Tassila Salomon1,2, Isabel Gomes3, Mina Cintho Ozahata4, Carlos Henrique Valente Moreira5, Claudia Di Lorenzo Oliveira6, Thelma T Gonçalez7, Maria Esther Duarte8, Carolina Miranda1, Anna Bárbara Carneiro Proietti1, Ester Sabino2, Cesar de Almeida Neto9,10, Brian Custer7. 1. The Department is GDTC (Technical-Scientific Development Management), Hemominas, Minas Gerais, Brazil. 2. Institute of Tropical Medicine, University of São Paulo, São Paulo, São Paulo, Brazil. 3. Faculdade Ciências Médicas, Belo Horizonte, Minas Gerais, Brazil. 4. Department of Infectology, University of São Paulo, São Paulo, São Paulo, Brazil. 5. Institute of Infectology Emílio Ribas, São Paulo, São Paulo, Brazil. 6. Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. 7. Vitalant Research Institute and University of California San Francisco, San Francisco, California. 8. Department of Hemotherapy Technical Coordinationno, Hemorio, Rio de Janeiro, Brazil. 9. Head of the Department Immunhematology Quality Control, Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, São Paulo, Brazil. 10. Disciplina de Ciências Médicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Men who have sex with men in Brazil are deferred from donation for 1 year since their last sexual contact. Legal proceedings in front of the Brazilian Supreme Court could compel blood collection agencies to discontinue use of sexual orientation questions. METHODS: Data from male participants in a completed HIV risk factor case-control study were used to evaluate whether it is possible to differentiate donors at lower and higher risk for HIV using two analytical approaches: latent class and random forest analyses. RESULTS: Male blood donors were divided into three distinct risk profile classes. Class 1 includes donors who are heterosexual (96.4%), are HIV negative (88.7%), have a main partner (99.4%), and practice unprotected sex (77.8%). Class 2 includes donors who are men who have sex with men /bisexuals' (100.0%), are HIV positive (97.4%), and were not aware of their sexual partners' HIV status (80.3%). Class 3 includes donors who are heterosexual (84.1%), practice unprotected vaginal/anal heterosexual sex (66.8% vs. 40.9%), and were both HIV positive and HIV negative (49.5% vs. 50.5%). We also found that asking donors about their partner(s)' HIV serostatus could replace asking about donors' sexual orientation and types of partners with relatively minor shifts in sensitivity (0.76 vs. 0.58), specificity (0.89 vs. 0.94), and positive predictive value (0.85 vs. 0.88). CONCLUSION: Sexual orientation questions on the donor questionnaire could be replaced without great loss in the sensitivity, specificity, and positive predictive value. Social and sexual behaviors of donors and their partners are proxies for HIV risk and can help to develop modified questions that will need controlled trials to be validated.
BACKGROUND: Men who have sex with men in Brazil are deferred from donation for 1 year since their last sexual contact. Legal proceedings in front of the Brazilian Supreme Court could compel blood collection agencies to discontinue use of sexual orientation questions. METHODS: Data from male participants in a completed HIV risk factor case-control study were used to evaluate whether it is possible to differentiate donors at lower and higher risk for HIV using two analytical approaches: latent class and random forest analyses. RESULTS: Male blood donors were divided into three distinct risk profile classes. Class 1 includes donors who are heterosexual (96.4%), are HIV negative (88.7%), have a main partner (99.4%), and practice unprotected sex (77.8%). Class 2 includes donors who are men who have sex with men /bisexuals' (100.0%), are HIV positive (97.4%), and were not aware of their sexual partners' HIV status (80.3%). Class 3 includes donors who are heterosexual (84.1%), practice unprotected vaginal/anal heterosexual sex (66.8% vs. 40.9%), and were both HIV positive and HIV negative (49.5% vs. 50.5%). We also found that asking donors about their partner(s)' HIV serostatus could replace asking about donors' sexual orientation and types of partners with relatively minor shifts in sensitivity (0.76 vs. 0.58), specificity (0.89 vs. 0.94), and positive predictive value (0.85 vs. 0.88). CONCLUSION: Sexual orientation questions on the donor questionnaire could be replaced without great loss in the sensitivity, specificity, and positive predictive value. Social and sexual behaviors of donors and their partners are proxies for HIV risk and can help to develop modified questions that will need controlled trials to be validated.
Authors: Ana M Sanchez; George B Schreiber; Simone A Glynn; James Bethel; Debra Kessler; David Chang; Thomas F Zuck Journal: Transfusion Date: 2003-02 Impact factor: 3.157
Authors: R J Benjamin; C Bianco; M Goldman; C R Seed; H Yang; J Lee; A J Keller; S Wendel; S Biagini; J Murray; D V Devine; Y Zhu; P Turek; F M Moftah; R Kullaste; J Pillonel; B Danic; F Bigey; G Folléa; E Seifried; M M Mueller; C K Lin; R N Makroo; G Grazzini; S Pupella; C Velati; K Tadokoro; A Bravo Lindoro; A D'Artote González; V T Giner; P Flanagan; R W Olaussen; M Letowska; A Rosiek; R Poglod; E Zhiburt; P Mali; P Rozman; S Gulube; E Castro Izaguirre; B Ekermo; S M Barnes; L McLaughlin; A F Eder; S Panzer; H W Reesink Journal: Vox Sang Date: 2011-11 Impact factor: 2.144
Authors: Giuseppina Maria Patavino; Cesar de Almeida-Neto; Jing Liu; David J Wright; Alfredo Mendrone-Junior; Maria Inês Lopes Ferreira; Anna Bárbara de Freitas Carneiro; Brian Custer; João Eduardo Ferreira; Michael P Busch; Ester Cerdeira Sabino Journal: Transfusion Date: 2011-07-14 Impact factor: 3.157
Authors: Ester C Sabino; Thelma T Gonçalez; Anna Bárbara Carneiro-Proietti; Moussa Sarr; João Eduardo Ferreira; Divaldo A Sampaio; Nanci A Salles; David J Wright; Brian Custer; Michael Busch Journal: Transfusion Date: 2011-10-07 Impact factor: 3.157
Authors: Lindsay E Young; Stuart Michaels; Adam Jonas; Aditya S Khanna; Britt Skaathun; Ethan Morgan; John A Schneider Journal: AIDS Behav Date: 2017-10
Authors: Paula Fraiman Blatyta; Brian Custer; Thelma Terezinha Gonçalez; Rebecca Birch; Maria Esther Lopes; Maria Ines Lopes Ferreira; Anna Barbara Carneiro Proietti; Ester Cerdeira Sabino; Kimberly Page; Cesar de Almeida-Neto Journal: Transfusion Date: 2013-03-22 Impact factor: 3.157
Authors: P F Blatyta; S Kelly; T T Goncalez; A B Carneiro-Proietti; T Salomon; C Miranda; E Sabino; L Preiss; C Maximo; P Loureiro; B Custer; C de Almeida-Neto Journal: BMC Public Health Date: 2020-10-23 Impact factor: 3.295