title: Undisclosed human immunodeficiency virus risk factors identified through a computer-based questionnaire program among blood donors in Brazil.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) risk factor screening among blood donors remains a cornerstone for the safety of blood supply and is dependent on prospective donor self-disclosure and an attentive predonation interview. Audio computer-assisted structured interview (ACASI) has been shown to increase self-reporting of risk behaviors.
  
  
  METHODS
  This cross-sectional study was conducted between January 2009 and March 2011 at four Brazilian blood centers to identify the population of HIV-negative eligible blood donors that answered face-to-face interviews without disclosing risks, but subsequently disclosed deferrable risk factors by ACASI. Compared to the donor interview, the ACASI contained expanded content on demographics, sexual behavior, and other HIV risk factors questions.
  
  
  RESULTS
  A total of 901 HIV-negative blood donors were interviewed. On the ACASI, 13% of donors (n = 120) declared a risk factor that would have resulted in deferral that was not disclosed during the face-to-face assessment. The main risk factors identified were recent unprotected sex with an unknown or irregular partner (49 donors), sex with a person with exposure to blood or fluids (26 donors), multiple sexual partners (19 donors), and male-male sexual behavior (10 donors). Independent factors associated with the disclosure of any risk factor for HIV were age (≥40 years vs. 18-25 years; adjusted odds ratio [AOR], 0.45; 95% confidence interval [CI], 0.23-0.88) and blood center (Hemope vs. Hemominas; AOR, 2.51; 95% CI, 1.42-4.44).
  
  
  CONCLUSIONS
  ACASI elicited increased disclosure of HIV risk factors among blood donors. ACASI may be a valuable modality of interview to be introduced in Brazilian blood banks.
authors.affiliation: Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, SP, Brazil; Blood Systems Research Institute, San Francisco, California; Westat, Rockville, Maryland; Fundação Hemorio, Rio de Janeiro, RJ, Brazil; Fundação Hemope, Recife, PE, Brazil; Fundação Hemominas, Belo Horizonte, MG, Brazil; Department of Infectious Diseases, Medical School, University of São Paulo, São Paulo, SP, Brazil; University of California at San Francisco, San Francisco, California.
authors.forename: Paula Fraiman
authors.initials: PF
authors.lastname: Blatyta
authors.forename: Brian
authors.initials: B
authors.lastname: Custer
authors.forename: Thelma Terezinha
authors.initials: TT
authors.lastname: Gonçalez
authors.forename: Rebecca
authors.initials: R
authors.lastname: Birch
authors.forename: Maria Esther
authors.initials: ME
authors.lastname: Lopes
authors.forename: Maria Ines
authors.initials: MI
authors.lastname: Lopes Ferreira
authors.forename: Anna Barbara
authors.initials: AB
authors.lastname: Carneiro Proietti
authors.forename: Ester Cerdeira
authors.initials: EC
authors.lastname: Sabino
authors.forename: Kimberly
authors.initials: K
authors.lastname: Page
authors.forename: Cesar
authors.initials: C
authors.lastname: de Almeida-Neto
mesh_terms: D000293:Adolescent; D000328:Adult; D001782:Blood Donors; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000209:etiology*; D006801:Humans; D008297:Male; D012307:Risk Factors; D011795:Surveys and Questionnaires