title: Does offering human immunodeficiency virus testing at the time of blood donation reduce transfusion transmission risk and increase disclosure counseling? Results of a randomized controlled trial, São Paulo, Brazil.
abstract: BACKGROUND
  In a randomized controlled trial (RCT) in a blood bank in São Paulo, we tested the hypotheses that offering client-centered human immunodeficiency virus (HIV) counseling and testing to blood donors would: 1) reduce the risk of HIV contamination in the blood supply by diverting higher-risk, test-seeking donors away from donation and 2) increase return for results and referrals to care.
  
  
  METHODS
  We randomly selected weeks between August 2012 and May 2013 when donors were offered HIV counseling and testing (n = 6298), leaving usual procedure weeks as control (n = 5569).
  
  
  RESULTS
  Few candidate donors chose HIV testing (n = 81, 1.3%). There was no significant difference in herpes simplex virus Type 2 (HSV-2) prevalence (a marker of sexual risk) among donors during intervention weeks compared to control (10.4% vs. 11.1%, p = 0.245). No donor choosing testing was HIV infected, and there was no difference in HSV-2 prevalence between testers and donors (9.9% vs. 10.4%, p = 0.887). Returning for positive results did not differ between testers and donors (three of three vs. 58 of 80, p = 0.386). A higher proportion of donors acknowledged that HIV testing was a strong motivation to donate during intervention weeks compared to control (2.6% vs. 2.0%, p = 0.032).
  
  
  CONCLUSIONS
  The evidence of our RCT is that offering HIV counseling and testing at the time of donation would not change the risk of contamination in the blood supply, nor improve results disclosure and referral to care.
authors: Blood Systems Research Institute, San Francisco, California.
authors: Thelma T
authors: TT
authors: Goncalez
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Paula F
authors: PF
authors: Blatyta
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Fernanda M
authors: FM
authors: Santos
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Sandra
authors: S
authors: Montebello
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Sandra P D
authors: SP
authors: Esposti
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Fatima N
authors: FN
authors: Hangai
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Nanci A
authors: NA
authors: Salles
authors: Fundação Pró-Sangue/Hemocentro De São Paulo, São Paulo, Brazil.
authors: Alfredo
authors: A
authors: Mendrone
authors: University of California at San Francisco, San Francisco, California.
authors: Hong-Ha M
authors: HM
authors: Truong
authors: University of São Paulo, São Paulo, Brazil.
authors: Ester C
authors: EC
authors: Sabino
authors: University of California at San Francisco, San Francisco, California.|San Francisco Department of Public Health, San Francisco, California.
authors: Willi
authors: W
authors: McFarland
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D015415:Biomarkers; D001782:Blood Donors / Q000523:psychology* / Q000706:statistics & numerical data; D058731:Blood Safety; D001938:Brazil / Q000453:epidemiology; D003376:Counseling; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D015528:HIV Seroprevalence; D007722:Health Knowledge, Attitudes, Practice; D006558:Herpes Genitalis / Q000097:blood / Q000453:epidemiology* / Q000635:transmission; D018258:Herpesvirus 2, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D012017:Referral and Consultation; D012309:Risk-Taking; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014342:Truth Disclosure
chemical_list: D015415:Biomarkers
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