called upon blood banks to prepare to handle increased requests for cryoprecipitate (AABB, et al. 1983).
During the early months of 1983, prior to any PHS recommendations, many blood banks added to their donor questionnaires inquiries about symptoms associated with AIDS, such as presence of enlarged lymph nodes, night sweats, and weight loss. On January 14, 1983, the Medical and Scientific Advisory Council (MASAC) of the National Hemophilia Foundation (NHF) recommended that the plasma product industry take steps to eliminate high-risk donors (e.g., IV drug users, homosexuals) from plasma donation. The plasma fractionators began questioning donors and excluding high-risk donors in the first months of 1983, but did not implement surrogate testing (NHF 1983).
The American Blood Resources Association (ABRA), a trade organization for the manufacturers of blood products, issued its recommendations on donor deferral on January 28, 1983. One of the three focal areas of ABRA's recommendations was surrogate laboratory testing. At the time, ABRA recommended against large scale surrogate testing pending an assessment of the issues underlying the implementation of surrogate testing, specifically determining "the adequate availability of testing reagents and equipment of any of the several possible tests under consideration, their economic and logistical impact upon the plasma supply network, the efficacy of the test to exclude high-risk individuals, and other potential consequences to plasma products resulting from the imposition of additional testing requirements" (ABRA 1983).
The PHS promulgated its first official recommendations on the prevention of HIV on March 4, 1983. Individuals at high risk for AIDS were required to refrain from donating plasma and/or blood. Persons at increased risk of AIDS included the following:
persons with symptoms and signs suggestive of AIDS,
sexual partners of AIDS patients,
sexually active homosexual or bisexual men with multiple partners,
Haitian entrants to the United States,
present or past abusers of IV drugs,
patients with hemophilia, and
sexual partners of individuals at increased risk for AIDS.
Prior to the issuance of these recommendations, donor selection policies (AABB 1982 Standards for Transfusion Services) for both the collection of whole blood and plasma already sought to identify people in the following high-risk groups as being at increased risk of infectious diseases: drug abusers, persons with residence in or recent travel to Haiti, and those with a history of recent treatment with blood products. The PHS made the following new recommendations for preventing transmission of AIDS through blood and blood products: