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Blood Donor Counselling: Implementation Guidelines. Geneva: World Health Organization; 2014.

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Blood Donor Counselling: Implementation Guidelines.

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Annex 5HIV infection: information for blood donors

The human immunodeficiency virus (HIV) is one of the world's leading infectious diseases, claiming more than 25 million lives over the last 30 years. In 2010, there were approximately 34 million people living with HIV.

Once someone is infected with HIV, it is present in the body permanently. HIV invades white blood cells, called T-lymphocytes, which have an important role to play in the body's defences against infection and cancer. HIV destroys these cells and, if unchecked, causes the body's defence mechanism – or immune system – to fail. This is known as “immune deficiency”. Failure of the immune system allows infections which are usually kept under control to cause illness, and makes the person more likely to develop certain cancers. The most advanced stage of HIV infection is acquired immunodeficiency syndrome (AIDS), which can take 10–15 years to develop. This stage is defined by the development of certain cancers, infections or other severe clinical manifestations.

Transmission

HIV is a sexually-transmitted disease and can be transmitted via unprotected sex and close contact with a variety of body fluids of infected individuals, such as blood, breast milk, semen and vaginal secretions. HIV can also be passed from mother to baby during pregnancy and through breastfeeding. Although primarily transmitted through person-to-person sexual contact, HIV can also be transmitted by blood transfusion from an infected blood donor.

Examples of HIV transmission routes include:

  • Unprotected anal or vaginal sex with an HIV-infected partner
  • Mother-to-child transmission during pregnancy, childbirth, or breastfeeding
  • Transfusion with HIV-infected blood or blood products
  • Sharing of contaminated injection equipment, tattooing, skin-piercing tools and surgical equipment.

HIV infection cannot be spread through ordinary day-to-day contact such as shaking hands or sharing personal objects, food or water. Activities such as eating and drinking with friends or family, sharing washing or toilet facilities, and hugs and kisses are all safe. There is no risk of infection from shared cooking and eating utensils, or baths, showers or swimming pools. HIV cannot be passed on by tears, sweat, coughs, sneezes or insect bites.

Signs and symptoms

The symptoms of HIV vary depending on the stage of infection. Although people living with HIV tend to be most infectious in the first few months, many are unaware of their status until later stages. In the first few weeks after initial infection, individuals may experience no symptoms or a flu-like illness including fever, headache, rash or sore throat.

As the infection progressively weakens the person's immune system, the individual can develop other signs and symptoms such as swollen lymph nodes, weight loss, fever, diarrhoea and cough. Without treatment, they could also develop severe illnesses such as tuberculosis, cryptococcal meningitis, and cancers such as lymphomas and Kaposi's sarcoma, among others.

Important information about your test results

The tests performed on your donation have given positive results for the antibodies and the virus particles in your blood, which means that you are infected with HIV. Antibodies are the body's reaction to infection, but unlike antibodies to other infections, HIV antibody is unable to overcome the virus and eliminate it from the body. Because the virus is also in the blood, it can be passed on to the recipient of blood transfusion. The tests do not give any information about when or how you became infected, or the state of your immune system. The positive test result does not mean that you have AIDS. Other tests must be performed which will give much more information about your health.

Your test results are regarded as strictly confidential and will not be disclosed to anyone without your consent. However, we could refer you to a hospital or an HIV/AIDS centre for further medical care and treatment. Furthermore, you are infectious to your sexual partner and should seek treatment for both yourself and your partner. If you do not want to, or are unable to inform your partner, the HIV/AIDS centre may be able to help you with that.

We advise you to think very carefully before telling anyone, particularly in the first few days after hearing the news, when the initial reaction may be to take others into your confidence without thinking of the possible consequences.

You should tell those with whom you recently or regularly had sexual contact. You should also tell your doctor and any other doctor who may look after you, particularly if it may help in diagnosing an illness. Your dentist should be informed about the HIV-positive status so that he/she can take the necessary precautions in the surgery to prevent the spread of infection.

If you are a health care worker, you will need to inform your occupational health adviser. If you are engaged in exposure-prone procedures with patients, you should not work until this has been done. For most people there are no occupational health issues and other people do not need to know.

Having someone to talk to may help, especially in the first few days after you hear the news. You can contact the doctor or nurse at the BTS again. The specialist centre that we refer you to will also have people who can help you. There are helplines which offer counselling and support as well as information leaflets on a wide range of topics. You may also look up “AIDS” or “HIV helplines” on the internet for access to other organizations. If you would like to get in contact with someone who also has HIV infection, one of these organizations may be able to put you in touch with a local support group.

Medical care and treatment

It is very important that you have a full medical check-up. This should be arranged at a specialist centre or voluntary counselling and testing centre for the care of people with HIV infection. The centre will arrange a full medical assessment which will give much more information about your health. You will also have access to support for other problems which may arise as a result of the infection, such as informing partners and family.

There is no cure for HIV infection, but modern treatments aim to keep people with HIV healthy for as long as possible. HIV can be suppressed by combination antiretroviral therapy (ART) consisting of three or more antiretroviral (ARV) drugs. ART does not cure HIV infection but controls viral replication within a person's body and allows an individual's immune system to strengthen and regain the power to fight off infections. With ART, HIV-infected individuals can live healthy and productive lives.

How to prevent the virus from being transmitted to others

Blood donation: Unfortunately, you will no longer be able to give blood. Any current sexual partner cannot be a donor either.

Sexual contact: Understanding and practicing “safer sex” can reduce the risk of passing on the virus. For sex to be “unsafe”, infected body fluids from one person need to get inside the body of another person, enabling the virus to get into the bloodstream. The body fluids most likely to transmit the virus are semen, vaginal fluids and blood.

This means that the sexual activities most likely to pass on the virus are:

  • Unprotected anal intercourse (that is, without a condom). This activity carries a particularly high risk and, even with a condom, is still “high-risk” because of the high failure rate of condoms in these circumstances. This is why the infection is transmitted so easily from an infected man to another man.
  • Unprotected vaginal intercourse (that is, without a condom).
  • Any activity which draws blood – this would include sexual intercourse during the menstrual period.

The infection is passed more readily from a man to a woman than from a woman to a man, but it is recommended that condoms are used with all partners, and consideration is given to other forms of sexual activity which do not allow exchange of infected body fluids. Vaccines against HIV are under development and are being tested in clinical trials, but are not yet available for general use. Immunization of a partner is not currently possible.

Pregnancy and breastfeeding: The virus can be passed on to the baby during pregnancy. Treating the mother reduces this risk, but it is advisable to seek expert advice before planning pregnancy. Any existing children can be tested at the specialist centre. Breastfeeding should be avoided.

Accidents which involve blood spillage could expose other people to risk, so it is recommended that you:

  • Wipe up spillages yourself, using disposable paper towels and then swab the area with household bleach or detergent
  • Cover cuts or open wounds
  • Dispose carefully of soiled dressings and used sanitary towels or tampons, by flushing them down the toilet, or by packing them carefully in waterproof wrapping (plastic) before disposal
  • Wash blood-stained linen or clothing in the usual way using a domestic washing machine
  • Do not share razors, toothbrushes or nail scissors since traces of blood may be left on them after use
  • Do not play contact sports if you have a cut or other injury which is likely to bleed.
Copyright © World Health Organization 2014.

All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: tni.ohw@sredrokoob).

Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO web site (www.who.int/about/licensing/copyright_form/en/index.html).

Bookshelf ID: NBK310571

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