Blood donation provides a critical resource for healthcare. The human immunodeficiency virus (HIV) attacks the body’s immune system, potentially leading to acquired immunodeficiency syndrome (AIDS) if untreated. Understanding blood donation eligibility, especially concerning HIV, is important for maintaining a safe blood supply.
Current Regulations for HIV and Blood Donation
Individuals diagnosed with HIV are indefinitely deferred from donating blood in most countries. This policy protects the blood supply and prevents transmission, even with advanced testing methods. Regulatory bodies, such as the Food and Drug Administration (FDA) in the U.S., establish these guidelines, requiring blood establishments to test each donation for transfusion-transmitted infections, including HIV.
While the risk of HIV transmission through screened blood is very low, these measures serve as a precaution. Even if an individual with HIV has an undetectable viral load, they are still permanently deferred from donating blood. This is because “undetectable equals untransmissible” (U=U) applies to sexual transmission, but not to the higher concentration of virus that could be present in a blood transfusion. The lifetime deferral for those who have ever tested positive for HIV or taken medication to treat HIV infection remains unchanged.
Ensuring Blood Supply Safety
The safety of the donated blood supply is maintained through a multi-layered approach, beginning with rigorous donor screening. Potential donors complete detailed health history questionnaires to identify behaviors or exposures that might pose an infection risk.
Following collection, every donated unit undergoes comprehensive laboratory testing for infectious diseases. These tests include Nucleic Acid Testing (NAT) and antibody/antigen tests for HIV, Hepatitis B and C, West Nile Virus, and Syphilis. NAT directly detects viral genetic material, shortening the “window period”—the time between infection and when the virus becomes detectable. This combination of donor screening and advanced laboratory testing makes the blood supply remarkably safe.
General Blood Donation Eligibility
Beyond HIV status, several other factors determine blood donation eligibility, ensuring the safety of both the donor and the recipient. Donors must generally be in good health and feeling well on the day of donation. Age and weight requirements are also in place; for instance, many organizations require donors to be at least 17 years old and weigh at least 110 pounds.
Other common reasons for temporary deferral include recent travel to regions where diseases like malaria are prevalent, specific medical conditions, and recent tattoos or piercings. Certain medications, such as some antibiotics or blood thinners, can also affect eligibility, with deferral periods varying depending on the medication. These diverse criteria collectively contribute to maintaining a safe and suitable donor pool.
Blood Donation for Individuals on PrEP or PEP
Individuals taking Pre-Exposure Prophylaxis (PrEP) or Post-Exposure Prophylaxis (PEP) medications are typically deferred from donating blood. PrEP involves taking daily medication to prevent HIV infection, while PEP is taken after potential exposure to HIV. The deferral for these medications is usually temporary, but it is a standard practice.
These medications can interfere with HIV screening tests, potentially masking a new or recent HIV infection. If a person is in the early stages of an HIV infection while on PrEP or PEP, the medication might suppress the viral load to undetectable levels, leading to a false negative result. For oral PrEP or PEP, a deferral period of three months from the last dose is common, while injectable PrEP may require a two-year deferral.