title: The impact of simple donor education on donor behavioral deferral and infectious disease rates in São Paulo, Brazil.
abstract: Studies have shown that human immunodeficiency virus (HIV) residual risk is higher in Brazilian than in US and European blood donors, probably due to failure to defer at-risk individuals in Brazil. This study assessed the impact of an educational brochure in enhancing blood donors' knowledge about screening test window phase and reducing at-risk individuals from donating.
  
  
  
  This trial compared an educational intervention with a blood center's usual practice. The brochure was distributed in alternating months to all donors. After donating, sampled participants completed two questions about their HIV window period knowledge. The impact on HIV risk deferral, leaving without donation, confidential unit exclusion (CUE) use, and test positivity was also analyzed.
  
  
  
  From August to November 2007 we evaluated 33,940 donations in the main collection center of Fundação Pró-Sangue/Hemocentro de São Paulo in São Paulo, Brazil. A significant (p < 0.001) pamphlet effect was found on correct responses to both questions assessing HIV window phase knowledge (68.1% vs. 52.9%) and transfusion risk (91.1% vs. 87.2%). After adjusting for sex and age, the pamphlet effect was strongest for people with more than 8 years of education. There was no significant pamphlet effect on HIV risk deferral rate, leaving without donation, use of CUE, or infectious disease rates.
  
  
  
  While the educational pamphlet increased window period knowledge, contrary to expectations this information alone was not enough to make donors self-defer or acknowledge their behavioral risk.
authors.affiliation: Blood Systems Research Institute, 270, Masonic Avenue, San Francisco, CA 94118, USA. tgoncalez@bloodsystems.org
authors.forename: Thelma T
authors.initials: TT
authors.lastname: Gonçalez
authors.forename: Ester C
authors.initials: EC
authors.lastname: Sabino
authors.forename: Nanci Alves
authors.initials: NA
authors.lastname: Salles
authors.forename: Cesar
authors.initials: C
authors.lastname: de Almeida-Neto
authors.forename: Alfredo
authors.initials: A
authors.lastname: Mendrone
authors.forename: Pedro E
authors.initials: PE
authors.lastname: Dorlhiac-Laccer
authors.forename: Jing
authors.initials: J
authors.lastname: Liu
authors.forename: Edward L
authors.initials: EL
authors.lastname: Murphy
authors.forename: George B
authors.initials: GB
authors.lastname: Schreiber
mesh_terms: D000328:Adult; D000368:Aged; D001771:Blood Banks / Q000592:standards; D001782:Blood Donors / Q000193:education*; D001938:Brazil / Q000453:epidemiology; D003141:Communicable Diseases / Q000453:epidemiology*; D003219:Confidentiality; D018562:Disease Transmission, Infectious / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D018570:Risk Assessment; D012308:Risk Management / Q000379:methods; D065227:Transfusion Reaction; D014505:Urban Population / Q000706:statistics & numerical data