Blood donor deferral for men who have sex with men: the Blood Donation Rules Opinion Study (Blood DROPS)

Abstract

Background In the US, any man who discloses having had sex with another man (MSM) even once since 1977 is currently deferred from donating blood. A study was conducted to assess noncompliance with the policy at four geographically dispersed blood centers. Methods Male donors 18+ years of age with email addresses were randomly selected and invited to complete a confidential online survey between Aug – Oct 2013. No additional recruitment emails were sent. Survey content included: demographics, sexual history, donation history, compliance with the policy, and opinions about current and modified policies. Results Response rate was 11.5% overall but varied by center (6.3 to 21.7%). Of 3183 completed surveys, 2.6% of respondents (95% Confidence Interval 2.1 – 3.2%) reported donation after male-male sex. Noncompliance was not statistically different among the centers [p=0.1], but was related to age with 5.7%, 4.6%, 2.5%, and 1.0% of donors 18-24, 25-34, 35-54, and 50+ years of age, respectively, reporting noncompliance [p<0.001]. Of all respondents, 6.8% reported ≥6 female sex partners and 0.3% reported ≥6 male sex partners in the last five years. Opinions about the current MSM policy were mixed with noncomplying donors more supportive of change than complying donors. About half of noncompliers indicated they would adhere to a 1-year deferral policy. Conclusion Noncompliance with the MSM policy is evident and may be increasing compared to earlier data. It is expected that any change from the current policy will require close monitoring to determine whether it affects residual risk of HIV in the US blood supply.

Reasons for noncompliance in donor risk reporting regarding male‐to‐male sex

“…The percentage for self-reported noncompliance are in line with percentages (0.8%-3.9%) found in other compliance studies under permanent deferral policies. 18,19 This study showed discrepancies in reporting maleto-male sex before and after a definition was given, indicating that for some donors the definition of male-tomale sex as applied by the Blood Service is unclear. This could partly be explained because educational materials for Dutch donors do not contain information about the definitions of (male-to-male) sex.…”

“…15 Rates of noncompliance found for MSM vary from 0.23% in Australia 16 (12-month deferral) to 0.8% to 1.4% in Canada 17 (currently a 5-year deferral, permanent exclusion during study period), 2.8% in the United States 18 (permanent exclusion), and from 1.9% to 3.9% in another recently published study in the United States. 19 In 2012 the Dutch government has passed a motion to adjust the donor policy regarding MSM. In the context of this motion, Sanquin Blood Supply has been requested to examine the possibilities of a potential adjustment of donor selection criteria.…”

The beliefs and willingness of men who have sex with men to comply with a one‐year blood donation deferral policy: a cross‐sectional study

“…In a study of American MSM blood donors before the lifetime deferral period was lifted, 65% admitted that they intended to continue donating blood regardless if the lifetime deferral policy was or was not amended. 19 There are several limitations of our study. Our study only targeted men on social media sites, so our results may not be generalizable to all men in the MSM community.…”

Blood donor deferral: time for change? An evidence-based analysis

“…However, many jurisdictions have sought to reexamine their policy on deferral of MSM guided by model-based analysis and not based on evidence. 80 Replacing the precautionary principle by an evidencebased approach would thus imply certain challenges. If we do not want to replace the precautionary principle (based on science, be it on weak evidence) by a mere clash of preferences (in which advocacy determines the outcome in the absence of any scientific evidence), more and better primary research and evidence-based analyses are needed.…”