OBJECTIVETo determine the sero-prevalence of and the risk factors for human immunodeficiency virus infection among residents in a former commercial blood donating community, Shanxi Province.

METHODSA community-based cross-sectional survey was conducted among all residents aged 18 - 64 years in 4 villages in a rural county of Shanxi Province. A standardized structured questionnaire was administered to collect socio-demographic, medical and risk behavioral information. Venous blood was collected for HIV antibody testing. Generalized estimating equation with logistic regression was used to analyze the risk factors for HIV infection. Population attributable fraction was used to evaluate the role of public health in the risk factors for the incidence of HIV.

RESULTSA total of 3062 villagers participated in the study and provided their blood samples for HIV antibody testing. 29.5% of the participants had a history of selling blood and/or plasma. Among the subgroup of former blood donors (FBDs), 71.9% sold whole blood only, 4.1% sold plasma only and 24.0% sold both. Forty HIV infected persons were identified in the four villages. HIV prevalence was 1.3%, overall, 4.1% in FBDs and 0.1% in non-FBDs in the community. Amongst the subgroup of FBDs, HIV prevalence was 1.5% for whole blood only, 21.6% for plasma only and 8.8% for both. Univariate analysis showed that village of residence, education, marital status, gender, plasma/blood donation were statistically associated with HIV seropositivity in the villagers. Other variables, such as gender, age, occupation, number of sexual partners, drug use, histories of tooth extraction, acupuncture, surgical operation and medical injection were not found to be statistically associated with HIV seropositivity. Multivariate analysis found that selling whole blood only (adjusted OR = 13.25, 95% CI: 3.02 - 58.25) and selling plasma or both (adjusted OR = 87.85, 95% CI: 22.22 - 347.27) were significantly associated with HIV seropositivity, and the additive population attributable fraction (PAF) was 89.8%. Villagers in village 03 were more likely to be HIV positive than those in village 04 (adjusted OR = 12.26, 95% CI: 1.46 - 103.00).

CONCLUSIONAt present, HIV epidemic in the former commercial blood donating community has a low prevalence in Shanxi Province and the majority of HIV infections should be related to the blood and plasma donation. This study reveals the existence of HIV second-generation transmission from the infected blood donors to the general population. However, HIV had not been evidently extended from the blood/plasma donors to general population.