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HIV and the Blood Supply: An Analysis of Crisis Decisionmaking
an infectious agent transmitted sexually or through exposure to blood or blood products (CDC, MMWR, January 7, 1983).
By January 1983, epidemiological evidence from CDC's investigations strongly suggested that blood and blood products transmitted AIDS and that the disease could be transmitted through intimate sexual contact. The evidence that the AIDS agent was blood-borne was the result of two findings. First, AIDS was occurring in transfusion recipients who did not belong to any known high-risk group and in individuals with hemophilia who had received AHF concentrate. Second, the epidemiological patterns of AIDS was similar to that of hepatitis B, another blood-borne disease.
IMMEDIATE RESPONSES TO EVIDENCE OF BLOOD-BORNE AIDS TRANSMISSION
In the first months of 1983, the epidemiologic evidence that the AIDS agent was blood-borne led to official meetings and public and private decisions that set the pattern of the blood industry's response to AIDS, starting with a public meeting convened by the CDC in Atlanta on January 4, 1983. Later that month, the leading blood bank organizations and, separately, the National Hemophilia Foundation (NHF) and the plasma fractionation industry issued statements. In March 1983, the Assistant Secretary for Health promulgated the first official PHS recommendations for preventing AIDS, and the FDA codified safe practices for plasma collection.
The CDC's Public Meeting
The purpose of the public meeting on January 4, 1983, was to identify opportunities to prevent AIDS. The CDC's objectives for the meeting were to tell the blood services community about the evidence they had gathered; to enlist the help of other PHS agencies, especially the FDA; and to formulate recommendations for the prevention of AIDS. According to data presented by the CDC, the manifestations of AIDS appeared 4–17 months after transmission of infection (Foege 1983).
The meeting produced a great deal of debate but no consensus on specific action (Bove, Curran, Evatt, Francis, Foege, McAuley, Sandler interviews). Donald Francis, assistant director for medical science of the Division of Virology at the CDC, recommended that the blood banks question donors