Risk behavior disclosure among blood donors in Sao Paulo, Brazil

The two main goals of blood banks are to ensure consistent and safe blood components to reduce morbidity and mortality in their surrounding communities. To achieve these goals, blood banks worldwide have implemented multiple methods including continuous improvements in the donor selection and retention, serological testing for transfusion transmissible infectious agents, standard written procedures, and investments to upgrade collection, screening, and storage technologies. Despite of precautions, there is still a risk of transmission of an infectious agent when individuals donate blood during the serological window period; that is, before the detection limits of the tests but after the donor is contagious. Therefore, the success of a blood transfusion system relies on effective donor recruitment and deferral strategies in addition to serological testing. Donor recruitment and retention are focused on identifying donors at low risk of infection while donor deferral criteria are used to distinguish those at high risk of infection, based on the epidemiology of the blood born infection. However, blood donor selection has been increasingly challenging due to educational, cultural, and socioeconomic diversity, in addition to differences in the epidemiology of the diverse transfusion transmitted infections worldwide. The donor screening process and the deferral timeframe has varied across countries and over time. Nonetheless, there are common, basic requirements. For example, blood donors in most settings are required to complete a health history questionnaire and answer questions regarding their current and past sexual behavior and use of intravenous drugs. High risk behaviors that may result in deferral from donation include being a male having sex with other males, having multiple sexual partners, being male or female sex workers, using intravenous drugs, or being the sex partner of any of these persons or of a person known to have HIV for any reason. The donors screening process is usually conducted in a private area to ensure confidentiality; it can be performed by trained physicians, nurses, or other trained health care providers using a standardized printed or electronic questionnaire, in face to face interviews, or by the donor answering the questions under physician supervision. Unfortunately, several studies have demonstrated low compliance with screening questionnaires in that some donors do not disclose high-risk behavior which ultimately poses a threat to the blood supply. In this issue of the Revista Brasileira de Hematologia e Hemoterapia, one article " Factors associated with failure of clinical screening among blood donors who have altered serological results in …