Dear Alice,

My boyfriend claims he is HIV negative based on the fact that his blood donations have not been rejected. Is this a safe assumption? Is each and every pint of donated blood really tested for HIV and other blood-transmittable diseases? Do they really contact the donor if the blood is rejected because it tested positive for a blood-borne disease?

Dear Reader,

Based on your boyfriend's history of donating blood, it may be reasonably safe to assume that your boyfriend is HIV-negative. However, this depends on how regularly he donates blood (i.e., every six months, every year, every two years, etc.), and when the last time he donated blood was, because HIV test results may not show up as positive (reliably) for at least several weeks to several months after exposure. In the case of a HIV-positive donation, notification protocols exist to make donors aware of their status and link them to counseling. However, relying on blood donation screening is a slower process than getting tested for HIV directly and it prolongs the process of knowing your status. What’s more, the American Red Cross strongly discourages blood donation as a means for confirming HIV status, as it could put the blood supply at risk and endanger potential recipients. With this in mind, an HIV test is the recommended way to know a person’s HIV status. 

In the realm of blood donation, there are U.S. Food and Drug Administration (FDA) regulations that require all of the nation's blood supply to be tested HIV (HIV-1 and HIV-2) — but that’s not all. Donated blood is also screened for a number of infections and conditions, including hepatitis B, hepatitis C, and syphilis (among others). If the donated blood has a positive result for any of these infectious agents, then the donor will be notified and their unit of blood will be rejected and not used. In addition, donor status and whether or not the person can donate blood again will depend on which specific test was positive or the number of repeated positive test results.

Back to your boyfriend, though: it may be worth exploring with him why he’s relying on blood donation screening to know his status, rather than getting an HIV test directly. Beyond the risks of donating HIV-positive blood, it’s also possible that the donation screening won’t accurately detect an HIV infection if he was recently infected. Talking to him about the reasons behind not getting tested can help you find ways to work through it together. If he’s feeling nervous, or even afraid, he’s certainly not alone. Is he concerned about who will know about his results? There are laws and policies in place to protect that information. If there’s a concern about how long it’ll take to get results once tested, rapid tests that typically take 10 to 20 minutes to yield results are available at many community and sexual health clinics (though they may require a second confirmatory test for positive results). Or, if he’s concerned about the potential inconvenience, or stigma, of getting tested in-person, there are even at-home tests available. Ultimately, if either of you’re curious or concerned about your HIV status, getting an actual HIV test is advised. Beyond knowing your status, getting an actual HIV test also means being able to take advantage of post-test counseling as soon as possible to discuss how to keep each other safe and healthy regardless of the result.

Knowing your status and that of your sexual partner is wise, so kudos to you for seeking more details about what a blood donation could indicate. A good next step might be to talk with your beau about your concerns and how you might move forward to keep each other safe. This may include being aware of your respective HIV statuses and figuring out what safer sex practices (e.g., using condoms and other barrier methods to reduce risk of STIs and pregnancy) make sense for your relationship if you haven’t already. On that note, perhaps you can suggest to your boyfriend to get tested for HIV and other sexually transmitted infections (STIs) together. There are many testing resources available and the Centers for Disease Control and Prevention's (CDC) Get Tested resource can be helpful to find a testing locations near you. For more on STIs (including HIV) and safer sex methods, take a look at the Q&As in the Go Ask Alice! Sexual and Reproductive Health archives.

Alice!

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