12 month deferral period is medically unjustified
By Peter Tatchell
Huffington Post – London, UK – 1 December 2014
READ & COMMENT: http://goo.gl/UBZ3ei
The current ban on gay and bisexual men donating blood within 12 months of them last having sex is medically unjustified discrimination based on sexual orientation. It is premised on a generalisation about men who have sex with men. The government should cut the basic exclusion period to three months, dependent on the risk factors associated with each individual donor. These risk factors include not only HIV but also other sexually-transmitted infections (STIs).
Protecting the blood supply is the number one priority but ensuring blood safety does not require a rule that no gay or bisexual man can donate blood for a year since his last same-sex experience.
The 12 month deferral rule in England, Wales and Scotland is simple and easy to understand but it is unwarranted discrimination and reduces the available supply of blood donations, to the detriment of the National Health Service and patients.
The only gay and bisexual donors who should be excluded are those who have engaged in risky, unprotected sexual behaviour and who’s HIV, hepatitis and other STI status cannot be accurately determined because of the delay between the date of infection and the date when the bacteria or virus and antibodies manifest and become detectable in their blood.
But even then, a six month deferral period would be adequate. This takes into account the fact that hepatitis B antibodies can take up to six months from the date of infection to show up in a donor’s blood. Hepatitis A may take six weeks to become detectable and HIV and hepatitis C three months. Most other STIs show up in the blood within one to three months.
For men who have not participated in unsafe sex, a three month deferral after sex would be sufficient, providing they have been vaccinated against hepatitis B at least six months before giving blood and they test negative at the time of blood donation.
Bizarrely, the current policy of the blood service in England makes no distinction between sex with a condom and sex without one. Any oral or anal sex between men in the previous 12 months – even with a condom – is grounds for refusing a donor.
The rule states: ‘You should NOT give blood for 12 months after sex with a man (if you’re a male). Men who have had anal or oral sex with another man (with or without a condom) are deferred from blood donation for 12 months.’
This lengthy restriction is unjustified. If a condom is used correctly, it protects against the transmission and contraction of HIV. Men who use condoms every time without breakages – and who test HIV negative – should not be barred from donating blood for a whole year.
Reducing the exclusion period for blood donations from gay and bisexual men should be conditional on four policies to protect the blood supply:
The government should promote a ‘Safe Blood’ education campaign within the gay community, to ensure that no one donates blood if they are at risk of HIV and other blood-borne infections due to unsafe sexual behaviour.
There needs to be a major drive to vaccinate gay and bisexual men against hepatitis A and B, to protect their health and to prevent these infections getting into the blood supply. Men who are vaccinated and test negative for hepatitis A and B are not at risk of passing the virus into the blood stock.
The questionnaire that would-be donors have to answer should be made more detailed for men who have sex with men, in order to more accurately identify the degree of risk, if any, that their blood may pose. A few additional questions would improve donor awareness of risk factors, as well as more definitively ascertaining those men whose blood is not safe. These extra questions could include points like: Have you been vaccinated against hepatitis A and B and when?
All blood donations are already subjected to tests for hepatitis B and C and for HIV antibodies, proteins and the virus itself. The latter combination of tests identifies any new HIV infections in the previous one to three months. There is an argument that gay and bisexual men should also be tested for hepatitis A.
With these four measures, a shorter exclusion period of three months would be reasonable and not endanger the blood supply. The blood donated would be safe.
Similar criteria should, of course, apply to at risk heterosexual blood donors – not just to gay and bisexual ones.
Over to you David Cameron and Nick Clegg. It’s time for change.
NOTE: The 12 month deferral period applies in England, Wales and Scotland. Northern Ireland continues to maintain a blanket lifetime ban on blood donations from all men who’ve had oral or anal sex with another man – even with a condom and even if only once 50 years ago, which is long before the start of the HIV pandemic.