Blood donor deferral for men who have sex with men: still room to move

Abstract

A 12-month deferral for gay and bisexual men exceeds what is required to maintain blood safety. This disparity potentially causes social harm without any additional benefit to public health. Reducing the deferral period to 3 months will not increase health risk to recipients and may have the social benefit of increasing inclusiveness.

Attitudes and willingness to donate blood among gay and bisexual men in Australia

“…By 1985, Australia had implemented universal testing for human immunodeficiency virus (HIV) in all blood donations. Questions on sexual activity were included during donor selection screening, indefinitely excluding (i.e., deferring) all men who reported any history of sex with another man from donating blood …”

“…However, blood policies should evolve in pace with scientific developments. The attitudes of communities such as gay men toward blood donor deferral policies are therefore also important, since perceptions that policies are unfair or unscientific can erode cooperation and compliance . Unnecessarily conservative eligibility policies also prevent blood donation from communities who wish to donate, limiting access to much needed blood products, including rare blood types.…”

“…In 2012, the Australian Red Cross Lifeblood (hereafter Lifeblood) initiated an independently chaired review of sexual activity–based deferral policies . The recommendations of the committee included a proposal to change the 12‐month deferral for men who have sex with men to a 6‐month deferral since last sexual contact.…”

“…The recommendations of the committee included a proposal to change the 12‐month deferral for men who have sex with men to a 6‐month deferral since last sexual contact. This recommendation was not approved by the Australian blood sector regulator (Therapeutic Goods Administration), primarily on the basis that such a change would not significantly increase the blood supply and that, at the time of the review, cases of newly diagnosed HIV among MSM were increasing …”

Do high‐risk behavior deferrals work? How to make it better?

“…Second, regional TTI epidemiological features are important to consider. For example, in some countries, such as Australia, where there is a highly MSM‐focused epidemiology of the HIV epidemic, using ungendered high‐risk behavioral criteria for donor selection may overestimate the risk in heterosexual donors and result in unnecessary deferrals . This is in contrast to Brazil, where heterosexual transmission of HIV also plays a significant role in the HIV epidemic and accounts for more than 60% of new HIV cases in the general population .…”