title: Non-compliance to infectious disease deferral criteria among Hong Kong's blood donors.
abstract: OBJECTIVE
  Donor screening alone cannot eliminate the risk of transfusion-transmitted HIV infection. Donor deferral according to established criteria is a supplemental strategy, which has focused largely on men who have sex with men (MSM). A study was conducted to determine the compliance of non-MSM donors with such criteria and examine its implications on blood safety.
  
  
  METHODS
  Chinese donors who have just donated blood at blood donor centres in Hong Kong were recruited. Based on the contents of the routinely administered predonation Health Screening Questionnaires, participants were requested to complete a survey to assess their practice of deferrable risk behaviours and lifestyle encounters, using tablet computers.
  
  
  RESULTS
  Over an 8-week period in mid-2016, 1614 donors (male-to-female ratio 1·23) had enrolled in the survey, accounting for 40% of donors giving blood on the survey days. The proportion of respondents who gave blood despite having deferrable HIV risk was 5%: MSM 1·2% (of the male donors); non-MSM risk behaviours 2·6%; risky lifestyle encounters 2·1%. If inconsistent declaration and suspected risk behaviours were included, the total non-compliance rate became 10·8%. Male donors had a higher prevalence of deferrable behavioural risk, even after excluding MSM. Unawareness and non-acceptability were main reasons for non-compliance.
  
  
  CONCLUSIONS
  The non-compliance rate of donors to deferral was high, although the ultimate infection risk might be small in the presence of universal screening. Simplification of questionnaires, focus on time-limited deferral and a reduction of deferral items may improve the deferral mechanism without compromising blood safety.
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: S S
authors.identifier: http://orcid.org/0000-0003-1448-765X
authors.initials: SS
authors.lastname: Lee
authors.affiliation: Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Shatin, Hong Kong.
authors.forename: E K H
authors.initials: EKH
authors.lastname: Cheung
authors.affiliation: Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong.
authors.forename: J N S
authors.initials: JNS
authors.lastname: Leung
authors.affiliation: Hong Kong Red Cross Blood Transfusion Service, Kowloon, Hong Kong.
authors.forename: C K
authors.initials: CK
authors.lastname: Lee
mesh_terms: D000328:Adult; D001782:Blood Donors; D058731:Blood Safety; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control*; D018451:Homosexuality, Male; D006723:Hong Kong; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012309:Risk-Taking; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: blood donation; blood safety; donor deferral; men who have sex with men; risk behaviours