An analysis of risk factors for human immunodeficiency virus infection among Chinese blood donors

Authors

  • Jingxing Wang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Jing Liu,

    Corresponding author
    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
    • Address reprint requests to: Jing Liu, PhD, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Baltimore, MD 21287; e-mail: jliu84@jhmi.edu.

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  • Yi Huang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Tonghan Yang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Fuzhu Yao,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Xiangdong Dong,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Guoxin Wen,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Xinhong Bi,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Mingjiang Zhao,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Xiuqiong Wen,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Mei Huang,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Yunlai Lü,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Hongli Ma,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Qilu Yu,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • David Wright,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Nan Guo,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Paul Ness,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • Hua Shan,

    1. Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P.R. China
    2. Johns Hopkins Medical Institutions, Baltimore, Maryland
    3. Kunming Blood Center, Kunming, Yunnan, P.R. China
    4. Urumqi Blood Center, Urumqi, Xinjiang, P.R. China
    5. Mianyang Blood Center, Mianyang, Sichuan, P.R.China
    6. Luoyang Blood Center, Luoyang, Henan, P.R. China
    7. Westat, Inc., Rockville, Maryland
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  • and for the National Heart, Lung, and Blood Institute (NHLBI) Retrovirus Epidemiology Donor Study-II (REDS-II), International Component


Abstract

Background

Information regarding the risk factors for human immunodeficiency virus (HIV) infection among Chinese donors is important for understanding the trend of HIV transmission routes and for developing effective donor behavioral screening policies.

Study Design and Methods

In 2009 to 2011, a total of 77 HIV-positive and 649 HIV-negative consented donors who screened nonreactive for hepatitis B virus, hepatitis C virus, syphilis, and alanine aminotransferase in four Retrovirus Epidemiology Donor Study-II Chinese regions received and completed a questionnaire by mail regarding their recent and past medical procedures, drug use, and sexual behaviors, etc. Exploratory and confirmatory factor analyses grouped questions into three risk factors. Multivariable logistic regression analysis examined the relationship between risk factors and HIV status adjusting for center, age, sex, and education.

Results

The three risk factors were test-seeking tendency, medical-related risks, and behavioral risks. In multivariable logistic regression analysis, greater test-seeking tendency and behavioral risks were associated with HIV infection, with the adjusted odds ratios (ORs) being 2.2 (95% confidence interval [CI], 1.2-4.1) and 3.8 (95% CI, 1.8-7.9), respectively, but medical risks were not (OR, 1.2; 95% CI, 0.6-2.2). In comparison to less high school education, high school and more education was associated with lower risks for HIV infection, with the ORs being 0.35 (95% CI, 0.17-0.70) and 0.17 (95% CI, 0.09-0.33), respectively.

Conclusions

Test-seeking tendency and high-risk sexual behaviors are important predictors of HIV infection in Chinese blood donors, suggesting that the health history inquiry used in donor selection process needs improvement to defer high-risk donors more effectively.

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