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Tiberghien P, Lecam S, Huet J, Malard L, Tavenard T, Pillonel J, Sauvage C, Bocquet T, Bliem C, Morel P, Richard P, Laperche S. Evolving deferral criteria for blood donation in France: Plasma donation by men who have sex with men. Vox Sang 2023; 118:440-446. [PMID: 37183555 DOI: 10.1111/vox.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND AND OBJECTIVES Since the advent of AIDS, men who have sex with men (MSM) have often been deferred from blood donation. In France, quarantine plasma donation by MSM donors with the same deferral rules as for other donors was introduced in July 2016 and continued up to March 2022. At this time, MSM-specific deferral criteria were lifted for all blood or plasma donation. The donor deferral, as well as rate of infectious markers in plasma donors who would have been otherwise deferred for MSM activity, was evaluated and compared with those of the other donors during the same time period from June 2016 to March 2022. RESULTS A total of 8843 MSM donors made 12,250 plasma donation applications. The overall deferral rate was very high (75.2%), mainly due to the absence of apheresis capacity at the donation site. The deferral criteria for sexual risk were present in 12.1% of MSM donors compared with 1.0% in other plasma and blood donors (p < 0.001). Overall, 994 MSM donors made 2880 plasma donations. Of these, one donation was HIV positive (34.7 vs. 0.6/105 donations by other donors, relative risk [RR]: 61.0 [95% confidence interval [CI]: 8.5-437.7]), one was HBV positive (34.7 vs. 4.5/105 , RR: 7.7 [95% CI: 1.1-54.6]) and none were HCV positive (0 vs. 2.4/105 ). Additionally, 21 donations were syphilis positive (729.2 vs. 10.7/105 , RR: 67.9 [95% CI: 44.2-104.4]). A post hoc analysis of eligible MSM donors who were unable to donate plasma due to logistic constraints yielded similar findings. CONCLUSION Plasma donation by donors who would have been otherwise deferred for MSM activity was associated with both an increased deferral rate for sexual risk and an increased rate of infectious markers, notably syphilis.
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Affiliation(s)
- Pierre Tiberghien
- Etablissement Français du Sang, La Plaine Saint-Denis, France
- UMR RIGHT 1098 Inserm, Université de Franche-Comté, Etablissement Français du Sang, Besançon, France
| | - Sophie Lecam
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Julie Huet
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Lucile Malard
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | | | | | | | - Thibaut Bocquet
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Cathy Bliem
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Pascal Morel
- Etablissement Français du Sang, La Plaine Saint-Denis, France
- UMR RIGHT 1098 Inserm, Université de Franche-Comté, Etablissement Français du Sang, Besançon, France
| | - Pascale Richard
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Syria Laperche
- Etablissement Français du Sang, La Plaine Saint-Denis, France
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Yost CC, Peedin AR. LGBTQ+ inclusivity in blood donation: Sexual behavior-based screening is the first step to getting it right. Transfusion 2023; 63:441-444. [PMID: 36810773 DOI: 10.1111/trf.17290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Colin C Yost
- Sidney Kimmel Medical College, Philadelphia, Pennsylvania, USA
| | - Alexis R Peedin
- Pathology, Anatomy, & Cell Biology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA
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Yost CC, Samuel R, Karp JK, Peedin AR. Advocacy in medicine: An LGTBQ+ Ally Blood Drive. MEDICAL EDUCATION 2022; 56:1145-1146. [PMID: 36040118 DOI: 10.1111/medu.14928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Perceptions and practices of the Brazilian LGBT+ population toward blood donation. Transfus Apher Sci 2022; 62:103578. [PMID: 36114122 DOI: 10.1016/j.transci.2022.103578] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 11/22/2022]
Abstract
In May 2020, after years of demands by activists and in light of COVID-19-related blood shortages, the Brazilian Federal Supreme Court abolished the rules that demanded a 12-month celibacy period for men who have sex with men (MSM) to donate blood. The objective of this open web survey was to assess the perceptions and practices regarding blood donation and blood donation rules among members of the Brazilian LGBT+ community. The data collection was conducted between October 2019 and March 2020, before the changes in the rules for blood donation and before the onset of the COVID-19 pandemic in Brazil. A total of 1639 adult individuals, self-declared as LGBT+ , participated (54.3 % MSM, 2.2 non-MSM, 43.5 % women). As expected, most of the study participants did not agree with the 12-month deferral period for MSM donate blood. Blood donation was already practiced by MSM, even before the abolition of the restrictions on donation. Among MSM and women, 38.7 % and 41.0 % have already donated blood, respectively. A significant number of participants reported lying in screening interviews at blood banks in order to be able to donate, and many said they knew people who were MSM and disobeyed the rules for donation, even though they knew them. Therefore, the practice of blood donation was already present among these people, even before the restriction policy change, confirming the need for revised rules for blood donation.
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Affiliation(s)
- Evan M Bloch
- Johns Hopkins University School of Medicine, Department of Pathology, Baltimore, MD, USA.
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Johns C, Simonson G, Hiwatig BM, Ross M. Actions and Attitudes of Men who have Sex with Men under Past, Current, and Hypothetical Future Blood Donation Deferral Policies. Transfus Med Rev 2022; 36:152-158. [DOI: 10.1016/j.tmrv.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 01/28/2023]
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Should individuals who have been cured of hepatitis C virus and their partners be allowed to donate blood? LANCET HAEMATOLOGY 2020; 8:e8-e10. [PMID: 33357486 DOI: 10.1016/s2352-3026(20)30402-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 10/19/2020] [Accepted: 11/25/2020] [Indexed: 11/20/2022]
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Park C, Gellman C, O'Brien M, Eidelberg A, Subudhi I, Gorodetsky EF, Asriel B, Furlow A, Mullen M, Nadkarni G, Somani S, Sigel K, Reich DL. Blood Donation and COVID-19: Reconsidering the 3-Month Deferral Policy for Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men. Am J Public Health 2020; 111:247-252. [PMID: 33211588 DOI: 10.2105/ajph.2020.305974] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In April 2020, in light of COVID-19-related blood shortages, the US Food and Drug Administration (FDA) reduced the deferral period for men who have sex with men (MSM) from its previous duration of 1 year to 3 months.Although originally born out of necessity, the decades-old restrictions on MSM donors have been mitigated by significant advancements in HIV screening, treatment, and public education. The severity of the ongoing COVID-19 pandemic-and the urgent need for safe blood products to respond to such crises-demands an immediate reconsideration of the 3-month deferral policy for MSM.We review historical HIV testing and transmission evidence, discuss the ethical ramifications of the current deferral period, and examine the issue of noncompliance with donor deferral rules. We also propose an eligibility screening format that involves an individual risk-based screening protocol and, unlike current FDA guidelines, does not effectively exclude donors on the basis of gender identity or sexual orientation. Our policy proposal would allow historically marginalized community members to participate with dignity in the blood donation process without compromising blood donation and transfusion safety outcomes.
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Affiliation(s)
- Christopher Park
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Caroline Gellman
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Madeline O'Brien
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Andrew Eidelberg
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Ipsita Subudhi
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Elizabeth F Gorodetsky
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Benjamin Asriel
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Andrew Furlow
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Michael Mullen
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Girish Nadkarni
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Sulaiman Somani
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - Keith Sigel
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
| | - David L Reich
- Christopher Park, Caroline Gellman, Madeline O'Brien, Benjamin Asriel, Andrew Furlow, Michael Mullen, Girish Nadkarni, Sulaiman Somani, Keith Sigel, and David L. Reich are with the Icahn School of Medicine at Mount Sinai, New York, NY. Andrew Eidelberg is with the Weill Cornell School of Medicine, New York, NY. Ipsita Subudhi and Elizabeth F. Gorodetsky are with the New York University Grossman School of Medicine, New York, NY
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Sugar A, Van Meter WS. Using Data to Rethink the Ban on Cornea Donation From Men Who Have Sex With Men. JAMA Ophthalmol 2020; 138:1150. [PMID: 32970094 DOI: 10.1001/jamaophthalmol.2020.3629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Alan Sugar
- Kellogg Eye Center, University of Michigan, Ann Arbor
| | - Woodford S Van Meter
- Department of Ophthalmology and Visual Science, University of Kentucky, Lexington
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Kelly-Hedrick M, Gross MS. HIV-, HBV-, and HCV-Related Information on U.S. Fertility Clinic Websites: A Content Analysis. Health Equity 2020; 4:345-352. [PMID: 32908955 PMCID: PMC7473042 DOI: 10.1089/heq.2019.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose: People living with human immunodeficiency virus, hepatitis B virus, or hepatitis C virus (PLHIV/HBV/HCV) face barriers to assisted reproductive technologies (ART), in part, due to laws and professional regulations mandating dedicated laboratory facilities and storage tanks for reproductive tissue to minimize theoretical risk of cross-contamination. These guidelines greatly increase the expense of providing equal care, however, fertility clinics are neither required to treat nor disclose whether they treat PLHIV/HBV/HCV. Clinics' websites are an important source of information regarding available services for prospective patients and referring providers. We assessed whether clinic websites disclose availability of ART for PLHIV/HBV/HCV. Methods: Websites for Society for Assisted Reproductive Technology-accredited clinics in Northeast and South Atlantic United States were searched systematically for HIV-, HBV-, or HCV-specific content. Qualitative and thematic analysis was performed. Clinic characteristics (annual volume, practice setting) were collected. Results: Of 136 websites, nine (6.6%) had information relevant to PLHIV seeking infertility treatment, and seven (5.1%) offered at least some treatments. Three clinics (2.2%) also mentioned treatment information relevant for PLHBV/HCV, one of which offered treatment. Information was often difficult to find or interpret. By contrast, 77/136 (56.6%) of clinics mentioned universally screening patients for HIV and 77/136 (56.6%) mentioned screening for HBV/HCV before ART. Conclusion: Given economic disincentives to providing ART to PLHIV/HBV/HCV under current guidelines, the paucity of clinics openly offering treatment suggests a troubling lack of transparency or, possibly, a lack of available care. Further research should examine the impact of current guidelines and whether dedicated facilities and storage are medically indicated.
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Affiliation(s)
- Margot Kelly-Hedrick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marielle S Gross
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
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Germain M. Men having sex with men and blood donation: is there a game changer on the horizon? Transfusion 2020; 60:437-440. [PMID: 32128837 DOI: 10.1111/trf.15706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Marc Germain
- Héma-Québec, Medical Affairs and Innovation Quebec City, Canada
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12
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Sauvage C, Charpentier F, Garrabé É, Pelat C, Spinardi R, Danic B, Lot F, Morel P, Laperche S, Pillonel J. Noncompliance to blood donor selection criteria by men who have sex with men - Complidon 2017, France. Vox Sang 2020; 115:628-636. [PMID: 32687631 DOI: 10.1111/vox.12975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES In France, blood donation deferral for men who have sex with men (MSM) was reduced from permanent to 12 months in July 2016. Assessing noncompliance (rate and reasons) with this criterion is important to maintain a high level of viral safety in blood products. MATERIALS AND METHODS An anonymous online survey (Complidon) of a sample of blood donors was conducted in 2017. Data were post-stratified to be representative of all those who donated blood between July 2016 and December 2017. A multivariable analysis was performed to assess factors associated with noncompliance. RESULTS Among male donors, 0·73% [95% CI: 0·63-0·83] reported having sex with men in the 12 months preceding their donation. Factors associated with noncompliance were as follows: young age, a low educational level, concerns about privacy, and better knowledge of donor selection criteria and the window period than compliant men. More than half of noncompliant MSM donors (57·6% [95% CI: 50·6-64·3]) felt that sexual orientation should not be a criterion for donation, 47·2% [95% CI: 40·4-54·0] did not disclose their male-to-male sexual relations in order to avoid being excluded from donating, 40·5% [95% CI: 34·0-47·4] reported using condoms and 21·8% [95% CI: 16·7-27·9] had the same male partner for at least 12 months. CONCLUSION Complidon showed that compliance with blood donation criteria in MSM was high, but not optimal, especially among younger men. HIV residual risk did not increase after the implementation of 12-month deferral. Data from Complidon helped French policymakers to assess the additional HIV risk posed by increased access to blood donation for MSM.
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Affiliation(s)
| | | | - Éliane Garrabé
- Centre de Transfusion Sanguine des Armées, Clamart, France
| | | | - Roxane Spinardi
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Bruno Danic
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | | | - Pascal Morel
- Etablissement Français du Sang, La Plaine Saint-Denis, France
| | - Syria Laperche
- Centre national de référence Risque infectieux transfusionnel, Institut National de la Transfusion Sanguine, Paris, France
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van Bilsen WPH, Zaaijer HL, Matser A, van den Hurk K, Slot E, Schim van der Loeff MF, Prins M, van de Laar TJW. Infection Pressure in Men Who Have Sex With Men and Their Suitability to Donate Blood. Clin Infect Dis 2020; 68:1001-1008. [PMID: 30052873 DOI: 10.1093/cid/ciy596] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood. METHODS We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19). RESULTS Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P < .001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P < .001). CONCLUSIONS IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.
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Affiliation(s)
- Ward P H van Bilsen
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
| | - Amy Matser
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands
| | - Katja van den Hurk
- Department of Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Ed Slot
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, The Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Research and Prevention, Public Health Service of Amsterdam, Amsterdam, The Netherlands.,Department of Internal Medicine, Amsterdam Infection and Immunity Institute, Academic Medical Center, Amsterdam, The Netherlands
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Negotiating risk-group categorization and the co-production of blood safety: the evolution of sociotechnical imaginaries mobilized in the public debate on the deferral of men who have sex with men as blood donors in Belgium. BIOSOCIETIES 2019. [DOI: 10.1057/s41292-019-00161-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Blood donation deferral policies among men who have sex with men in Brazil. Hematol Transfus Cell Ther 2018; 41:164-168. [PMID: 31084766 PMCID: PMC6517649 DOI: 10.1016/j.htct.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/28/2018] [Accepted: 09/12/2018] [Indexed: 11/22/2022] Open
Abstract
Reevaluation of the deferral from voluntary blood donation by men who have sex with men (MSM) is being discussed in several countries, motivated by the need to ensure a blood supply free from transfusion-transmissible infections (e.g., HIV, syphilis). Policies being considered include: permanent exclusion for any male-male sexual encounter, temporary deferral (3 months, 12 months, 5 years) from the last encounter, or specifying behaviors that differentiate MSM at high risk from those at low risk. Current Brazilian regulations defer MSM from blood donation for 12-months after the last male-male sexual encounter. Broad epidemiological evidence indicates that many MSM are at increased risk for HIV in the present era, and few data exist to distinguish which men are likely to be in the immunological window for detection of these infections. A multicenter study developed in Brazil demonstrated that the history of male-male sex was the most strongly associated with being an HIV-positive blood donor. Meanwhile, the blanket deferral of MSM from blood donation has generated considerable controversy. Rejection of the deferral policies stems in part from perspectives defending human rights, promoting equality and citizenship, and alleging bias and discrimination. The objective of this report is to discuss the current situation of blood donation among MSM in Brazil. We highlight the lack of evidence for a true risk profile for male-male sex in the context of blood donation upon which to base sound policy. We recommend research to establish effective and acceptable criteria for blood donation by MSM and other blood donors.
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Wentz AE, Merchant RC, Clark MA, Liu T, Rosenberger JG, Bauermeister JA, Mayer KH. Blood Donation, Sexual Practices, and Self-Perceived Risk for HIV in the United States Among Young Adult Men Who Have Sex With Men. Public Health Rep 2018; 134:36-46. [PMID: 30526313 PMCID: PMC6304728 DOI: 10.1177/0033354918815182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES In the United States, all men who have sex with men (MSM) were banned from donating blood from 1985 through 2015. In 2016, the guideline was amended such that men who had sexual contact with other men within the previous 12 months could not donate blood. We aimed to identify blood donation practices and their relationship with HIV risk and testing among young adult MSM (YMSM) at risk for having HIV. METHODS In 2014, we recruited HIV-negative non-Hispanic black, Hispanic, and non-Hispanic white YMSM aged 18-24 from across the United States through social media platforms to complete an online survey. Among these YMSM who previously donated blood, we conducted a secondary analysis examining the relationship between having donated blood within the past 12 months and sexual risk behavior from recent condomless anal intercourse (CAI), HIV testing, and self-perceived risk of having an undiagnosed HIV infection. RESULTS Of the 2261 YMSM surveyed, 1104 (48.8%) had ever previously donated blood and 305 (13.5%) had donated blood within the past 12 months. Of the 305 blood donors, 50 (16.4%) had ever had CAI before their most recent blood donation. Among YMSM who donated blood, past-12-month blood donation was more likely among YMSM who never had CAI (adjusted odds ratio [aOR] = 1.84; 95% confidence interval [CI], 1.24-2.73) than among YMSM who had CAI and more likely among YMSM who believed it was not possible at all that they had an undiagnosed HIV infection (aOR = 1.57; 95% CI, 1.14-2.16) than among YMSM who believed there was any possibility of having an undiagnosed HIV infection; it was not related to past-12-month HIV testing. CONCLUSIONS YMSM donated blood frequently, suggesting that the deferral process in place did not prevent YMSM from donating blood. The current donor screening process should be reconsidered if it is to prevent YMSM from donating blood. Future research could identify screening questions that permit YMSM with a low risk of HIV infection to donate blood while maintaining the safety of the blood supply.
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Affiliation(s)
- Anna E. Wentz
- Department of Epidemiology, School of Public Health, Brown University,
Providence, RI, USA
| | - Roland C. Merchant
- Department of Epidemiology, School of Public Health, Brown University,
Providence, RI, USA
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA,
USA
| | - Melissa A. Clark
- Department of Quantitative Health Sciences and Center for Health Policy and
Research, University of Massachusetts Medical School, Worcester, MA, USA
| | - Tao Liu
- Department of Biostatistics, Center for Statistical Sciences, School of
Public Health, Brown University, Providence, RI, USA
| | | | - José A. Bauermeister
- Department of Family and Community Health, School of Nursing, University of
Pennsylvania, Philadelphia, PA, USA
| | - Kenneth H. Mayer
- Fenway Health, Beth Israel Deaconess Medical Center, Harvard Medical School,
Boston, MA, USA
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17
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Blood’s ontologies-entangled: Qualitative inquiry into the enactment, representation, and organizational modes of coordination of blood’s multiplicity in a Belgian blood establishment. ORGANIZATION 2018. [DOI: 10.1177/1350508418808234] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Since British sociologist Titmuss authoritatively conceived blood donation as an altruistic ‘gift relationship’, blood establishments have adopted blood’s highly symbolic status as a core professional belief. However, important developments since the 1970s have resulted in blood’s bio-objectification, making blood a renewed object of concern. Because different versions of this bio-object are simultaneously present and interfere with one another, we ask how the organization renders this multiplicity workable? Studying how ontological versions are enacted in a specific blood establishment and how the organizational model of a blood establishment functions as a mode of coordination, we develop a praxiographic appreciation of blood in the context of a specific Belgian blood establishment. We show how the organizational mode of coordination allocates versions of blood in specific departments along functional and chronological dimensions. Blood remains the object of a gift relationship but is accompanied by blood’s enactment and representation as the object of suspicion, management, research/biology, and a blood economy. Furthermore, the organizational mode of coordination also allocates personalized and depersonalized enactments according to the level of contact with the donor population. This reflects a third dimension: (de)personalization of blood. Whereas the organizational mode of coordination is successful in rendering blood’s multiplicity workable, at times, it causes suboptimal practices. Moreover, we showed how sometimes a focus on intra-departmental modes of coordination is necessary to understand how blood’s multiplicity complicates the practices of the blood establishment.
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18
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Moshirfar M, Brown TW, Goldberg JL, Wagner WD, Ronquillo YC. Transgender Corneal Donors: A Dilemma Worthy of Attention. Ophthalmol Ther 2018; 7:217-222. [PMID: 30259499 PMCID: PMC6258576 DOI: 10.1007/s40123-018-0148-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Indexed: 11/26/2022] Open
Abstract
Currently, there are no specific guidelines in place to direct eye banks on how to deal with donated tissue from transgender individuals. This commentary will examine the history of corneal transplantation and the importance of the corneal tissue donor. In doing so, the donor selection criteria established by the Food and Drug Administration will be presented. Additionally, the history of blood donor deferral policies created for men who have sex with men and how those policies have changed over time will be explored. We provide an evidence-based framework for potential guidelines regarding the transgender population and eye tissue donation.
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Affiliation(s)
- Majid Moshirfar
- HDR Research Center, Hoopes Vision, Draper, UT, USA.
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Utah Lions Eye Bank, Murray, UT, USA.
| | - Tanner W Brown
- The University of Texas Health Science Center at Houston School of Medicine, Houston, TX, USA
| | - Jackson L Goldberg
- The University of Texas Health Science Center at Houston School of Medicine, Houston, TX, USA
| | - William D Wagner
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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19
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Fred HL, Thangam M, Aisenberg GM. Pathogens transmitted in red blood cell transfusions: An up-to-date table. Proc (Bayl Univ Med Cent) 2018; 31:307-309. [PMID: 29904294 DOI: 10.1080/08998280.2018.1459397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/16/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Herbert L Fred
- Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
| | - Manoj Thangam
- Division of Cardiovascular Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Gabriel M Aisenberg
- Department of Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas
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20
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Karamitros G, Kitsos N, Karamitrou I. The ban on blood donation on men who have sex with men: time to rethink and reassess an outdated policy. Pan Afr Med J 2017; 27:99. [PMID: 28819520 PMCID: PMC5554671 DOI: 10.11604/pamj.2017.27.99.12891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 05/31/2017] [Indexed: 12/03/2022] Open
Abstract
During the 1980s the HIV/AIDS epidemic outbreak occurred. Due to the high prevalence of the disease on men who had sex with men (MSM) a lifetime ban on blood donations on men who had sex with men (MSM) was implemented. In the recent years, organizations like the European Union (EU) and the World Health Organization (WHO) have established new guidelines introducing the term of “risky sexual behavior” without any reference to the sex orientation of the potential donor, however many countries are hesitant to review the ban on men who had sex with men (MSM). Given the lack of screening methods for HIV back in the '80s the ban on men who had sex with men seemed like the only choice in order to limit the disease. However, nowadays the screening methods have advanced and the possibility of a transfusion related HIV infection is extremely low. Many countries, considering the new data available, have reformed their policies and moved from the lifetime ban to 5-year and 1-year deferrals but only a fraction of countries have adopted the guidelines for the “risky sexual behavior” assessment. The ban that forbid men who have sex with men from donating blood was implemented more than 30 years ago. During the '80s, the epidemiology was different and it seems not only hypocritical but also naïve to rely on guidelines that are far outdated and old-fashioned. The medical community has a duty to secure safe blood for every person who might need it, let us not waste safe potential donors and stigmatize them by focusing on outdated policies.
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Affiliation(s)
| | - Nikolaos Kitsos
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ioanna Karamitrou
- Law School, Democritus University of Thrace (DUTH), Komotini, Greece
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21
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Tiberghien P, Pillonel J, Toujas F, Vallet B. Changes in France's Deferral of Blood Donation by Men Who Have Sex with Men. N Engl J Med 2017; 376:1485-1486. [PMID: 28402774 DOI: 10.1056/nejmc1700740] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - François Toujas
- Etablissement Français du Sang, La Plaine Saint-Denis, France
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22
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Sacks CA, Goldstein RH, Walensky RP. The Blood Supply and Men Who Have Sex with Men. N Engl J Med 2017; 376:1486. [PMID: 28402775 DOI: 10.1056/nejmc1701828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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23
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van de Laar TJ, Bezemer D, van Laethem K, Vandewalle G, de Smet A, van Wijngaerden E, Claas EC, van Sighem AI, Vandamme AM, Compernolle V, Zaaijer HL. Phylogenetic evidence for underreporting of male-to-male sex among human immunodeficiency virus-infected donors in the Netherlands and Flanders. Transfusion 2017; 57:1235-1247. [PMID: 28375576 DOI: 10.1111/trf.14097] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/14/2016] [Accepted: 01/08/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Separate transmission networks for human immunodeficiency virus (HIV) coexist. Molecular typing of viral genomes can provide insight in HIV transmission routes in donors for whom risk behavior-based donor selection failed. STUDY DESIGN AND METHODS This study includes all HIV-infected Dutch and Flemish donors in the period 2005 to 2014 (n = 55). Part of the HIV polymerase (pol) gene was amplified, sequenced, and compared with more than 10,000 HIV strains obtained from HIV-infected Dutch and Flemish patients. The most likely transmission route was determined based on HIV phylogeny and the donor's self-reported risk behavior during the exit interview. RESULTS HIV-infected donors were predominantly male (69%), were repeat donors (73%), were born in the Netherlands or Belgium (95%), and harbored HIV Subtype B (68%). Seventy-five percent of HIV-infected male donors were part of robust phylogenetic clusters linked to male-to-male sex, while only 24% of HIV-infected male donors reported male-to-male sex during posttest counseling. Sex between men and women accounted for 13% of HIV infections in male donors and 93% of HIV infections in female donors based on phylogenetic analysis. Only 40% of HIV-infected female donors had HIV Subtype B; 65% of female donors reported a foreign partner and indeed HIV sequences interspersed with sequences from HIV-endemic areas abroad, in particular sub-Saharan Africa. CONCLUSION HIV typing helps to understand HIV transmission routes in donor populations. We found substantial underreporting of male-to-male sex among HIV-infected male donors. Donor education on HIV risk factors and the danger of window-period donations and a donor environment that encourages frank disclosure of sexual behavior will contribute to a decrease of HIV-infected donors.
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Affiliation(s)
- Thijs J van de Laar
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, the Netherlands
| | | | - Kristel van Laethem
- Laboratory for Clinical and Epidemiological Virology, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven-Leuven University, Leuven, Belgium.,AIDS Reference Laboratory, University Hospitals Leuven, Leuven, Belgium
| | | | - Annie de Smet
- Blood Service, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Eric van Wijngaerden
- AIDS Reference Center, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Clinical Infectious and Inflammatory Disorders, Department of Microbiology and Immunology, KU Leuven-Leuven University, Leuven, Belgium
| | - Eric C Claas
- Department of Medical Microbiology, Leiden University Medical Centre, Leiden, the Netherlands.,Department of Molecular Biology, MC Slotervaart, Amsterdam, the Netherlands
| | | | - Anne-Mieke Vandamme
- Laboratory for Clinical and Epidemiological Virology, Department of Microbiology and Immunology, Rega Institute for Medical Research, KU Leuven-Leuven University, Leuven, Belgium.,Center for Global Health and Tropical Medicine, Microbiology Unit, Institute for Hygiene and Tropical Medicine, University Nova de Lisboa, Lisbon, Portugal
| | - Veerle Compernolle
- Blood Service, Belgian Red Cross-Flanders, Mechelen, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Hans L Zaaijer
- Department of Blood-borne Infections, Sanquin Research, Amsterdam, the Netherlands.,Department of Medical Microbiology (CINIMA), Academic Medical Center/University of Amsterdam, Amsterdam, the Netherlands
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24
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Timmermann C. The Precautionary Principle and the Social Institution of Blood Donation. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2017; 17:52-54. [PMID: 28207364 DOI: 10.1080/15265161.2016.1274801] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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