In the aftermath of the horror in Orlando, there was a push from the local blood bank for donations to help the wounded. The response was overwhelming. But gay and bisexual men wanting to offer both the solidarity and practical help of a blood donation are still prohibited from doing so, if they’ve had sex in the last year. This has reignited the debate about who can or can’t donate blood, with Democratic lawmakers petitioning the Food and Drug Administration (which administers the policy of blood donation) to remove the ban.
What’s the blood donation situation in Australia?
Australia, like the US, has a 12-month deferral policy for men who have had sexual contact with other men (abbreviated in documents as “MSM”). That means a man who has had any sexual contact with another man in the past 12 months cannot give blood — regardless of whether they are in a monogamous relationship, use condoms or regularly get tested for STIs.
The UK has the same rules as Australia and US, but the Department of Health announced last week it was going to review the rules. Canada currently has a five-year deferral policy, though MPs are currently considering a review that would bring it down to 12 months.
Who administers the policy?
The policy is set by the Therapeutic Goods Administration, and is implemented by the Australian Red Cross Blood Service.
What’s the justification?
The deferral is justified by the Red Cross Blood Service as an issue of blood safety. Its information sheet regarding blood donations and male homosexual contact says the ban is not discriminatory against gay men:
“… [it] is in place for the sole purpose of protecting public health by minimising the risk of transmission of HIV and other blood-borne viruses to patients through the blood which we supply to hospitals. Men who have had sex with men within the past 12 months are at a higher risk of carrying such viruses.”
Does the deferral not breach anti-discrimination legislation?
There have been a series of court cases questioning whether the MSM policy is discriminatory. The most recent was Michael Cain v The Australian Red Cross Society. In the May 2009 case, the Tasmanian Anti-Discrimination Tribunal found the conduct of the Blood Service in deferring Cain (a gay man) as a donor was neither direct nor indirect discrimination. The tribunal found that the reason for the policy “is the fact that people who engage in male-to-male sex have, as a group, a high risk of HIV transmission” and that the Blood Service is required to keep the risk to the blood supply as low as possible.
Is it just gay and bisexual men who are subject to these restrictions?
No. Australia’s blood donation rules are very strict, and many people face restrictions on whether they can donate. People within six months of having had surgery or a tattoo; within nine months of giving birth; or who lived for more than six months in the UK between 1980 and 1996 (this preclusion is on account of mad cow disease) are all, among others, prohibited from giving blood.
Can’t they just test the blood?
The blood is tested, but the Blood Service website says there is a “window period” in which diseases such as HIV, hepatitis B and syphilis can’t be detected.
“No test, regardless how sophisticated, is capable of always detecting the early signs of a transfusion transmissible infection,” said Shaun Inguanzo, media manager at the Australian Red Cross Blood Service.
“For this reason, we need deferral periods in place for people who engage in activities that show a higher level of risk of infection.”
Testing alone isn’t enough to guarantee safety, and as such, the service takes into account risk factors, such as sexual behaviour.
“In the case of MSM, health surveillance data shows that around 90% of all newly acquired cases of HIV infections in Australia are attributed to men who have sex with men,” he said.
Is 12 months the appropriate time frame?
A lot of people don’t think so. The Australian Red Cross issued a joint submission with peak HIV/AIDS research group the Kirby Institute of the University of New South Wales recommending that the deferral period be lowered. It was unsuccessful.
“We believe this period could be safely lowered to six months, however our application to change it was rejected by the Therapeutic Goods Administration — so it still stands at 12 months,” Ingaunzo said.