By the end of 2022, men who have sex with men (MSM) will no longer automatically be assumed to have “high-risk sexual behaviours” when seeking to donate blood. Canadian Blood Services’ submission to eliminate the three-month blanket donor deferral period for men who have sex with men was authorized by Health Canada on April 28.
Their new policy, which they plan to implement by September 30, will see all sexually active blood and plasma donors given the same screening questionnaire about their sexual behaviour.
Any potential donor that reports having engaged in designated “high-risk sexual activities” within the past three months, regardless of their gender identity and sexuality, will have their donation deferred for another three months in which they must not engage in said activities.
Men’s health advocacy groups and LGBTQIA+ organizations have long argued that Health Canada’s blanket ban on blood donation by gay men, which was instituted in 1992 at the height of the HIV crisis, was always discriminatory.
Evan Matchett-Wong, program director for BC’s Health Initiative for Men (HIM), said in a statement to the Times Chronicle that “as a grassroots organization dedicated to strengthening health and well-being in communities of gay, bisexual men, and gender diverse people, we value evidence-informed health decisions.”
Thus, HIM “welcomes the decision to enact a gender-neutral, behaviour-based approach instead of the outdated ban on men who have sex with men” and they hope that more work will be done by government agencies “to alleviate the stigmatization faced by gay and bisexual men and gender diverse people that this blood ban contributed to.”
Matchett-Wong also hopes that advancements in HIV treatment and viral load suppression will lead Heath Canada to open up blood donor eligibility in the future.
“Currently many gay and bisexual men will still not be able to donate blood although they are unlikely to acquire HIV being on PrEP (pre-exposure prophylaxis for HIV), or have a partner living with HIV, but with a suppressed and/or undetectable viral load.”
Tests to screen blood donations for HIV were put into use as early as 1985 in the United States, and highly sensitive antigen tests have been used since 1995 to reduce false positives in the donation supply.
In a statement on their website, Dr. Graham Sher, CEO of Canadian Blood Services, credited their successful submission to “numerous 2SLGBTQIA+ and other stakeholder groups, researchers and Canadian Blood Services employees, who “contributed countless hours to this effort over the years.”
“Today’s approval from Health Canada is the result of over a decade of work to make participation in Canada’s Lifeline as inclusive as possible, without compromising the safety of biological products or the security of supply.”
However, he also acknowledged that “while this eligibility change represents a significant step on our continual journey to build a more diverse, equitable and inclusive national transfusion and transplantation system, we still have considerable work to do to build trust and repair relationships with 2SLGBTQIA+ communities.”
Prime Minister Justin Trudeau said in a news conference on the day of the announcement that he felt the ban should have been lifted 10 to 15 years ago, but his Liberal government was delayed by a lack of research on the part of previous governments.
Health Canada did chip away at what was once a blanket ban on blood donation by gay men during that time, reducing their abstinence-dependent deferral period to five years, then one year, and finally the current restriction of three months.
“The current approach was discriminatory and wrong,” said Trudeau. “This is a significant milestone for moving forward on both the safety of our blood supply, but also, non-discriminatory blood practices.”
Liberal MP Rob Oliphant, who lost his first partner to AIDS 30 years ago, also celebrated the change in his remarks to the press: “They pushed, we pushed, and it’s been heard. Canadians can have confidence in their blood system and gay men or men who have sex with men can now donate blood and save another person’s life. What a gift that is.”
The Canadian Hemophilia Society (CHS), however, released a statement by president Wendy Quinn expressing their disappointment that Health Canada “has not followed our advice regarding the changes to donor selection criteria for blood and plasma donation.”
“We believe this change will result in an increased risk, albeit very small, of transmitting blood-borne pathogens such as HIV to recipients of fresh components,” said Quinn.
“The CHS would have preferred that Health Canada introduce these new donor selection criteria in two stages: first for plasma donors and then, at a later date if data support, to donors of fresh components.”
The statement called on Health Canada and Canadian Blood Services to indicate what monitoring threshold would lead them to reverse the decision, as well as its planned compensation procedure for recipients that are infected with blood-borne pathogens.
Quinn did not explain the reasoning behind the society’s concern nor offer any scientific precedent, only asserting that “the current deferral policy … has proven to be safe.”
