Factors associated with HIV infection in U.S. blood donors across evolving deferral policies

The implementation of revised blood donor deferral policies may change factors associated with HIV infection in donors. Here, we assessed factors associated with HIV in the U.S. blood donor population between 2015 and 2023. Using exposure data obtained from interviews of HIV cases and matched controls, we investigated sociodemographic and behavioral factors associated with any HIV infection or recently acquired HIV infection, overall and by strata of deferral policy period (lifetime, 12-month and 3-month), for men who have sex with men and other potential risk groups using conditional logistic regression. Multivariable analyses showed that several sociodemographic and behavioral factors were significantly associated with HIV infection, but with no clear evidence of changes in these factors across deferral policy periods. Similarly, several factors were significantly associated with recent HIV infection, with odds ratios similar to those observed for any HIV infection. An association between non-heterosexual orientation and HIV infection remained stable across deferral periods included in the study after adjustment for potential confounders. We found no evidence that non-heterosexual orientation is more strongly associated with recent than with any HIV infection among blood donors. Our findings suggest no major impact of revised deferral policies on HIV risk factors among blood donors, nor among risk factors for any HIV and recent HIV infection in this population. These findings should be reassessed after sufficient accrual of data from the individual donor assessment deferral policy period.