Because HIV is transmitted by unsafe sex not gay sex, blood donors should be
screened for the safety of their sexual activity, not the gender of their sexual partner.
Australian gay blood donation litigant, Michael Cain.
The global movement for reform
On this page…
Gay blood donation policies around the world
Spain and Italy leading the way
Expert public health and blood donation bodies
1. Gay blood donation policies around the world
Deferral based on unsafe sexual activity
- Spain and Italy
Deferral of all gay and bisexual men from blood donation for one year after sexual activity
- Argentina, Australia, Japan, Hungary
Deferral for five years
- South Africa, New Zealand (reduced from 10 years in mid 2008)
Indefinite, lifetime or effective lifetime deferral
- US, UK, Germany, Hong Kong, Canada (confirmed by a 2007 report)
2. Italy and Spain
The Italian regulation which prevented blood donation by those engaged in “homosexual intercourse” was repealed by a decree of the Ministry of Health on the 26th January 2001.
Now, people who have had “sexual intercourse with a high risk of transmission of STIs” are permanently excluded, while persons who have had “occasional sexual intercourse with a risk of transmission of STIs” are excluded for one year.
Importantly, men who have sex with other men can donate blood if they have not engaged in high-risk activity.
Italy’s figures for HIV infection via blood donation show the impact of this policy.
In 1998-9, 24 people were infected with HIV through blood donation in Italy. In 2000-1 that figure fell to 10. In 2002-3 it was 9, in 2004, 4.
This is partly because of improvements in clinical testing, but we believe it is also because Italy has implemented a new donor screening policy that focuses on safety of sexual practice.
In Spain men who have had sex with other men are not necessarily barred or from donating blood.
And as with Italy, Spain’s policy has not resulted in an increase in HIV infection through blood transfusion.
Indeed, according to the Spanish Ministry for Health, the number of HIV infections which have occurred through blood donation has steadily decreased since the turn of the century, from 13 in 2001 to 4 in 2003 and 2 each in 2004 and 2005.
Both Spain and Italy have much larger populations, and a far higher average rate of HIV infection in the general population, than Australia.
This accounts for the fact they have higher overall HIV infection rates through transfusion.
But this does not change the fact that infection rates are falling despite, and possibly because of, the country’s new, non-discriminatory blood donation policy.
3. Expert public health and blood donation bodies
On March 9th 2006 the American Red Cross, together with the American Association of Blood Banks and America’s Blood Centers, wrote to the US Food and Drug Administration seeking an end to the lifetime ban on blood donation from sexually-active gay and bisexual men.
According to the three organisations, advances in clinical testing have dramatically changed the blood donor landscape.
"Current duplicate testing using NAT and serologic methods allow detection of HIV- infected donors between 10 and 21 days after exposure. Beyond this window period, there is no valid scientific reason to differentiate between individuals infected a few months or many years previously."
For the three organizations concerned this meant that,
"It does not appear rational to broadly differentiate sexual transmission via male-to-male sexual activity from that via heterosexual activity on scientific grounds. Neither does it seem reasonable to extend this reasoning to other infectious agents."
The three bodies then went on to highlight the negative consequences of arbitrarily discriminating against men who have sex with men, as well as flaws in the research currently being used to justify this discrimination.
"To many, this differentiation (between homosexual and heterosexual) is unfair and discriminatory, resulting in negative attitudes to blood donor eligibility criteria, blood collection facilities and, in some cases, to cancellation of blood drives. We think FDA should consider that the continued requirement for a deferral standard seen as scientifically marginal and unfair or discriminatory by individuals with the identified characteristic may motivate them to actively ignore the prohibition and provide blood collection facilities with less accurate information.
"AABB, ABC and ARC acknowledge the concern that relaxation of deferral criteria may increase the number of presenting donors who are marker positive. However, this impact has not been measured directly; it has only been modeled using what may be incomplete assumptions. The blood collectors are willing to assist in collecting data regarding the actual impact of changes in the deferral, in order to allow for informed decision-making, and/or for the development of additional, appropriate interventions to ameliorate the impact."
The three groups stated that they are willing to settle for a deferral period that is “consistent with deferrals for those judged to be at risk of infection via heterosexual routes.”
4. Community concern
There is a vocal and active global movement for gay blood donation reform.
This movement includes public figures, political leaders and grass roots community groups in most western countries.
For example, gay blood donation has been raised in a number of national legislatures, most recently, the