In the present study, blood from paid and unpaid donors was screened for the presence of HIV infection using a competitive ELISA test. None of the 8,000 unpaid donors but 4 (0.23%) of the 1,700 paid donors showed evidence of HIV infection. All of these four ELISA-positive samples were confirmed by the Western blot test. The present study indicates that HIV infection has entered the group of paid donors in the Delhi metropolitan area. Careful donor screening, discouraging use of paid donors, and stringent screening of donated units of blood has become mandatory in India to prevent HIV transmission through blood and blood products.
PIP: In Delhi, India, researchers collected sera from 1700 paid blood donors between January-February 1989 and from 8000 voluntary blood donors between September 1, 1988-February 28, 1989. Laboratory personnel screened all the sera for HIV antibodies using a competitive ELISA test. Any samples found to be reactive were tested again using the ELISA technique. Laboratory personnel determined reactivity a 2nd time in 4 samples. They confirmed that these 4 samples were positive for HIV by the Western blot test. The 4 positive samples came from paid donors (.23%), while no positives occurred in the volunteer group. Characteristics of the paid donors included male, 50% unemployed, illiterate, and median age of 28 years. 95% of the volunteers were males. Also volunteers were generally literate and educated. 3 of the 4 HIV positive donors were daily-wage unskilled laborers who went from city to city seeking employment. To sustain themselves or support their families, they would donate their blood often. All 3 have had sex with prostitutes. The 4th donor could not be found. Even though the prevalence of HIV is low among prostitutes in INdia, they are the largest risk group and prevalence is climbing. Since paid blood donors are usually transient, they can spread HIV to prostitutes of other cities as well as to recipients of their donated blood. 2 possible targets of intervention include educating the public to not accept blood from professional blood donors since their blood is not tested for HIV and educating prostitutes on methods of prevention of HIV infection.