The authors acknowledge funding jointly from the Australian Red Cross Blood Service and the Kirby Institute. The Australian Red Cross Blood Service is fully funded by the Australian Government for the provision of blood products and services to the Australian community. The Kirby Institute is funded by the Australian Government Department of Health and Ageing and is affiliated with the Faculty of Medicine at the University of New South Wales.
BLOOD DONORS AND BLOOD COLLECTION
Understanding noncompliance with selective donor deferral criteria for high-risk behaviors in Australian blood donors
Version of Record online: 10 APR 2014
© 2014 AABB
Volume 54, Issue 7, pages 1739–1749, July 2014
How to Cite
Lucky, T. T.A., Seed, C. R., Waller, D., Lee, J. F., McDonald, A., Wand, H., Wroth, S., Shuttleworth, G., Keller, A. J., Pink, J. and Wilson, D. P. (2014), Understanding noncompliance with selective donor deferral criteria for high-risk behaviors in Australian blood donors. Transfusion, 54: 1739–1749. doi: 10.1111/trf.12554
- Issue online: 14 JUL 2014
- Version of Record online: 10 APR 2014
- Manuscript Revised: 27 NOV 2013
- Manuscript Accepted: 27 NOV 2013
- Manuscript Received: 27 SEP 2013
- Australian Red Cross Blood Service
- Kirby Institute
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.
Study Design and 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.
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.
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.