Inked-up Aussies can now walk straight from the tattoo parlour to a blood donation centre to give plasma. Gay men, on the other hand, still have to remain celibate for a year before donating — even if they’re married or monogamous.
The new rules for tattooed Australians came into effect earlier this month as the Australian Red Cross Lifeblood tries to pull new donors — especially those who aren’t afraid of needles — into its centres amid dwindling donations during the pandemic.
But restrictions on LGBTIQ donors exclude up to a million Australians from giving blood — a rule, community members say, is based on prejudice instead of science.
What’s the logic?
Following the HIV/AIDs crisis, LGBTIQ community members were barred from donating blood until the turn of the century, when the deferral period was introduced.
The restrictions apply to those in “high risk” categories and include men and transgender people who have sex with men, women who have sex with men who have had sex with men, people who have had sex with an injecting drug user, and sex workers.
The timeframe for donating blood, plasma and platelets will be reduced to three months from next year following a submission made by Lifeblood to the Therapeutic Goods Administration (TGA).
A spokeswoman for Lifeblood told Crikey that information from a potential donor about their partner’s sexual behaviour may not be reliable.
“Lifeblood is unable to determine the monogamous status of a donor’s partner,” she said.
She cited data from the Kirby Institute which found monogamous men who engaged in sex with men have on average a 50 times higher risk of acquiring HIV than people in a heterosexual relationship.
This data is eight years old, collected before the widespread availability of HIV prevention and suppression medication.
The spokeswoman added that although every donation was tested for a range of infectious diseases, tests can’t pick up recently acquired infections. The short shelf life of blood — 42 days — makes quarantining and retesting blood not feasible.
“We’d like as many Australians as possible to donate blood,” she says. A submission around men on HIV medication is being considered by the TGA.
What’s the science?
The Kirby Institute’s Professor John Kaldor said that while current tests could detect HIV less than two weeks after acquisition, Lifeblood and the TGA took a deliberately conservative approach.
“The strategy builds on what might go wrong rather than averages, and that’s why Australia has a good safety reputation,” he says.
Nationally 7.9% of gay and bisexual men have HIV, compared with 0.14% of the general adult population. In 62% of cases, HIV is transmitted through men who have sex with men, and 23% through heterosexual sex.
HIV annual case numbers have dropped by almost a quarter since 2014. There are an estimated 28,180 people living with HIV in Australia.
But, Kaldor said, this reduction wasn’t substantial enough to change policy.
“Regardless of behaviours, the risk for men who have sex with men compared to heterosexual people to acquire HIV is still vastly higher,” he says.
“Lifeblood has to take an efficient, national approach.”
What’s the impact?
Jackson Heilberg is a Melbourne-based emergency nurse and member of the LGBTIQ community. He wants to donate blood but like many others can’t.
He told Crikey the restrictions were based on religion, prejudice and stigma — a bygone mentality from the HIV/AIDS crisis in the ’80s, and one not rooted in current literature or best practice.
“In Australia, there’s always a shortage of blood. We’re allowed to save people’s lives as health professionals, but not donate blood,” he said.
Italy, Spain, Portugal and South Africa have scrapped the deferral period, and rely on individual risk assessments rather than sexual orientation.
The Australian Human Rights and Equal Opportunity Commission has found Lifeblood’s practices are not discriminatory.