The revelation last month that a man was infected with HIV through a tainted blood product was another reminder that people at risk should not donate blood.
Part of the problem is that some people persist in trying to use the donation process as a way to be tested for HIV.
Unfortunately, it is technically impossible to completely exclude tainted blood, and plasma contaminated with the human immunodeficiency virus is liable to slip through safety checks at donation centers if the donor is in the initial phase of infection.
It is believed there is an average window of 40 to 50 days during which HIV can’t be detected with existing technology because only a trace amount of the virus is in the blood.
Given the lack of a perfect screening method, it is important to raise awareness of the possibility of inaccuracies involving donated blood and to provide facilities where potentially infected people can take tests more readily.
The latest infection through blood transfusion was not the first in Japan. The government and the Red Cross had been calling on people not to donate blood just for testing purposes since an HIV infection in 2003 through donated blood slipped through checks.
Unfortunately, not everyone has gotten the message.
The Red Cross even says it will not inform donors if the blood they gave tests positive.
In 2010, the society checked the interview sheets of around 5.33 million people who visited blood donation centers nationwide and found 337 people replied yes when asked whether they had come to donate blood to check for HIV. Many of them were in their teens and 20s. Donations were declined from these people.
The number may be small, but it is “not insignificant,” a Red Cross official said, adding that the understanding that blood donations should not be viewed as a way to test for HIV “may not have got through to the public.”
In the latest case, a man in his 40s did not declare that sexual contact two weeks before he donated blood in February had put him at risk of HIV.
The health ministry and the Red Cross said a man in his 60s became infected through a blood product made from the infected donor’s blood. A woman in her 80s, meanwhile, escaped infection despite using another type of product derived from the same donor’s blood.
It is up for debate whether penalties should be imposed in such cases. Health, Labor and Welfare Minister Tamura Norihisa has indicated that the government will investigate the systems in other countries.
According to the Red Cross, Australia imprisons or fines donors who falsely report their status and cause HIV infections in others.
The health ministry here is cautious about taking a similar approach.
“Blood donation is an act of good will on the part of people,” a ministry official said. “We wonder if a penalizing mechanism would be appropriate.”
To prevent people from using donations for HIV tests, it could be useful to ease the anxiety of people whose lifestyle leaves them risk of carrying the virus.
Currently, public health centers in Japan offer free and anonymous HIV checks, but their operating hours have generally been limited to weekdays. An expert said that in recent years some efforts have been made to give consideration to alternative lifestyles.
The proportion of testing facilities admitting visitors on weekends or at night during weekdays increased to 48 percent in 2012 from 26 percent in 2006, according to Mitsunobu Imai, a vice president of Den-en Chofu University specializing in public health who has been surveying HIV testing facilities nationwide.
Imai says the efforts of these facilities to operate during unconventional office hours is admirable, but he wants to see them “go one step further.”
He believes the facilities should also offer tests to check for hepatitis and other infections during a single visit and that they could provide same-day results.
He also suggests simplified checks such as taking a mucous membrane sample from the mouth in place of drawing blood.
“Drawing more people to health centers by offering various options will help lead to the prevention of blood donations for testing purposes,” he said.
The National AIDS Surveillance Committee, a part of the health ministry, says that while many HIV cases stem from sexual contact between men, the virus can infect anyone. Experts say there is strong discrimination and prejudice against homosexuals, a factor that could discourage people from getting tested.
Junko Araki, 49, who heads Community Center Akta, a group raising awareness on the issue in the Nichome gay district in Shinjuku Ward, Tokyo, said one person who went to take an HIV test was told that “HIV is a disease of gays.”
To improve the public’s understanding of homosexuals, the center is offering training for local government officials together with other organizations.
In such training, public health nurses get to sit down with gays and learn how they should receive them when accepting test applications or offering counseling.
“We need to create an environment in which everyone, including homosexuals, can take the tests without hesitation and dispel negative images about HIV,” Araki said.