Correlates of HIV infection among former blood/plasma donors in rural China

BACKGROUND: In 1995, when the first cases of HIV infection were reported among former plasma donors (FPDs), the Chinese government closed all commercial plasma collection stations. OBJECTIVE: To determine the prevalence of HIV among FPDs and non-donors in affected villages in Anhui, China. METHODS: A cross-sectional survey was conducted among residents, aged 25-55 years, in 40 villages randomly selected from villages with many former blood/plasma donors, using a two-stage clustered sampling method. A questionnaire was administered face-to-face to 1997 villagers without collecting any identifying information, and venous blood specimens were collected for HIV testing with two enzyme-linked immunosorbent assays and western blotting. EpiData was used for data entry, and STATA was used for data analysis. RESULTS: Overall HIV prevalence was 10.8%, with values of 15.1% among FPDs and 4.8% among non-donors. Among FPDs, factors associated with HIV infection included: donating plasma more than 10 times odds ratio (OR) 4.09; P < 0.001] compared with subjects who donated 1-3 times; spouse being HIV-positive (OR, 4.06; P = 0.001); and being male (OR, 2.04; P = 0.011). Condom use was rare, and was not associated with HIV infection (OR, 1.09; P = 0.872). Among non-plasma donors, spouse being HIV-positive (OR, 11.07, P < 0.001) and having multiple sexual partners (OR, 7.04; P = 0.006) were associated with HIV infection. CONCLUSIONS: The prevalence of HIV infection is high among rural residents in villages with former commercial plasma businesses. Plasma but not blood donations were associated with HIV infection. The HIV/AIDS epidemic has spread to non-donors primarily through sexual transmission. HIV/AIDS education, testing, and condoms should be promoted urgently to prevent further transmission.