HIV testing in the U.S. household population aged 15-44: data from the National Survey of Family Growth, 2006-2010.
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This report presents nationally representative estimates and trends for human immunodeficiency virus (HIV) testing among the U.S. household population aged 15-44. Data are presented for lifetime experience with HIV testing and HIV testing in the past year, including testing done as part of prenatal care.Data for this report come from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The overall response rate for the 2006-2010 NSFG was 77%: 78% for women and 75% for men.Among U.S. women aged 15-44, the percentage ever tested for HIV outside of blood donation increased significantly from 35% in 1995 to 55% in 2002, and to 59% in 2006-2010. Among men aged 15-44, the percentage ever tested outside blood donation fell from 47% in 2002 to 42% in 2006-2010. Within gender groups in 2006-2010, the proportions ever tested for HIV outside of blood donation were similar for Hispanic and non-Hispanic white persons: roughly 6 out of 10 among women and 4 out of 10 among men. However, a higher percentage of non-Hispanic black women (75%) and non-Hispanic black men (61%) had ever been tested for HIV outside of blood donation. Based on 2006-2010 data, 21% of women were tested for HIV within the 12 months prior to interview, compared with 13% of men. While NSFG data cannot ascertain the temporal sequencing of risk-related behaviors and HIV testing, the data indicate that testing within the past year occurs more often among individuals reporting potential HIV risk-related behaviors.Keywords:
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Background and Objective In the United States, approximately 15 million whole blood products are collected each year from 10 million volunteer donors. African Americans are underrepresented in the donor pool. In 2008, 7% of white versus 4% of African American and Hispanics adults donated in the previous year. The donor rates vary by region in the United States: 77–93% for whites, 1–16% for African Americans and 1–13% for Hispanics. In the Atlanta metropolitan area whose donor pool is 77% white, 16% African American and 4% Hispanic, the blood donor rate (number of blood donors per population) was 11/1000 population for whites, 6/1000 for African Americans and 3/1000 population for Hispanics; and the blood donation rate (number of units donated by population over the total population) was 77 donations/1000 population for whites, 22/1000 population for African Americans and 10/1000 population for Hispanics. Thus, African Americans and Hispanics represent half of the donors as whites when adjusted for their percentage of the population and more strikingly donate a significantly fewer number of units per each donor. Materials and Methods Literature on reasons for racial/ethnic differences in donation rates and methods to address these differences was reviewed. Results The reasons for these differences are multifactorial. First, although 41% of the total US population is estimated to be eligible to donate, African Americans and Hispanics have lower eligibility rates (whites 46%, African Americans 36%, and Hispanics 41%). Second, donor deferral rates are higher for minorities: whites 11%, African Americans 18%, Hispanics 14% and Asians 16%. Deferral is most commonly secondary to temporary deferral reasons such as low hemoglobin level, yet donors are less likely to return once deferred, and thus deferral affects donor and donation rates. Third, minorities may have different motivators and barriers. The most cited motivators to blood donation are more convenient place and times, and being asked; and the most cited barriers are fear of catching a disease and feeling faint/dizzy, and not have time or knowing where to donate. Racial differences in motivating factors identified include African Americans are more likely than whites to donate to receive an item/gift and be tested for infectious disease, and if assured that donating is safe. Notably, these motivators are not the primary cited motivators. African Americans compared with whites more commonly cite fear, difficulty finding veins and not knowing where to donate as deterrents. In addition, African Americans have distrust in the healthcare system, which is correlated with lower donation rates. Fourth, different racial/ethnic groups may have different preferred marketing strategies, including methods of contact, as well as culturally specific motivators for behavioural change. Conclusion Thus, with an improved understanding of these differences as well as accurate tools to measure the outcomes, culturally targeted recruitment programs can be developed to increase donation rates.
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This report presents nationally representative estimates and trends for human immunodeficiency virus (HIV) testing among the U.S. household population aged 15-44. Data are presented for lifetime experience with HIV testing and HIV testing in the past year, including testing done as part of prenatal care.Data for this report come from the 2006-2010 National Survey of Family Growth (NSFG), consisting of 22,682 interviews with men and women aged 15-44, conducted from June 2006 through June 2010. The overall response rate for the 2006-2010 NSFG was 77%: 78% for women and 75% for men.Among U.S. women aged 15-44, the percentage ever tested for HIV outside of blood donation increased significantly from 35% in 1995 to 55% in 2002, and to 59% in 2006-2010. Among men aged 15-44, the percentage ever tested outside blood donation fell from 47% in 2002 to 42% in 2006-2010. Within gender groups in 2006-2010, the proportions ever tested for HIV outside of blood donation were similar for Hispanic and non-Hispanic white persons: roughly 6 out of 10 among women and 4 out of 10 among men. However, a higher percentage of non-Hispanic black women (75%) and non-Hispanic black men (61%) had ever been tested for HIV outside of blood donation. Based on 2006-2010 data, 21% of women were tested for HIV within the 12 months prior to interview, compared with 13% of men. While NSFG data cannot ascertain the temporal sequencing of risk-related behaviors and HIV testing, the data indicate that testing within the past year occurs more often among individuals reporting potential HIV risk-related behaviors.
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The yearly increases in the rate of HIV incidence among voluntary non-remunerated blood donors (VBD) over more than 10 years is of great concern, since it threatens blood safety.A questionnaire survey on ideas about preventive measures for avoiding HIV test-seeking donors was given to members of the Japanese Society of Transfusion Medicine (JSBT; n=361) and to VBD in each donation room in 2 Japanese Red Cross Blood Centers (RCBC; n=717).Requesting self-identification cards (ID) in interviews at the time of donation was accepted by more than 80% of both groups, 85% of whom would personally continue blood donation with ID presentation. Notification of positive HIV test results was agreed to by more than 80% of each group. Regarding notification of the results to donors, interviews were mentioned by 50% of the JSBT members, and confidential letters by 71% of the VBD.The idea that donors giving false replies to HIV-related items in interviews at the time of donation should be penalized was supported by more than half of both groups, but received an undecided response from 35% of the VBD, while the idea that donors refusing to accept notification of the test results should be disqualified for donation was accepted by only 38% of the JSBT members and 20% of the VBD, and received an undecided response from 18% of the JSBT members and 43% of the VBD.These results indicate that requesting ID at interview and notification of HIV infection can be introduced into our blood program. However, treatment of donors providing untrue information at interviews and/or declining to accept test results should be resolved by providing more information on the actual attitudes of these donors.
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This report presents the percentage of men and women aged 15-44 in the United States who have never been tested for HIV outside of blood or blood product donation based on 2011-2015 data from the National Survey of Family Growth (NSFG). Additionally, this report describes the main reasons reported for having never been tested for HIV. Data are shown by selected demographic characteristics and HIV risk-related behaviors.
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The pathophysiological role of the thymus in myasthenia gravis, and the mechanism of therapeutic effect of thymectomy, are incompletely understood. Nevertheless, thymectomy is a valuable treatment modality in selected patients with generalised myasthenia gravis. There are several types of thymectomy operation, but no one operative approach is clearly superior to the others. Total removal of the thymus gland is essential. Additional excision of associated mediastinal and cervical tissue, that may harbor ectopic thymic rests, is a controversial surgical issue. Surgeons that advocate thymectomy through small, cosmetically favourable, incisions usually believe that simple removal of the thymus gland is an adequate operation. Surgeons that emphasise the importance of removing extrathymic tissue, in addition to the thymus gland, usually favour greater operative exposure through a median sternotomy. To minimise operative morbidity, surgery for myasthenia gravis requires a multidisciplinary (neurology, surgery, anaesthesia) approach to peri-operative care.
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BACKGROUND To meet the needs of a diverse patient population, an adequate supply of red blood cells (RBCs) from ethnic/racial minority donors is essential. We previously described the 10‐year changes in minority blood donation in the United States. This study describes donation patterns by donor status, age, and race/ethnicity. STUDY DESIGN AND METHODS Data on the age and the number of unique black/African American, Hispanic/Latino, Asian, and white RBC donors were obtained from eight US blood collectors for 2006, 2009, 2012, and 2015. Donors self‐identified their race/ethnicity. First‐time (FT) and repeat (R) donors were analyzed separately. RESULTS Overall, for both FT and R donor groups, whites constituted the majority of unique donors (FT 66.7% and R 82.7%) and also donated the greatest proportion of RBC units (FT 66.6% and R 83.8%). Donors less than 20 years old comprised the greatest proportion of FT donors for all racial/ethnic groups (39.2%) and had the highest mean number of RBC donations per donor (1.12) among FT donors. Conversely, R donors less than 20 years old had some of the lowest mean number of RBC donations per donor (1.55) among R donors, whereas R donors at least 60 years old had the highest mean (1.88). Year by year, the percentage of FT donors who were less than 20 years old increased for all race/ethnicities. For R donors, whites were more frequently older, while Hispanics/Latinos and Asians were younger. CONCLUSIONS Greater efforts to convert FT donors less than 20 years into R donors should be undertaken to ensure the continued diversity of the blood supply.
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Background As populations in the developed world shift toward an older and more ethnically diverse population, the challenges of recruiting and retaining sufficient donors to secure an adequate, safe supply of blood in the future will increase. Study Design and Methods The study population included all first‐time (n = 348,740) and repeat (n = 1,805,255) blood donors and their donations (n = 3,854,460) received by NHS Blood and Transplant during 2010 and 2011. Rates of new and repeat donors per 1000 population were estimated using O ffice for N ational S tatistics 2011 population estimates. Factors associated with new blood donors returning within 6 months were analyzed using multivariate logistic regression. Results The majority (87.9%) of donors were white British; 5.5% were unknown; 3.4% white Irish or white other; and 3.2% composed of all other ethnic groups. The median ages of new and repeat donors in 2010 were 28.0 and 45.0 years, respectively, compared to 29.0 and 47.0 years in 2011. Rates of donation varied by ethnicity, ranging from 1.59 per 1000 among A sian B angladeshi origin, compared to 22.1 per 1000 among white B ritish origin. Approximately two in five (38.4%) new blood donors returned within 6 months and were more likely to be male and of white ethnicity. Conclusions Blood supply is impacted by numerous factors, including an aging population and an increasing population of migrant communities with lower donation rates. It is therefore critical that changes within the blood donor and wider population are monitored to inform donor recruitment and retention strategies.
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We sent out questionnaires to 906 hospitals with more than 100 beds in the Tokyo Metropolitan area (Tokyo, Kanagawa, Saitama and Chiba), Yamanashi, Nagano and Niigata Prefectures to investigate the hospital blood donations from 1994 to 1995, in particular whether blood donors were asked for their histories and whether they were informed of the results of testing after donation. Blood collection was performed in 79 of the 478 (17%) hospitals that replied representing 7, 186 prospective donors. Donors were asked about their histories at 67 of the 79 (84%) hospitals, and only 15 of the 67 (19%) hospitals positively questioned the donors if they had risk behavior for HIV infection in its window period. 55 of the 67 hospitals tested donor blood for HIV and HTLV-I, with 3 of all prospective donors (at least 42 of 100, 000 donors) positive for HIV confirmatory tests. To exclude unsuitable donors from donating blood, it is imperative that both interviews with donors and blood donor screening tests be consistent. Notification of HIV antibody-positive results to donors was carried out in only 50% of the hospitals. Although Japanese Red Cross Blood Centers do not currently officially inform positive results of HIV antibody tests to donors, this policy should be reconsidered on the basis of avoidance of donation for HIV testing by education and enlightenment, as well as the prevention of secondary HIV infection from positive donors.
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