There’s no such thing as gay blood, and gay men shouldn’t be discriminated against when they try to donate blood. That’s the message behind a national social media campaign by the Canadian Centre for Diversity and Inclusion that launched this week in an effort to convince Canadian Blood Services (and its Québec counterpart, Héma-Québec) to remove the five-year ban from donating blood for men who’ve had sex with other men.
The ban dates back to mid-1980s when thousands of Canadians were infected through tainted blood products before the introduction of HIV testing. The Canadian Red Cross Society, who was responsible for Canada’s blood supply at the time, introduced donor eligibility criteria that singled out gay men.
“The deferral came into place in the 1980s at the very height of the HIV/AIDS epidemic,” says CCDI founder and CEO Michael Bach. “They were reacting to the tainted blood scandal, and they had good reason [for the ban].
“But that was 30 years ago. The science has changed.”
In the 1980s, it could take three to six months after an infection for HIV/AIDS to show up in a test, and the turnaround time on the tests themselves were three to four weeks.
“Today you can buy an over-the-counter HIV test and get results in 15 minutes,” says Bach.
Initially, all men who had gay sex even once since 1977 were excluded from donating blood. In 2013, CBS received approval from Health Canada to allow blood donations from men who had gay sex, as long as it had been at least five years since their last sexual encounter with another man.
However, that still excludes nearly all gay men, says Bach. He would like to the deferral removed entirely – as is currently the case in countries like Spain, Portugal, South Korea, Russia, Italy, Chile, and Argentina – and more rigorous testing conducted.
“If I was a heterosexual man, I could go out tonight and have unprotected sex with a dozen random women and be OK to donate blood tomorrow,” says Bach. “But if I was in a monogamous relationship with another man, I wouldn’t be allowed.”
The donor health assessment questionnaire used to screen donors unfairly discriminates against gay men, he contends, and is ultimately doing the Canadian blood supply a disservice by preventing donations.
CCDI’s online campaign features a web video that states, “There’s no such thing as gay blood,” while a Twitter campaign urges CBS to #EndTheBan. Bach is urging people to sign CCDI’s petition at Change.org to help put pressure on CBS to change their policy.
Dr. Mindy Goldman is the executive medical director for Canadian Blood Services, and says the organization is actively working to reduce the deferral period for sexually active gay men. However, she says CBS must demonstrate to Health Canada that it is not introducing undue risk into the blood supply, and in the wake of the tainted blood scandal, the scientific burden of proof is extremely high.
In the early 1980s, 2,000 Canadians were infected with HIV from tainted blood products, while anywhere from 30,000 to 60,000 are believed to have contracted Hepatitis C.
Currently, sexually active gay men are at the highest risk of any population group in Canada for contracting HIV, close to 50 times that of the general population.
Goldman said there are several reasons why abolishing the deferral period altogether would be problematic.
While all blood donated to CBS is tested for HIV/AIDS – as well as hepatitis B and C, syphilis, and a number of other infectious diseases – the tests are not 100 per cent accurate. The nucleic acid test used to screen HIV is only accurate two weeks after infection, so a recently infected person’s blood might slip past the screening process. Additionally, not all HIV strains are picked up by the nucleic acid test, and the secondary antibody test is only accurate more than a month after infection.
The questionnaire helps reduce blood from high-risk groups from entering the system, reducing the likelihood of a recipient receiving tainted blood, said Goldman.
However, there’s nothing stopping a donor from lying on the questionnaire, and Bach believes that is putting the blood supply at risk.
“[CBS] says it’s about the safety of the blood supply, but they are relying on the honour system to determine if a person’s blood is acceptable,” says Bach. “That makes me call into question the testing process.”
In addition to excluding sexually active gay men from donating blood, the donor health assessment questionnaire also excludes anyone who has spent more than three months in the UK or France between 1980 and 1996, anyone who has spent more than five years in Europe during that span, or anyone who has visited areas where malaria is known to be present. Additionally, anyone who has recently had a tattoo, body piercing, or electrolysis must wait at least six months before being eligible to donate blood.
Goldman admitted there are limitations to the current questionnaire.
“It’s not an individual risk assessment,” she said. “It lumps people into group and takes only a couple minutes to complete.”
While the questionnaire doesn’t differentiate between gay men in monogamous relationships and those who are having unprotected sex, neither does the questionnaire ask those who have spent time in the UK if they were vegan at the time, which would have prevented exposure to mad cow disease.
In all, the questionnaire excludes about 15 per cent of the population from donating blood. But before CBS can abandon the questionnaire, it must prove that doing so doesn’t present a risk to the blood supply.
“It’s a bit of a paradigm shift [to do away with the questionnaire altogether],” Goldman said. “It’s hard to shift to a different approach without the data there.”
CBS is currently reviewing its five-year deferral period, and has established a working group that includes members of the LGBTQ community to help develop further policy changes and collect data.
“We saw [the five-year deferral] as the first step,” said Goldman. “We’re now two years out and we’re hoping to reduce the deferral to one year.”
That would bring CBS in line with blood donation regulations in Australia, Japan, and the UK, which have a one-year deferral period for sexually active gay men.
“But we have to prove this step is safe before we can take the next one,” said Goldman.
Goldman said there are still options to donate blood for those excluded by the donor health assessment questionnaire. As long as a donor is disease free, they can donate blood for scientific purposes through the Canadian Blood Services Network Centre for Applied Development (netCAD), or through the OneMatch Stem Cell and Marrow Network.
