Deferral policy

  • 文章类型: Journal Article
    截至2014年底,美国法医实验室估计积压了570,100份所有法医服务请求。潜在打印请求约占总积压的12%[1,NIJ2019]。随着不断增加的需求和积压,对实验室或部门实践的审查对操作至关重要。工作流程和业务实践的变化可以提高效率,并减少案例积压和周转时间。凤凰城警察局实验室服务局(PPDLSB)的潜在打印比较部门(LPCS)实施的自动指纹识别系统(AFIS)延期政策用于解决潜在的打印积压问题。分析了五年的多种AFIS请求类型,以证明此类政策的积极影响和好处,包括数据收集和分析期间的周转时间减少了26.32%,一年的积压请求减少了90.96%。
    Forensic laboratories in the United States had an estimated backlog of 570,100 requests for all forensic services at the end of 2014. Latent print requests represented approximately 12% of that total backlog [1, NIJ 2019]. With ever-increasing demands and backlogs, a review of laboratory or section practices becomes vital to operations. Work process and business practice changes can increase efficiencies and result in the reduction of casework backlogs and turnaround times. The automated fingerprint identification system (AFIS) deferral policy implemented by the Latent Print Comparative Section (LPCS) of the Phoenix Police Department Laboratory Services Bureau (PPD LSB) was employed to address the latent print backlog. Five years of multiple AFIS request types were analyzed to demonstrate the positive effects and benefits of such policies, including a 26.32% decrease in turnaround time over the data collection and analysis period and a 90.96% reduction in backlogged requests for one year.
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  • 文章类型: Journal Article
    背景:在澳大利亚,与男性发生性关系的男性(MSM)从上次性接触开始推迟献血3个月。国际上,MSM的延期政策正在朝着扩大包容性的方向发展,以响应社区的期望。为将来的政策选择提供信息,我们评估了澳大利亚MSM人群对输血传播HIV风险的看法.
    方法:Flux是澳大利亚同性恋和双性恋男性的在线前瞻性队列(顺式或反式,无论他们的性史如何)和其他与男性发生性关系的男性(gbMSM)。我们提出了有关献血规则的问题,窗口期(WP)持续时间,在对Flux参与者的定期调查中,对来自HIV感染者的治疗和态度对性行为进行更详细的询问,并对回答进行了描述性分析。
    结果:在2019年的716名Flux参与者中,有703人回答了献血问题。平均年龄为43.7岁(SD13.6岁)。总的来说,74%的人愿意秘密回答特定的性行为问题,比如他们上一次做爱的时间和做爱的类型,以被视为有资格献血。大多数(92%)的参与者正确评估WP的持续时间少于1个月。当被问及从携带艾滋病毒的献血者输血和检测不到的病毒载量是否可以传播艾滋病毒时,不到一半(48%)的人正确地回答了。
    结论:我们的研究表明,澳大利亚gbMSM通常愿意在捐赠评估期间回答有关性活动的更详细问题,表明他们会诚实地这样做。GBMSM了解WP持续时间,对他们正确自我评估艾滋病毒风险的能力很重要。然而,一半的参与者错误地评估了从一个病毒载量无法检测到的HIV阳性者输血的可传播性,表明需要有针对性的教育运动。
    In Australia, men who have sex with men (MSM) are deferred from blood donation for 3 months from last sexual contact. Internationally, deferral policies for MSM are evolving in the direction of expanded inclusivity in response to community expectations. To inform future policy options, we assessed perceptions of the risk of HIV transmission from blood transfusion among Australian MSM.
    Flux is an online prospective cohort of Australian gay and bisexual men (cis or trans, regardless of their sexual history) and other men who have had sex with men (gbMSM). We included questions on blood donation rules, window period (WP) duration, infectivity of blood from people with HIV on treatment and attitudes to more detailed questioning of sexual practices in the regular survey of Flux participants and conducted a descriptive analysis of responses.
    Of 716 Flux participants in 2019, 703 responded to the blood donation questions. The mean age was 43.7 years (SD 13.6 years). Overall, 74% were willing to confidentially respond to specific sexual behavior questions, such as the last time they had sex and the type of sex they had, in order to be considered eligible to donate blood. The majority (92%) of participants correctly assessed the duration of the WP as less than 1 month. When asked whether transfusion of blood from a donor with HIV and an undetectable viral load could transmit HIV, just under half (48%) correctly said yes.
    Our study suggests Australian gbMSM are generally comfortable with answering more detailed questions regarding sexual activity during the assessment to donate, indicating they would do so honestly. gbMSM are knowledgeable about the WP duration, important for their ability to correctly self-assess their HIV risk. However, half of participants incorrectly assessed the transmissibility by blood transfusion from an HIV positive person with an undetectable viral load, suggesting the need for a targeted education campaign.
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  • 文章类型: Journal Article
    目标:在许多国家,同性恋和双性恋男性(GBM)被推迟献血。GBM认为推迟献血政策是不合理的歧视性政策,特别是由于艾滋病毒预防的进步,可能导致不遵守,需要理解。我们首次在新西兰(NZ)探索了GBM中的献血兴趣和历史以及对捐赠者推迟政策的态度。
    方法:研究了新西兰GBM横断面在线调查的数据。我们建立了三组:(1)从未献血,不感兴趣;(2)从未献血,但表达了兴趣;(3)以前献血。我们测试了这些与人口统计学和行为变量的关联,以及对献血政策的态度。
    结果:总共607GBM符合研究条件,其中32.9%的人以前曾献血,44.3%的人从未献血,但表示有兴趣,22.7%的人表示没有兴趣献血。在以前的捐助者中,三分之一(占样本总数的8.6%)报告不遵守延期政策。大多数参与者发现12个月的延期政策过于严格(81.8%),不公平(75.4%)和仇视同性恋(68.8%)。
    结论:我们估计,第一次在新西兰,近10%的样本未报告男男性行为者(MSM)符合12个月的延期政策.对延期政策的消极态度很普遍,如果依从性降低,可能会增加血液供应的风险。需要进一步的工作来告知GBM接受的延期政策,同时保持新西兰血液供应的安全。
    OBJECTIVE: Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non-compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ).
    METHODS: Data from a cross-sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy.
    RESULTS: A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non-compliance with the deferral policy. Most participants found the 12-month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%).
    CONCLUSIONS: We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12-month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ\'s blood supply.
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  • 文章类型: Journal Article
    为了更好地平衡血液供应的安全性和包括与男性发生性关系的男性(MSM),需要进一步改进荷兰采用的风险管理策略,以减少输血传播性感染(TTIs).性别中立的个人风险评估可以通过根据已知会增加TTI风险的性行为确定捐赠者资格来提供解决方案。我们的目标是估计这种评估会推迟的献血者比例,以及他们回答这些问题的不适感。
    在2020年5月分发了两项调查,以评估过去4、6和12个月献血者的性行为。以及他们报告这些信息的不适。两项调查的组合衡量了不适与报告性行为相关的程度。高风险性行为模式被定义为有多个性伴侣并从事肛交,没有持续使用避孕套。
    在所有2177名参与的全血献血者中,0.8%的人报告在过去4个月中从事高风险的性行为,因此没有资格捐赠。如果考虑到报告此类问题的捐助者的额外比例会阻止他们捐款,2.0%和3.2%的女性和男性捐赠者,分别,会丢失。
    基于高风险性行为的性别中立资格标准可能会减少荷兰合格捐赠者的总数,但可以使更广泛的献血者更容易献血。
    To better balance the safety of the blood supply and the inclusion of men who have sex with men (MSM), further improvements are needed to the risk management strategy employed in the Netherlands to reduce transfusion-transmissible infections (TTIs). A gender-neutral individual risk assessment could provide a solution by determining donor eligibility based on sexual behaviors known to increase the risk of TTIs. Our objective is to estimate the proportion of blood donors that would be deferred by such an assessment, as well as their discomfort answering such questions.
    Two surveys were distributed in May 2020 to assess sexual behavior in blood donors in the last 4, 6, and 12 months, as well as their discomfort reporting such information. A combination of both surveys measured the extent to which discomfort was associated with reporting sexual behavior. A high-risk sexual behavior pattern was defined as having had multiple sexual partners and having engaged in anal sex, without consistent condom use.
    Of all 2177 participating whole blood donors, 0.8% report engaging in high-risk sexual behaviors over the last 4 months and would therefore be ineligible to donate. When accounting for the additional proportion of donors that reported such questions would stop them from donating, 2.0% and 3.2% of female and male donors, respectively, would be lost.
    Gender-neutral eligibility criteria based on high-risk sexual behaviors may reduce the overall number of eligible donors in the Netherlands, but could make blood donation more accessible to a broader group of donors.
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  • 文章类型: Journal Article
    Deferral of men who have sex with men (MSM) from blood donation is highly debated. We therefore investigated their suitability to donate blood.
    We compared the antibody prevalence of 10 sexually and transfusion-transmissible infections (TTIs) among 583 MSM and 583 age-matched repeat male blood donors. MSM were classified as low risk (lr) or medium-to-high risk (hr) based on self-reported sexual behavior and as qualified or unqualified using Dutch donor deferral criteria. Infection pressure (IP) was defined as the number of antibody-reactive infections, with class A infections (human immunodeficiency virus-1/2, hepatitis B virus, hepatitis C virus, human T-cell lymphotropic virus-1/2, syphilis) given double weight compared to class B infections (cytomegalovirus, herpes simplex virus-1/2, human herpesvirus 8, hepatitis E virus, parvovirus B19).
    Donors had a lower median IP than qualified lr-MSM and qualified hr-MSM (2 [interquartile range {IQR}, 1-2] vs 3 [IQR, 2-4]; P < .001). Low IP was found in 76% of donors, 39% of qualified lr-MSM, and 27% of qualified hr-MSM. The prevalence of class A infections did not differ between donors and qualified lr-MSM but was significantly higher in qualified hr-MSM and unqualified MSM. Recently acquired class A infections were detected in hr-MSM only. Compared to blood donors, human herpesviruses were more prevalent in all MSM groups (P < .001).
    IP correlates with self-reported risk behavior among MSM. Although lr-MSM might form a low threat for blood safety with regard to class A infections, the high seroprevalence of human herpesviruses in lr-MSM warrants further investigation.
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  • 文章类型: Editorial
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