New research published on bmj.com today supports a change to the lifetime ban on blood donations from homosexual men.
In the 1980s, blood services in many countries introduced a lifetime ban on blood donations by men who had ever had oral or anal sex with a man. Some other groups at increased risk of HIV (drug users) are allowed to donate blood after a year's deferral since last risky activity under the rationale that you can stop using drugs but can't choose to stop being gay.
Since then, several countries have introduced deferral periods since last sex with a man, for example, six months in South Africa; 12 months in Australia, Sweden and Japan; and five years in New Zealand. This, along with advances in blood screening techniques and knowledge of HIV, prompted calls for the UK to revise its blood donor policy.
Researchers led by Kaye Wellings, Professor of Sexual and Reproductive Health Research at the London School of Hygiene and Tropical Medicine, set out to explore compliance with the lifetime ban and to assess the possible effects of revising this policy. The results of the study were used to inform a review of the policy by the Advisory Committee on the Safety of Blood, Tissues and Organs (SaBTO) recommendations.
Between April 2009 and June 2010, they surveyed 1,028 men in Britain reporting any male sexual contact and conducted 30 in-depth interviews with men who had and had not ever donated blood ineligibly.
Many men considered the lifetime ban to be unfair, discriminatory and lacking a clear rationale whereas a one-year deferral rule was generally seen as feasible and acceptable. 10.6% of men reported donating blood since having penetrative sex with a man, 2.5% in the past 12 months. Reasons for not complying included self categorisation as low risk, confidentiality concerns, and a misunderstanding or perceived inequity of the rule.
Others had discounted the experience that barred them from donating blood, highlighting the need to extend health information beyond men who identify as gay and bisexual, say the authors.
"Our research reveals that a small but important minority of men ineligible to donate blood under current UK rules have nevertheless done so in the past 12 months," say the authors. However, many of the reasons identified for non-compliance appear amenable to intervention.
A move to a one-year deferral, which would bring the deferral period more in line with other groups, is likely to be welcomed by most men who have sex with men. Improvements to communication and confidentiality, and a clear explanation of the rationale, will be essential. Careful monitoring of its effects will also be needed, they conclude.