ＨＩＶ感染献血者の高危険性行為に関する調査と血液の安全性確保対策

Abstract

HIV-infected voluntary blood donors have increased to more than 80 a year in the last 5 years. There are concerns that blood donation is being used for HIV testing by persons with high-risk behaviors, whose blood in the window period might result in HIV infection of recipients.A questionnaire was sent to 366 AIDS Care Core Hospitals, asking them to report the number of consultation by and characteristics of HIV-positive blood donors found by testing donations over the last 3 years. There were 185 HIV-positive donors reported, 158 (85%) of whom were male. Only 22 donors sought testing (12%), which increased to 13% over the last 5 years compared to 8% in previous years (not significant). However, 132 donors (71%) had high-risk behaviors including men who have sex with men (MSM: 57%) and multiple heterosexual partners (15%), but no intravenous drug users. Among the male donors, irrespective of whether they agreed to, denied or were undecided about donation for the purpose of HIV testing, MSM were the highest in each group (90%, 59%, and 77%, respectively), showing a remarkable increase to 71% over the last 5 years compared to 55% in 1993-1997 and 27% in 1986-1992. In addition, the fact that most infected donors did not approve of donation for the purpose of testing but revealed high-risk behavior once consulted a doctor in the hospitals shows a clear contradiction to their attitude at donation, at which time they ignored notices against donations for HIV testing or by those with high-risk behaviors before, at the time of, and after donation. Therefore, it should be considered that most but not all HIV-positive donors, particularly MSM, donated in order to obtain a HIV test.To ensure safety, it is recommended that MSM should be denied donating blood, and that donor recruitment should be focused on repeat donors, since HIV infection rates in first-time donors were three times higher than those in repeat donors.