Abstract

PIP: In 1993, Zimbabwe's blood service revised its notification system to protect the confidentiality of blood donors found to be positive for human immunodeficiency virus (HIV) or another sexually transmitted disease (STD). In the past, such donors were referred back to their physicians, many of whom were unable or unwilling to discuss STDs; other donors had no personal physician. Now, donors who test positive for HIV, syphilis, or gonorrhea are informed by mail they have an unspecified infection and offered follow-up and counseling services from an organization or doctor (who also receive letters) of their choice. However, some nongovernmental organizations to which infected donors are referred report that less than half present for counseling. Common reasons include a reluctance to go to a site perceived as an AIDS center, fears of an HIV diagnosis, concerns about encountering a counselor they know personally, difficulties related to travel or limited clinic hours, and problems with the postal service. Still in need of clarification is Zimbabwe's policy toward young blood donors. Many countries seek out school-age donors because of their presumed lower risk of infection; however, when these young people test positive, ethical dilemmas emerge about parental notification and consent for counseling. Finally, to reduce the misuse of blood donation services for HIV testing, measures are needed to improve the availability of HIV screening.