Hatten die Änderungen der Spendeauswahlkriterien eine Auswirkung auf die Häufigkeit von HIV-Infektionen unter Spendenden? Vergleich der Daten der Spendeepidemiologie aus 2017, 2019 und 2023
Individuals with high risk sexual behaviour are not allowed to donate. Using population-based deferral criteria, men who have sex with men (MSM) were indefinitely deferred until 2017 when the deferral period was reduced to 12 months after the last sexual contact. Since 2023 an individual donor screening approach is mandated. We compare data on HIV infections in the blood donor population in Germany prior to the implementation of temporary deferral, after the introduction of the 12-month deferral and after the change to individual assessment.
Donor epidemiology data reported to the RKI were used for the analysis. All blood donation services report the number of tests performed for prospective, first time (FTD) and repeat donors (RD), stratified for age group, sex and type of donation. Information on donors tested positive for HIV include donation history, laboratory results and mode of transmission.
In 2023, the number of HIV infections decreased compared to 2017 and 2019. The HIV prevalence and incidence were 4.8, 5.7 and 2.5/100,000 in FTD and 1.6, 1.2 and 0.9/100,000 RD in 2017, 2019 and 2023, respectively. Male FTD and RD were more often found to be HIV-positive. The highest difference in HIV prevalence (factor of 9.4) was found in male FTD compared to female FTD in 2023. HIV infections were detected more often in younger age groups (18-34 years). No trend was seen in distribution of HIV infections with respect to sex or age group. The proportion of HIV infections with a reported mode of transmission was 47%, 50% and 46% in 2017, 2019 and 2023. Sexual contacts caused the majority of reported transmissions but the proportion of MSM and heterosexual exposures varied: In 2023, MSM accounted for 46% of the notifications (36% in 2017 and 17% in 2019) while heterosexual contacts (31%) were less often reported than in 2017 (48%) and 2019 (53%).
HIV infections declined unrelated to the donor selection criteria. No change in age or sex distribution was observed. An increased reporting of MSM as transmission mode was seen in 2023. This can be due to more MSM presenting at blood services or to a more open recording of this exposure. As the individual risk assessment was only implemented in 2023, more research is necessary to interpret these early findings. Post donation interviews of positive donors are of utmost importance to identify changes in donor risk profiles.
Both authors declare no conflicts of interest.