Understanding noncompliance with selective donor deferral criteria for high-risk behaviors in Australian blood donors.
BACKGROUND
Using a predonation screening questionnaire, potential blood donors are screened for medical or behavioral factors associated with an increased risk for transfusion-transmissible infection. After disclosure of these risks, potential donors are deferred from donating. Understanding the degree of failure to disclose full and truthful information (termed noncompliance) is important to determine and minimize residual risk. This study estimates the prevalence of, and likely reasons for, noncompliance among Australian donors with the deferrals for injecting drug use, sex with an injecting drug user, male-to-male sex, sex worker activity or contact, and sex with a partner from a high-HIV-prevalence country.


METHODS
An anonymous, online survey of a nationally representative sample of Australian blood donors was conducted. Prevalence of noncompliance with deferrable risk categories was estimated. Factors associated with noncompliance were determined using unadjusted and adjusted odds ratios.


RESULTS
Of 98,044 invited donors, 30,790 donors completed the survey. The estimated prevalence of overall noncompliance (i.e., to at least one screening question) was 1.65% (95% confidence interval CI, 1.51%-1.8%). Noncompliance with individual deferrals ranged from 0.05% (sex work) to 0.54% (sex with an injecting drug user). The prevalences of the disclosed exclusionary risk behaviors were three to 14 times lower than their estimated prevalence in the general population.


CONCLUSIONS
The prevalence of noncompliance is relatively low but our estimate is likely to be a lower bound. The selected high-risk behaviors were substantially less common in blood donors compared to the general population suggesting that self-deferral is effective. Nevertheless, a focus on further minimization should improve the blood safety.
The Kirby Institute, The University of New South Wales, Sydney, New South Wales, Australia.
Tarana T A
TT
Lucky
Clive R
CR
Seed
Daniel
D
Waller
June F
JF
Lee
Ann
A
McDonald
Handan
H
Wand
Stephen
S
Wroth
Glen
G
Shuttleworth
Anthony J
AJ
Keller
Joanne
J
Pink
David P
DP
Wilson
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001782:Blood Donors / Q000523:psychology / Q000706:statistics & numerical data; D046148:Donor Selection; D055030:Drug Users / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012309:Risk-Taking; D060386:Sex Workers / Q000523:psychology / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D055815:Young Adult