Blood donation restrictions on men who have sex with men
According to the 2015 surveillance report by Canadian Blood Services, the risk of HIV transfusion-transmitted infection was fairly low: in 1 in 21.4 million donations.
[3] Proponents of the lifetime restriction defend it because of the asserted risk of false negative test results[4] and because the MSM population in developed countries tends to have a higher prevalence of HIV/AIDS infection.
[6] NHS has said that there is currently a limited amount of data on effective ways of conducting such risk assessments and that the initial steps of scoping, evidence gathering and testing will potentially take up to two years to complete.
[11][12] Most national standards require direct questioning regarding a man's sexual history, but the length of deferral varies.
[169] In December 2020, it was announced that the UK would move to a personalised sexual behaviour risk assessment and scrap the deferral period specific to MSM.
On 27 July 2015, Tomás Heneghan, a 23-year-old University of Limerick student, and journalist from Galway began a legal challenge in the High Court against the permanent deferral imposed on MSM donors.
[171][172] He argued that the questionnaire and interview process used by the IBTS does not adequately assess the risk of disease transmission posed by his donation.
He said that both failed to consider the length of time between a donor's last sexual experience and the end of a "window period" in which infections are sometimes not detected.
Heneghan's previous sexual activity posed no risk of infection, according to HSE-approved advice and he said the service had no evidence upon which it could legitimately impose a life-long ban on him donating blood.
[173] On 26 July 2016, Tomás Heneghan dropped his High Court challenge against the service as an end to the lifetime deferral on MSM blood donors had been announced in the interim.
[177][178][179][180] On 20 May 2019, Heneghan (27) initiated a fresh legal challenge in the High Court against the blanket deferral on men who had had oral or anal sex with another man in the previous 12-month period.
In July 2019, a gay man in Ireland filed two formal complaints with the European Commission against the Department of Health and the Irish Blood Transfusion Service, and the Northern Ireland Blood Transfusion Service (the only part of the United Kingdom to maintain a 12-month deferral policy for MSM) over the MSM one-year deferral policy.
The UK interprets the directive to include all forms of homosexual sex as falling within 2.2.2 of Annex III to the directive "Persons whose behaviour or activity places them at risk of acquiring infectious diseases that may be transmitted by blood", requiring a deferral based on the window period for the diseases involved, and sets this at 12 months, despite the Annex suggesting 6 months for risk of exposure to hepatitis B. Hélder Trindade, President of the Portuguese Institute of Blood and Transplantation (IPST), stated in 2015 that sexually abstinent homosexuals may give blood, but that MSM is definitely seen as a risk factor.
[187] On the 28th of November 2022, the Irish Blood Transfusion Service introduced Individual Donor Risk Assessments and removed sexuality from the eligibility criteria.
[194] In the United States, the Food and Drug Administration (FDA) issues non-binding guidance for deferral of blood donations, though they are universally followed.
[10] Australia implemented a 12-month deferral in 1999; a comparison of confirmed HIV positive blood donations before and after the change did not see a statistically significant difference.
[11] The Australian Red Cross Blood Service pushed to have the deferral period lowered from twelve to six months, however it was rejected by the Therapeutic Goods Administration (TGA) in 2014.
Blood services commonly justify their bans against MSM due to the marginal increase in the risk for transfusion-transmitted HIV.
[220] Other groups with similar restrictions, or complete prohibition to donate blood, due to increased or possible risk for certain infectious diseases include intravenous drug users, recipients of animal organs or tissues, and those who have traveled or lived abroad in certain countries.
[221] In the 1980s, when the HIV/AIDS epidemic outbreak occurred, there was a high prevalence of the disease in MSM and no reliable tests for the virus, which justified blanket bans on blood donations from high-risk groups.
[189] Screening out those at high risk of blood borne diseases, including MSM, reduces the potential frequency and impact of such incidents.
Blood shortages are common, and advocates for change to the policies point out that excluding healthy donors only makes the problem worse.
In fact, advocates for change in other countries note that the ban encompasses all same-sex sexual contact, even if the partner's HIV status is shown beyond doubt to be negative.
Advocates for change point out that a promiscuous straight male is a higher-risk donor than a gay or bisexual man in a monogamous relationship, but the former will usually be allowed to donate blood.
Furthermore, in some countries, other high-risk activities determine a temporary ban, such as sexual contact with anyone who has used needles to take drugs not prescribed by their doctor, whereas MSM donors are deferred indefinitely.
