first-time, volunteer blood donors in Harare, Zimbabwe, in an attempt to identify risk factors for HIV infection which could serve as feasible criteria for excluding high-risk first-time blood donors in the country. 15% of study participants were HIV-positive. The following factors were significantly associated with HIV seropositivity: recruitment venue, age, marital status, donor residence, residence of primary partner, occupation, history of STD, and condom use. An exclusion strategy based upon donor age, condom use, recruitment venue, STD history, and primary partner's residence would exclude a large proportion of HIV-infected donors without substantial loss of uninfected donors.