Motivations for blood donation by HIV-positive individuals on antiretrovirals in South Africa: A qualitative study

Karin van den Berg; Edward L Murphy; Vernon J Louw; Gary Maartens; Shana D Hughes

doi:10.1111/tme.12957

Motivations for blood donation by HIV-positive individuals on antiretrovirals in South Africa: A qualitative study

Transfus Med. 2023 Aug;33(4):277-286. doi: 10.1111/tme.12957. Epub 2023 Feb 17.

Authors

Karin van den Berg^{1

2

3}, Edward L Murphy^{4

5

6}, Vernon J Louw², Gary Maartens⁷, Shana D Hughes⁶

Affiliations

¹ Medical Division, South African National Blood Service, Roodepoort, South Africa.
² Division of Clinical Haematology, Department of Medicine, University of Cape Town, Cape Town, South Africa.
³ Division of Clinical Haematology, University of the Free State, Bloemfontein, South Africa.
⁴ Department of Laboratory Medicine, University of California, San Franciscco, San Francisco, California, USA.
⁵ Department of Epidemiology/Biostatistics, University of California, San Franciscco, San Francisco, California, USA.
⁶ Epidemiology and Bioinformatics Core, Vitalant Research Institute, San Francisco, California, USA.
⁷ Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa.

PMID: 36799902
PMCID: PMC10403373 (available on 2024-08-01)
DOI: 10.1111/tme.12957

Abstract

Objectives: We performed a mixed-methods study to explore the motivations associated with blood donation by donors with known, but undisclosed HIV-positive status and ARV use (HIV+/ARV+), seeking potential strategies to reduce such donations and mitigate risk for blood recipients. Here, we report predominantly the qualitative component.

Background: A safe and sustainable blood supply is dependent in part, on effective pre-donation donor assessment. We previously described failure by HIV+/ARV+ blood donors to disclose their status. Such donations may lead to transfusion-transmitted HIV.

Methods: The social ecological model provided the conceptual framework for this study. Previously identified HIV+/ARV+ donors were invited to complete a survey (including a validated stigma scale) and qualitative interview, which underwent inductive and deductive thematic analysis.

Results: We uncovered two primary motivational paths to HIV+/ARV+ blood donations: privacy and altruism. The latter included a motivation not previously reported in the literature: donating specifically for other people living with HIV (PLWH). The other primary factor was a lack of privacy. These accounts often included donors encountering donation opportunities when accompanied by people to whom they had not and did not plan to disclose their HIV status. Most were highly confident their donations would be identified as HIV-positive and discarded.

Conclusion: We demonstrated a complex interaction between individual, social, cultural, and structural/policy factors in blood donations by PLWH who take ARV. Recommendations to limit HIV + ARV+ donations include: (1) Targeted communication strategies to increase knowledge among PLWH of their deferral from blood donation-without increasing stigma, and (2) development of procedures to assist those who feel unable to opt-out of donation due to privacy concerns.

Keywords: HIV; anti-retroviral agents; blood donation; health status disclosure; motivations.

MeSH terms

Blood Donation*
Blood Donors
Blood Transfusion
HIV Infections*
Humans
Motivation
South Africa

Abstract

MeSH terms

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