(P-PH-2) Blood Donor Attitudes to the Change to Individual Donor Assessment 

In May 2023, the FDA removed the requirement to defer for 3 months male donors reporting any sex with men (MSM); updated guidance recommends donor screening questions be applied universally, regardless of gender or sexual orientation. Individual donor assessment (IDA) includes new questions about sexual partners and anal sex, prompting curiosity about how current donors would perceive the new questions. Prior to the implementation of IDA, we sought to evaluate donor perspectives on the proposed changes.

Study

Design/Methods:

As part of a larger study of blood donation-related perceptions and behavior, we conducted in-depth interviews with active and lapsed donors at a blood center within a federal research hospital. Data were recorded with participants’ consent. Verbatim transcripts were imported into a mixed-methods data analysis platform (Dedoose, version 5.0.11, 2014); relevant segments were tagged to facilitate framework analysis.

Results/Findings:

From January to May 2023, 16 interviewees were asked about the proposed transition to IDA. Interviewees were primarily white, allogeneic blood donors, but diverse in age, gender, and donation history (Table 1). Awareness of MSM-related deferrals (historical and then-current) varied, as did cognizance of the proposed transition to IDA. After receiving a brief description of proposed new screening questions, over 3/4 of the sample expressed favorable opinions. Notable distinct subgroups shared an enthusiasm for IDA tempered only by a sense it might not "go far enough", as well as indifferent or ambivalent reactions to proposed changes. No interviewee reported that IDA would impact their donation practice.

Endorsements of IDA were often multifaceted and drew upon science, moral imperatives to treat all potential donors equally and protect blood recipients, maximization of the donor pool by avoiding deferral of “safe donors,” and aligning with wider social trends. “Science” played an important role in many interviews, but referred to diverse things, among them epidemiology and technological advancements. About a quarter of the sample expressed belief that testing would identify any infectious risk. Despite interviewees’ professed pragmatism around questions probing sexual behavior, broad consensus existed that “other people” might find the new screening questions problematic, whether due to invasiveness or sensitivities around storing these data. Educating donors about the rationale for the new questions was repeatedly suggested as a way to reduce unease and enhance disclosure.

Conclusions:

Blood donors expressed an overall positive perception of the proposed shift to IDA. Reasons offered for supporting the change included scientific evidence, non-discriminatory inclusion and maximization of the donor pool. Most interviewees were highly confident that the change would not negatively impact blood safety.