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U.S. Department of Health and Human Services

Vaccines, Blood & Biologics

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PPTA Risk Poster II, v1.2

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This document is one component of the full-length and abbreviated PPTA donor history questionnaire documents for source plasma organizations that do not use an approved test for antibodies to HIV that detect HIV-1 Group O. The full-length and abbreviated PPTA donor history questionnaire documents must be used collectively.
 

Do NOT donate PLASMA, whole blood or platelets if you…

Were born in, lived in, or travelled to any of the following African countries or had sexual contact with anyone who was born or lived in:

Cameroon, Central African Republic, Chad, Congo, Equatorial Guinea, Gabon, Niger, Nigeria, Senegal, Togo, Zambia, Benin or Kenya

Sexual contact means any of the following (whether or not a condom or barrier device was used):

  • Vaginal intercourse (contact between penis and vagina) 
  • Oral sex (mouth or tongue on someone’s vagina, penis, or anus)
  • Anal intercourse (contact between penis and anus).

Do NOT donate PLASMA, whole blood or platelets if you…

Ever

  • Had HIV/AIDS (see list of symptoms below)
  • Had a positive test for HIV (AIDS virus)
  • Had a positive test for hepatitis
  • Had hepatitis (after your 11th birthday)
  • Used needles to take drugs, steroids or anything not prescribed by your doctor
  • Used clotting factor concentrates for a bleeding disorder
  • Had a transplant such as organ or bone marrow

Since 1977

  • Received money, drugs or other payment for sex
  • (Male donors ) Had sexual contact with another male, even once

In the last 12 months

  • Have given money, drugs or other payment for sex
  • Have been treated for
    • syphilis
    • gonorrhea
  •  “Lived with” a person who has hepatitis (lived at same residence and shared kitchen and bathroom)
  • Had a blood transfusion or received other blood products
  • Received during surgery bone, tissue or skin
  • Had an accidental needle-stick involving exposure to blood
  • Had contact with someone else’s blood
  • Had a tattoo applied
  • Had ear or body piercing
  • Have been in  
    • juvenile detention       |
    • lock up                         | For more than 
    • jail                               |   72 hours
    • prison                          |

Had sexual contact with anyone who:

  • Has HIV/AIDS (see list of symptoms below)
  • Has a positive test for HIV (AIDS virus)
  • Has hepatitis
  • Used needles to take drugs, steroids or anything not prescribed by their doctor
  • Has hemophilia or has used clotting factor concentrates
  • (Female donors) Had sexual contact with a male who has had sexual contact with another male, even once

Signs or symptoms of HIV/AIDS:

  • Unexplained weight loss
  • Night sweats
  • Blue or purple spots in your mouth or skin
  • White spots or unusual sores in your mouth
  • Swollen lymph nodes for more than one month
  • Fever of more than100.5 oF for more than 10 days
  • Cough that won’t go away
  • Shortness of breath
  • Diarrhea that won’t go away

 

September 2012, v1.2

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