The heterogeneity of non-donors: A latent class analysis of demographic, social connection and sexual lifestyle of men who have sex with men who have never donated blood.

BACKGROUND: As blood donation policies become more inclusive and men who have sex with men (MSM) become eligible, understanding non-donors will become increasingly important. MSM non-donors are often treated as a homogenous group, despite growing evidence that there is no universal non-donor profile. This oversimplification may obscure variation in behavioural risk parameters and does not optimally inform the development of effective recruitment or retention strategies. We aim to address this gap by identifying subgroups of MSM non-donors and examining how their behaviours and attitudinal profiles may inform targeted recruitment efforts. METHODS: We used data from a cross-sectional voluntary online community survey of HIV risk behaviour and blood donation history. Latent Class Analysis (LCA) was used to identify subgroups of MSM who had never donated blood. Attitudes towards the MSM deferral policy, blood service and how civically important they view blood donation were compared across groups. RESULTS: 1339/3838 participants were non-donors. LCA identified four distinct subgroups of non-donors: 'Sexually, but not socially engaged' (16.1%), 'Young and single' (22.1%), 'Monogamous' (28.1%) and 'Socially and sexually engaged' (33.5%). These groups differed in their demographic make-up, social connections, sexual lifestyles and in their attitudes towards blood donation. CONCLUSION: This study highlights the heterogeneity within MSM non-donors. We propose that the 'Young and single' and 'Monogamous' MSM might be more readily recruited due to their favourable eligibility and attitudinal profile. Furthermore, there is potential need for tailored outreach to maximise future donor engagement and a safe blood supply under individualised donor assessment approaches.