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Transfusion-transmitted infections remain a grave concern for blood transfusion services. Thus, our aim was to determine the seroprevalence of human immunodeficiency virus (HIV) infection among Indian blood donors (BDs) and its trend over the past few decades. We searched PubMed and Indmed for studies containing data on HIV seroprevalence among Indian BDs published from January 1989 to December 2017. Pooled HIV seroprevalence, subgroup analysis, and trend of HIV seroprevalence depending upon the year of publication were calculated. Twenty articles met the inclusion criteria. Overall pooled HIV seroprevalence among Indian BDs was 3.22 per 1000 BD (95% confidence interval [CI] 2.65–3.8). Overall pooled HIV seroprevalence was found to be higher among the replacement BD (3.24 per 1000; 95% CI 2.45–4.03) as compared to voluntary BD (1.67 per 1000; 95% CI = 1.09–2.25). Region-wise highest overall pooled HIV seroprevalence was noted among BD from West 4.33 per 1000 (95% CI 0.96–7.7) followed by South 3.49 per 1000 (95% CI 1.47–5.51), East 3.4 per 1000 (95% CI 1.71–5.08), and North 2.76 per 1000 (95% CI 2.05–3.48). A significant rise in overall pooled HIV seroprevalence was noted over the two decades (1995–2005-2.8 per 1000; 2006–2015-3.46 per 1000; I2 = 97.7%; P < 0.001). Overall pooled HIV seroprevalence rate among Indian BDs in our study was 0.32%. There is a need to perform studies that will help in recommending appropriate deferral, selection, and testing strategies in these donors.
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