The high risk of transfusion-transmitted HIV infection is partially due to inadequate deferral of potential blood donors because of inappropriate risk behavior questionnaires. This is unfortunate because pre-donation medical screening is the least expensive and one of the most effective strategies for the blood-borne HIV infection in limited resources countries. Objectives: The overarching aim of this project is to improve the risk factor deferral process by implementing a new donor history questionnaire that will identify HIV infected individuals and prevent blood-borne HIV transmission in Cameroon. Methods: We propose to validate an African Specific donor heath Questionnaire (ASDHQ) and its scoring system developed during a previous HIV case-control study by the PI in Cameroon. This study will evaluate the performance of the new ASDHQ using a cross-sectional design comparing the HIV status of accepted versus deferred donors. All consenting volunteer or replacement blood donor aged between 18 and 65, in good general health, with an adequate hemoglobin level will be enrolled in the study. The ASDHQ will be administered to all donor candidates in 3 Cameroonian blood services independently of the existing questionnaire. The new ASDHQ and its scoring system for identification of HIV positive donors were constructed using data from the previous case-control study and principal component analysis (data reduction) and include 16 questions that can be administered within 15 minutes. HIV status of accepted donors will be obtained from routine blood center HIV testing and the HIV status of deferred donors will be tested as part of the study on a blood sample obtained after informed consent. Expected results: We hypothesize that the ASDHQ questionnaire will result in a reduction in the rate of risk deferrals compared to historical data, higher HIV prevalence in deferred versus accepted donors and reduction of HIV prevalence in accepted donors.