Abstract 3342

Background:

As part of Canadian Blood Services policy (CBS), men who have sex with men (MSM) are indefinitely deferred from donating blood due to an increased risk for HIV infection. This policy has generated controversy, especially amongst student populations, due its perceived discrimination against homosexual men.

Objectives:

1) To determine the acceptability of a behaviour-based donor health questionnaire amongst Canadian university students and assess its suitability as an alternative to the current MSM policy. 2) To determine the perception of blood safety associated with specific risk behaviours.

Methods:

We conducted a survey amongst students at the University of Western Ontario in London, Ontario, Canada. A questionnaire was designed that included questions found on the current CBS donor health survey, and behaviour-based questions derived from studies assessing high risk factors for HIV. For each question, participants were asked to rate its acceptability and its perceived effect on blood safety using 7-point Likert scales. They were also asked whether the question would deter them from future donations. Data was analyzed using non-parametric tests.

Results:

741/3500 (21.2%) students participated in the study. Students rated both current and behavioural questions as equally acceptable and the majority (89-97%) would not be deterred from donating blood in the future by any question. The response scores for both sets of questions were significantly correlated. Questions on donor's sexual practices were rated less acceptable compared to those on high risk behaviours. Sexually transmitted infections, injection drug use and sex for money were considered high risk behaviours for blood safety (69-95% unsafe). In contrast, sexual practices (MSM, anal intercourse, condom use, knowledge of partner's sexual background) were rated less important for blood safety (30 to 62% unsafe). We found an inverse correlation between the perception of safety and the acceptability of questions (Table). 24.4% of students rated both questions on MSM status and a behaviour-based alternative as equally unacceptable.

Table.

Influence of the perception of the effect of risk practices on blood safety and the acceptability of questions.

QuestionaAssociation testMedian score for acceptability (Interquartile range)
Spearman's ρPPerception of blood safety associated with the risk practicebP
“Unsafe”“Safe”
1. At any time since 1977, have you taken money or drugs for sex? −0.472 <0.001 6 (4–7) 4 (2–6) <0.001 
2. Female donors: In the last 12 months, have you had sex with a man who had sex, even one time since 1977 with another man? OR Male donors: Have you had sex with a man, even one time since 1977? −0.431 <0.001 6 (5–7) 3 (2–6) <0.00 
3. Do you have AIDS or have you ever tested positive for HIV/AIDS? −0.355 <0.001 7 (7–7) 7 (6–7) 0.001 
4. Have you ever taken illegal drugs or illegal steroids with a needle even one time? −0.365 <0.001 7 (6–7) 6 (6–7) 0.015 
5. In the past 6 months, have you had sex with someone whose sexual background you don't know? −0.414 <0.001 6 (6–7) 6 (4–7) <0.001 
6. At any time in the past 10 years, have you ever given or received money or drugs to have sexual intercourse? −0.474 <0.001 6 (5–7) 5 (3–6) <0.001 
7. Was a condom used the last time you had sexual intercourse? 0.076 0.040 6 (5–7) 6 (5–7) 0.445 
8. Have you at any time had 2 or more sexual partners in a short period of time in the past 10 years? −0.248 <0.001 6 (5–7) 5 (3–6) <0.001 
9. Have you had anal sex with any of your sexual partners during the last 10 years? −0.383 <0.001 6 (5–7) 4 (2–6) <0.001 
10. Have you ever had a sexually transmitted disease such as Gonorrhoea, Syphilis, Chlamydia, genital warts or genital herpes? −0.303 <0.001 7 (6–7) 6 (4–7) <0.001 
11. Have you or any of your sexual partners in the past 10 years ever injected street drugs, steroids or vitamins with a needle? −0.479 <0.001 6 (6–7) 6 (5–7) <0.001 
12. In the past 10 years, have you had a first sexual encounter with any of your sexual partners immediately after meeting them? −0.313 <0.001 6 (5–7) 3 (2–6) <0.001 
QuestionaAssociation testMedian score for acceptability (Interquartile range)
Spearman's ρPPerception of blood safety associated with the risk practicebP
“Unsafe”“Safe”
1. At any time since 1977, have you taken money or drugs for sex? −0.472 <0.001 6 (4–7) 4 (2–6) <0.001 
2. Female donors: In the last 12 months, have you had sex with a man who had sex, even one time since 1977 with another man? OR Male donors: Have you had sex with a man, even one time since 1977? −0.431 <0.001 6 (5–7) 3 (2–6) <0.00 
3. Do you have AIDS or have you ever tested positive for HIV/AIDS? −0.355 <0.001 7 (7–7) 7 (6–7) 0.001 
4. Have you ever taken illegal drugs or illegal steroids with a needle even one time? −0.365 <0.001 7 (6–7) 6 (6–7) 0.015 
5. In the past 6 months, have you had sex with someone whose sexual background you don't know? −0.414 <0.001 6 (6–7) 6 (4–7) <0.001 
6. At any time in the past 10 years, have you ever given or received money or drugs to have sexual intercourse? −0.474 <0.001 6 (5–7) 5 (3–6) <0.001 
7. Was a condom used the last time you had sexual intercourse? 0.076 0.040 6 (5–7) 6 (5–7) 0.445 
8. Have you at any time had 2 or more sexual partners in a short period of time in the past 10 years? −0.248 <0.001 6 (5–7) 5 (3–6) <0.001 
9. Have you had anal sex with any of your sexual partners during the last 10 years? −0.383 <0.001 6 (5–7) 4 (2–6) <0.001 
10. Have you ever had a sexually transmitted disease such as Gonorrhoea, Syphilis, Chlamydia, genital warts or genital herpes? −0.303 <0.001 7 (6–7) 6 (4–7) <0.001 
11. Have you or any of your sexual partners in the past 10 years ever injected street drugs, steroids or vitamins with a needle? −0.479 <0.001 6 (6–7) 6 (5–7) <0.001 
12. In the past 10 years, have you had a first sexual encounter with any of your sexual partners immediately after meeting them? −0.313 <0.001 6 (5–7) 3 (2–6) <0.001 
a

Questions 1 – 5 are the current CBS questions. Questions 6 – 12 are the behavioural-based questions.

b

Unsafe: Likert score 1–3; Safe: Likert score 5–7.

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Discussion:

A behaviour-based screening modification is unlikely to change opinions or satisfy those who object the current MSM policy. Acceptability of these questions might be related to a poor understanding of the effect of sexual practices on blood supply safety.

Disclosures:

No relevant conflicts of interest to declare.

Topics:
acquired immunodeficiency syndrome, blood donors, college students, genital herpes, genital warts, gonococcal infection, hiv infections, illicit drugs, likert scale, needles

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2010 by The American Society of Hematology
2010
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