Validation of new, gender-neutral questions on recent sexual behaviors among plasma donors and men who have sex with men.

BACKGROUND AND OBJECTIVES: Several blood services might eventually interview donors with gender-neutral questions on sexual behaviors to improve the inclusivity of blood donation. We tested two ways (i.e., "scenarios") of asking donors about their recent sexual behaviors. MATERIALS AND METHODS: The study comprised 126 regular source plasma donors and 102 gay, bisexual, and other men who have sex with men (gbMSM), including 73 cis-gbMSM (i.e., the "cis-gbMSM subgroup," which excluded nonbinary, genderqueer, and trans individuals). In Scenario 1, participants were asked if, in the last 3 months, they "have […] had a new sexual partner or more than one sexual partner." In Scenario 2, they were asked "Have you had a new sexual partner?" and "have you had more than one sexual partner?". Validation questions included more specific questions on the type of partners and sexual activity. RESULTS: Among plasma donors, sensitivity was 100.0% for both scenarios; specificity was 100.0% and 99.1% for Scenarios 1 and 2, respectively. Among gbMSM, sensitivity was 74.5% and 82.9% for Scenarios 1 and 2, respectively; specificity was 100.0% for both scenarios. Among cis-gbMSM, sensitivity was 88.6% and 100.0% for Scenarios 1 and 2, respectively; specificity was 100.0% for both scenarios. The area under the receiver operating characteristic curve of Scenario 2 was significantly higher than that of Scenario 1 among gbMSM and in the cis-gbMSM subgroup (all p < .05). CONCLUSION: Scenario 2 questions performed well among plasma donors and cis-gbMSM, but less so in the broader gbMSM population.

Risk of transfusion-related acute lung injury and human immunodeficiency virus associated with donations from trans donors in Quebec, Canada.

BACKGROUND AND OBJECTIVES: Blood operator must establish selection criteria according to the populations at risk of blood-related infections and complications. Therefore, this study aimed to assess the risks of transfusion-related acute lung injury (TRALI) and human immunodeficiency virus (HIV) associated with donations from trans persons. MATERIALS AND METHODS: Donor screening data from Héma-Québec were used. The risks of TRALI and HIV were estimated based on internal data and assumptions derived from the literature. The risk was assessed under four scenarios: a most likely scenario, an optimistic scenario and two pessimistic scenarios. All scenarios assumed no prior screening for trans donors. RESULTS: The trans population comprised 134 donors, including 94 (70.1%) trans men. Of the 134 donors, 58 (43.3%) were deferred from donating a blood-derived product because of an ongoing gender-affirming genital surgery, and the remaining 76 (56.7%) were eligible donors. The risk of having a TRALI-causing donation, given that it comes from a trans man, was estimated at one every 115-999 years for all scenarios. The risk of having an HIV-contaminated donation, given that it comes from a trans woman, was estimated at one every 1881-37,600 years for all scenarios. CONCLUSION: This study suggests that donations from trans persons are associated with a negligible risk of TRALI and HIV.

Determinants of the intention to participate in a programme of plasma donation for fractionation among men who have sex with men.

BACKGROUND AND OBJECTIVES: Several approaches are currently under study to contribute to efforts to allow men who have sex with men (MSM) to donate blood. One of these approaches involves implementing a programme of plasma donation for fractionation, with a quarantine period. The goal of this article is to identify the determinants of intention to participate in the plasma donation programme among MSM in Montreal, Canada. MATERIALS AND METHODS: Based on the theory of planned behaviour, a questionnaire was developed to measure MSM's intention to donate plasma and identify influencing factors. A multiple linear regression analysis was conducted to identify the determinants of intention to donate plasma. RESULTS: Respondents' (N = 933) intention to donate plasma in the next six months was moderate. The multiple linear regression model explained 55% (P < 0·001) of the variation of intention. Intention was predicted by attitudes (ß = 0·34, P < 0·001), perceived behavioural control (ß = 0·28, P < 0·001), aged under 35 years (ß = 0·26, P < 0·001), history of blood donation (ß = 0·24, P < 0·001), subjective norm (ß = 0·21, P < 0·001), income above $40,000 (ß = 0·20, P < 0·001), moral norm (ß = 0·18, P < 0·001) and higher level of involvement in various issues LGBTQ+ communities are fighting for (ß = 0·09, P < 0·001). CONCLUSION: Our analyses show that intention to donate plasma within the proposed programme is associated with personal, social and structural factors, but more strongly predicted by factors related to the theory of planned behaviour. Our results also highlight the importance of involving MSM; community acceptability of the plasma donation programme would probably be higher if MSM felt respected and party to the decisions.

'One step closer': Acceptability of a programme of plasma donation for fractionation from men who have sex with men.

BACKGROUND AND OBJECTIVES: In Canada, Héma-Québec is considering the possibility of allowing men who have sex with men (MSM) to donate plasma for fractionation combined with a mandatory quarantine period. This study aims to assess the acceptability and operational feasibility of the programme in the targeted population. MATERIALS AND METHODS: Seven focus groups with MSM (N = 47) were conducted in Montréal, regarding their beliefs underlying attitudes, subjective norms and perceived behavioural control relating to intention to participate in a programme of plasma donation for fractionation. A theoretical thematic content analysis was realized. RESULTS: Participants brought up benefits of the programme. Some are altruistic (help others, save lives, contribute as citizens), while others are linked to what it could bring to their community (progress, opportunity to include MSM in blood donation programmes, acknowledgement of MSM's contributions to the well-being of others). However, even if the programme is in accordance with their altruistic values, it clashes with their values of equality and social justice. Many disadvantages were raised (discrimination and stigmatization of MSM, the fact that their blood is presented as being not as good as the blood of others). Facilitating factors and barriers to participation were put forward in terms of programme characteristics and sites where donations would be made. CONCLUSION: The findings suggest some interest in the programme of plasma donation for fractionation, but this is significantly tempered by the fact that differential treatment for MSM would continue and that their demands regarding access to whole blood donation are still unmet.