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Undisclosed ARV use represents a risk to blood transfusion safety. We assessed the prevalence of and associations with undisclosed ARV use among HIV\u2010positive donors who donated during 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design and methods<\/jats:title><jats:p>South African National Blood Service (SANBS) blood donors are screened by self\u2010administered questionnaire, semi\u2010structured interview, and individual donation nucleic acid amplification testing for HIV. Stored samples from HIV\u2010positive donations were tested for ARV and characterized as recent\/longstanding using lag avidity testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1462 HIV\u2010positive donations in 2017, 1250 had plasma availability for testing of which 122 (9.8%) tested positive for ARV. Undisclosed ARV use did not differ by gender (<jats:italic>p<\/jats:italic>\u00a0=\u2009.205) or ethnicity (<jats:italic>p<\/jats:italic>\u00a0=\u2009.505) but did differ by age category (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.0001), donor (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.0001), clinic type (<jats:italic>p<\/jats:italic>\u00a0=\u2009.012), home province (<jats:italic>p<\/jats:italic>\u00a0=\u2009.01), and recency (<jats:italic>p<\/jats:italic>\u00a0&lt;\u2009.0001). Multivariable logistic regression found older age (adjusted odds ratio [aOR] 3.73, 95% confidence interval [CI] 1.98\u20137.04 for donors &gt;40 compared with those &lt;21), first\u2010time donation (aOR 5.24; 95% CI 2.48\u201311.11), and donation in a high HIV\u2010prevalence province (aOR 9.10; 95% CI 2.70\u201330.72) compared with Northern Rural provinces to be independently associated with undisclosed ARV use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Almost 1 in 10 HIV\u2010positive blood donors neglected to disclose their HIV status and ARV use. Demographic characteristics of donors with undisclosed ARV use differed from those noted in other study. Underlying motivations for nondisclosure among blood donors remain unclear and may differ from those in other populations with significant undisclosed ARV use.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16571","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T18:19:50Z","timestamp":1625509190000},"page":"2392-2400","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Undisclosed HIV status and antiretroviral therapy use among South African blood donors"],"prefix":"10.1111","volume":"61","author":[{"given":"Karin","family":"van den Berg","sequence":"first","affiliation":[{"name":"Medical Division, Translational Research Department South African National Blood Service  Roodepoort South Africa"},{"name":"Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences University of Cape Town  Cape Town South Africa"},{"name":"Division of Clinical Haematology University of the Free State  Bloemfontein South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4383-4526","authenticated-orcid":false,"given":"Marion","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Division of Clinical Haematology University of the Free State  Bloemfontein South Africa"},{"name":"Operations Testing Department, Operations Division South African National Blood Service  Roodepoort South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon J.","family":"Louw","sequence":"additional","affiliation":[{"name":"Division of Clinical Haematology, Department of Medicine, Faculty of Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward L.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Departments of Laboratory Medicine and Epidemiology\/Biostatistics University of California, San Francisco  San Francisco California USA"},{"name":"Vitalant Research Institute  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Maartens","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Medicine University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2019.v109i7.13859"},{"key":"e_1_2_9_3_1","volume-title":"South African haemovigilance report","author":"South African National Blood Service","year":"2018"},{"key":"e_1_2_9_4_1","volume-title":"Availability, safety and quality of blood products","author":"World Health Organisation","year":"2010"},{"key":"e_1_2_9_5_1","volume-title":"Global AIDS update 2016","author":"Joint United Nations Programme on HIV\/AIDS (UNAIDS), (WHO) WHO","year":"2016"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/trf.14959"},{"key":"e_1_2_9_7_1","volume-title":"Mid\u2010year population estimates, 2020","author":"Statistics South Africa","year":"2020"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2009.02110.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiz145"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1086\/500215"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciw365"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01922-18"},{"key":"e_1_2_9_13_1","unstructured":"Sedia Biosciences Corporation.Sedia\u00ae HIV\u20101 LAg\u2010Avidity EIA (for serum or plasma specimens).Portland OR:Sedia Biosciences Corporation;2014."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajhivmed.v18i1.776"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000012"},{"key":"e_1_2_9_16_1","volume-title":"South African National HIV Survey, 2017","author":"Simbayi L","year":"2019"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001227"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit390"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000002147"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.5293"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001862"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001706"},{"key":"e_1_2_9_23_1","unstructured":"DietrichC MoyoS Briggs\u2010HagenM Ochieng A Porter S Marinda E Rehle T.Sensitivity and specificity of self\u2010reported ARV use in a South African national household survey. 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