Profile of blood donors with serologic tests reactive for the presence of syphilis in São Paulo, Brazil.
BACKGROUND
Syphilis screening of blood donors is a common practice worldwide, but very little is known about the meaning of a positive serologic test for syphilis in blood donors and the risk profile of these donors. The aim of this study was to determine the demographic characteristics and risk behaviors of blood donors with recent and past syphilis and their implications for blood bank testing and deferral strategies.


METHODS
Demographic characteristics, category of donation, number of previous donations, sexual behavior, and history of sexually transmitted diseases were reviewed comparing blood donors with recent and past syphilis from January 1, 1999, to December 31, 2003.


RESULTS
A total of 2439 interviews were reviewed, including 2161 (88.6%) donors with past and 278 (11.4%) with recent syphilis infection. Factors associated with recent infection included younger age (< or = 20 years odds ratio [OR], 36.5; 95% confidence interval [CI], 15.8-84.1), two previous donations (OR, 2.7; 95% CI, 1.9-3.9), male-male sex (homosexual OR, 8.2; 95% CI, 3.2-20.8; and bisexual OR, 11.4; 95% CI, 3.6-36.3), two or more partners in the past 12 months (OR, 2.3; 95% CI, 1.3-4.0), symptoms for syphilis (OR, 4.5; 95% CI, 2.8-7.1), and human immunodeficiency virus (HIV) seropositivity (OR, 39.6; 95% CI, 4.6-339.8). Community donors were also associated with recent syphilis infection (OR, 1.5; 95% CI, 1.2-1.9) compared to replacement donors.


CONCLUSIONS
Sexual history, including male-male sex and multiple partners, were strongly associated with recent syphilis infection, which in turn was strongly associated with HIV. Continuous and vigilant surveillance that includes assessing sexual history and other factors associated with syphilis are needed to guide blood safety policies.
de Almeida Neto
Cesar
C
Fundação Pró-Sangue-Hemocentro de São Paulo, SP, Brazil. cesarnt@uol.com.br
Murphy
Edward L
EL
McFarland
William
W
Junior
Alfredo Mendrone
AM
Chen
Sanny
S
Chamone
Dalton A F
DA
Sabino
Ester C
EC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001782:Blood Donors / Q000706:statistics & numerical data*; D001938:Brazil / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology*; D003625:Data Collection; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D015231:Sexually Transmitted Diseases, Bacterial / Q000097:blood*; D013587:Syphilis / Q000453:epidemiology*; D013588:Syphilis Serodiagnosis / Q000379:methods*; D055815:Young Adult