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. 2025 Aug;65(8):1460-1471.
doi: 10.1111/trf.18313. Epub 2025 Jun 23.

Factors associated with active syphilis infection in US blood donors

Vivian I Avelino-Silva  1   2 , Roberta L Bruhn  1   3 , Zhanna Kaidarova  1 , Daniel Hindes  1 , Edward Notari  4 , Donna Burke  4 , Debra A Kessler  5 , Carlos Delvalle  5 , Rita Reik  6 , Vilson Ortiz  6 , Sheri Fallon  7 , Marion C Lanteri  3   8 , Susan L Stramer  9 , Benyam Hailu  10 , James J Berger  11 , Hong Yang  12 , Barbee Whitaker  12 , Brian Custer  1   3 ; Transfusion‐Transmissible Infections Monitoring System (TTIMS)
Collaborators, Affiliations

Factors associated with active syphilis infection in US blood donors

Vivian I Avelino-Silva et al. Transfusion. 2025 Aug.

Abstract

Background: Syphilis is increasing globally, with limited monitoring of risk factors in asymptomatic, low-risk populations. Here, we investigate contemporary demographic and behavioral risk factors associated with active syphilis infection (ASI) in US blood donors.

Study design and methods: Beginning with donations in October 2020, four US blood centers implemented standardized risk factor interviews for ASI in blood donors as part of a larger case-control study. Logistic regression models were used to assess ASI associations with demographics and behaviors within 12 months before donation. A conceptual framework explored causal ASI pathways.

Results: Responses were obtained from 369 ASI cases and 868 controls; from all eligible cases, the enrollment rate was 16%. Risk factors in the multivariable-adjusted model included age between 40 and 54 years old (compared to 55+), Black race (compared to White), lower income, single/never married and separated/divorced or widowed status (compared to married or living together), first-time donation, gay/homosexual sexual orientation, having ≥2 male or ≥2 female sexual partners in the 12 months before donation, and a history of sexually transmitted infection. The conceptual risk framework suggests that important determinants of ASI include complex variables and mediators that may have not been fully captured by the questionnaire and regression analyses.

Discussion: Although not fully defining causal relationships with ASI, our findings establish a baseline for factors associated with ASI among US blood donors, which can be used to refine the donor history questionnaire following the implementation of individual risk assessment and further surveillance efforts.

Keywords: blood donation; blood safety; risk factors; sexual behavior; syphilis.

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Conflict of interest statement

The authors have disclosed no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Selection of participants included in the study.
FIGURE 2
FIGURE 2
Multivariable model addressing factors associated with ASI.
FIGURE 3
FIGURE 3
Conceptual causal framework for syphilis infection showing directional pathways for direct and distal factors related to the likelihood of infection.
See this image and copyright information in PMC

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References

    1. World Health Organization . The Global Health Observatory. Active syphilis in adults. [Internet]. [cited2024 Jun 13]. Available from: https://www.who.int/data/gho/data/themes/topics/indicator-groups/indicat...
    1. European Centre for Disease Prevention and Control . Syphilis annual epidemiological report 2022. [cited 2024 Jun 13]. Available from: https://www.ecdc.europa.eu/en/publications-data/syphilis-annual-epidemio...
    1. Centers for Disease Control and Prevention . Sexually transmitted infections surveillance, 2022. [Internet]. [cited 2024 Jun 13]. Available from: https://www.cdc.gov/std/statistics/2022/default.htm
    1. Peeling RW, Mabey D, Chen XS, Garcia PJ. Syphilis. Lancet. 2023;402(10398):336–346. - PubMed
    1. Kaur G, Kaur P. Syphilis testing in blood donors: an update. Blood Transfus. 2015;13(2):197–204. 10.2450/2014.0146-14 - DOI - PMC - PubMed