(P-PH-2) Blood Donation by US Donors Living with HIV, with and Without Evidence of Antiretroviral Therapy: Self-reported Context and Motivations

Background/Case Studies: People living with HIV (PLWH) taking antiretroviral therapy (ART+) may donate blood, despite screening intended to defer them. Research in South Africa suggested two primary pathways to this type of noncompliant donation: 1) a lack of privacy (due to environmental factors or being accompanied) that constrained responses to screening questions, and 2) a belief that PLWH are able to donate for other PLWH. Lacking comparable research on HIV+/ART+ donation in the US context, the US Transfusion Transmissible Infections Monitoring System (TTIMS) initiated this study.

Study

Design/Methods: Study participants were drawn from a preexisting sampling frame that included donors at TTIMS-participating blood centers classified as HIV-positive and either negative or positive for ART (ART- or ART+) based on laboratory testing. In this study, 416 of these donors (140 ART+) were invited to complete an online survey on donation context and motivations, donation experience, and eligibility perceptions. Research aims were to gather data on a previously “hidden” population and compare donor responses by ART status. Descriptive statistics were calculated; response proportions by donor status were analyzed using exact logistic regression, due to small cell counts. Survey respondents were invited to opt in to individual follow-up qualitative interviews, now ongoing.

Results/Findings: 40 surveys (11 ART+) were collected. Respondents were primarily male, age 30-49, non-Hispanic white, single, and employed full-time. Response proportions differed by ART status on many questions but did not reach statistical significance, likely due to small sample size (see Table 1). More ART+ than ARV- respondents said being with others who wanted to donate was a “very” important motivator (54.5% ART+; 31% ART-). More ART+ respondents also felt at least some degree of pressure to donate (27.3% ART+; 13.7% ART-) though most reported this was “not at all” relevant. Fewer ART+ respondents reported having sufficient privacy to answer DHQ questions (72.7% vs. 86.2% ART-). Similar proportions of both groups reported having believed they were eligible to donate at their last donation (89.7% ART-; 81.8% ART+). However, when asked if they had ever been diagnosed with HIV, sizable proportions of both groups answered “No” or “I don’t know” (ART-= 17.2%; ART+= 45.5%). Further, asked about taking ART at the time of their last donation, most respondents in both categories did not answer the question (ART-=55.2%; ART+=63.6%).

Conclusions: Survey data suggest privacy concerns and eligibility misconceptions may play a role in noncompliant blood donation by PLWH taking ART in the US. However, a large proportion of respondents denied knowledge of HIV diagnosis and/or ART use, suggesting nondisclosure related to social desirability bias. This may have implications for the accuracy of DHQ responses.