AABB2025: Brazilian Data Confirm IDA Not Associated With Increased HIV Risk

The implementation of individual donor assessment (IDA) protocols in Brazil has not led to an increase in HIV incidence among blood donors, according to new data presented at Tuesday’s oral abstract session titled “Therapeutic and Donor Apheresis and Blood Donation Infectious Disease.”

The data, presented by Carolina Miranda, from the Universidade Federal de Minas Gerais in Brazil, was based on an assessment of HIV incidence among blood donors from five blood collection facilities in Brazil (São Paulo, Belo Horizonte, Rio de Janeiro, Recife and Manaus) before and after the country implenented IDA protocols in mid-2020. Miranda noted that Brazil’s IDA policies are slightly different compared with some other countries. “Brazil applies broader behavioral criteria, deferring donors with a new, multiple or concurrent sexual partner, regardless of sexual practice,” she said.

Miranda also noted that Brazil’s IDA policy was put in place in 2020 in response to both social pressure and blood shortages during the COVID-19 pandemic. “The policy in Brazil was enacted by law, without prior risk assessment or impact analysis,” she said, adding that this led some to question if the policy could be associated with any potential risks to blood safety. Miranda and her colleagues conducted this widespread study to address those questions.

The researchers analyzed data from approximately 1.68 million blood donations in Brazil. “Of these, 853 unique donors were confirmed HIV-positive, and 95 met the criteria for recent infection,” Miranda said. She added that recent infections were more likely to be seen in first-time male donors – findings which  are in line with other previous studies.

“Overall, we found no evidence of increased residual risk of transfusion-transmitted HIV,” Miranda said. She added that HIV incidence among Brazilian blood donors is higher than in many middle- and high-income countries, an issue that predated Brazil’s implementation of IDA. Miranda said issues such as non-compliance with screening questions and limited donor education may play a role in this. “Addressing these long-standing issues may have a greater impact on blood safety than eligibility criteria alone,” she said.