Comparison of different strategies for a generalized risk assessment of blood donors for sexual transmittable diseases independent of donor and partner gender

Background

Current German guidelines differentiate in risk assessment for sexual transmittable diseases (STD) according to donor and partner sex. This differentiation is currently revised. A recent FDA draft guidance recommends deferral of donors with a new sexual partner or more than 1 partner in the past 3 months only, if the donor had had anal sex. In Austria, only donors with more than 3 partners in the last 3 months or unprotected sex with a new partner are deferred.

Methods

All 21,570 donors with known email address were asked to fill in an anonymous online survey on risk factors for STD and on their attitude towards questions about sexual practices as part of donor risk assessment. Donors were allowed to skip single questions. Presumed eligibility was determined according to
(A) current guidelines,
(B) FDA draft guidance,
(C) considering ineligible all donors with a new or more than 2 partners during the last 3 months or
(D) donors with unprotected sex with a new partner during the last month or more than 2 partners during the last 3 months, or
(E) donors with more than 2 partners or with more than one partner and anal sex or with anal sex with a new partner during the last 4 months.

Results

6387 donors (29.6%) answered the survey. The proportion of ineligible donors was about 1% for strategy B, 2% for strategies A, D and E, and 8% for C. 15% of donors aged 18-29 years reported a new sexual partner during the last 4 months (6% had unprotected sex and 1% anal sex with the new partner).

1950 donors (28.3% of all donors) disliked questions about anal sex, and 371 (5.4%) would stop donating if those were asked. 372 donors (5.4%) reported that they would not answer truthfully about having anal sex. This proportion was increased in donors with many partners (e.g. 15.4% of donors with 3 or more partners during the last 3 months) and in donors having anal sex or unprotected sex with a new partner in the last month (12% and 10%).

Conclusion

A generalized deferral of donors with new partners would significantly decrease the number of eligible donors. Detailed questions about sexual activities should be omitted or restricted to subgroups of donors with increased risk (e. g. new or multiple partners) to avoid unnecessary deterrence of other donors. Extensive measures to convince donors of the necessity and effectiveness of such questions would be needed, as especially donors with high risk for STD tend not to answer truthfully.

Offenlegung Interessenkonflikt:

No conflict of interests.