Openness about sexuality predicts deferral policy noncompliance among recent MSM (men who have sex with men) blood donors: An exploratory analysis.

Background: Blood service providers use deferral policies to reduce the risk of transfusion-transmitted infections, but policy effectiveness depends on donors' honesty in disclosing risk behaviors. Identifying specific social factors within men who have sex with men (MSM) may provide insight into noncompliance with sexual behavioral deferral criteria.

Methods: We identified a sample of 136 recent blood donors from a large behavioral surveillance survey of MSM in New Zealand. Univariate analyses were used to identify factors associated with self-reported noncompliance before a two-step hierarchical regression assessed whether MSM-related social factors added to the prediction of noncompliance, compared to only considering background characteristics.

Results: Incorporating the MSM-related social factors significantly enhanced the model fit, explaining 23.2% additional variance in noncompliance (Nagelkerke R² = 0.331, p = .002). Only MSM who were more open about their sexuality had increased odds of noncompliance (Odds ratio 5.25, 95% Confidence Interval 1.78-15.48, p = .003). Full-time employment remained a predictor of lower noncompliance in the final model (OR 0.19, 95% CI 0.05-0.69, p = .012).

Conclusion: This exploratory evidence suggests that blood service providers should consider the broader social context, particularly openness about sexuality, in understanding noncompliance with time-based sexual behavior donor deferral criteria. This "outness" in MSM donors likely reflects confidence in making disclosure decisions based on their perceived HIV risk, challenging the notion that noncompliance necessarily arises from discomfort or lack of knowledge about policies. Future research should explore the gap between perceived risk and policy understanding to better address MSM donors' complex decision-making processes.