Can blood donations be used to test for HIV?

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, 

These are worthwhile questions to consider.  In the United States (US), all donated blood is tested for human immunodeficiency virus (HIV) and other transmissible diseases. Screenings done with blood donors are intended to ensure recipients of the blood receive safe products and are not meant to be used as a diagnostic tool for donors. That said, if your boyfriend was honest about his blood donations not getting rejected, it may be reasonably safe to assume that he’s HIV-negative but it’s still better to get tested to be sure. 

Blood donations that test positive for specified conditions may be denied or deferred depending on the risk of transfusion-transmitted infection. Examples of denials often include a positive screening for HIV, a diagnosis of acquired immunodeficiency syndrome (AIDS), or a diagnosis of hepatitis B or C infections. Deferrals on the other hand may happen for a variety of reasons including testing positive for a treatable infection or providing a certain answer on a list of screening questions. 

In the case of HIV, even with the best technology, it may take some time between infection and a positive test result. Following infection, the body develops a cellular immune response to the virus. During this time the virus may go undetected, resulting in a negative test result. The duration of the window period varies depending on the type of test administered. 

Additionally, the FDA recently recommended that a standardized blood donation eligibility risk assessment be implemented with all potential donors. This means that deferrals can now occur for any donor—including your boyfriend. Donors are deferred based on responses related to the types of sex they may be having, the number of sexual partners they have, and the durations of time they have been with those partners. This is a drastic change from the previous assessments where these questions were often only conducted with men-who-have-sex-with-men (MSM) and women who have sex with MSM. 

That said, blood donation centers strongly discourage blood donation as a way to confirm HIV status. Not only does this practice put potential recipients at risk for infection, but an undetected disease may place the facility staff and others handling the donations at risk as well. Instead, it’s recommended that a person get an HIV test specifically to be certain about their HIV status. 

Although you and your boyfriend have talked about HIV status, it may be worth exploring why he’s relying on blood donation testing to know his status rather than getting an HIV test directly. You can also explore whether he's concerned about the reliability of the test or how long it’ll take to get results after testing. Other potential concerns to consider include: 

  • Potential inconvenience or stigma of getting tested in person: HIV self-tests are often available online or at local pharmacies and can be completed at home. Another option he may consider is mail-in HIV tests that can be ordered online and sent to a lab for testing after a sample is collected. 
  • Who will know about his results: Most HIV tests are anonymous (only you know your result) or confidential (the result appears on your medical record and might be seen by a health care provider or the health insurance company if you use them to offset the cost). It’s important to note that confidential results are often protected by certain disclosure policies that prevent your result from being shared without your permission. However, these policies may vary by U.S. state
  • Finances and insurance coverage: HIV screening in the US is often covered by health insurance if you’re between the ages of 15 and 65 or are at an increased risk of contracting the virus. However, if you don’t have insurance, free or low-cost tests are often available through the local department of health (DOH). Consider checking out CDC’s Get Tested resource to filter for options near you. 

If starting this conversation with your partner seems overwhelming or you’re unsure about how to approach it, you might consider researching some conversation starters so you feel more confident headed into the discussion. 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. 

Stay safe, 

Last updated Oct 06, 2023
Originally published Jun 06, 1997

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