The government has announced that it is scrapping the blanket, lifetime ban on blood donations from men who've had oral or anal sex with other men. Bravo! At last, after nearly three decades, health officials have realised that they got it wrong. The panic over HIV led them to maintain an irrational, unscientific policy which discriminated against gay and bisexual men based on prejudiced, stereotypical assumptions. It also deprived the NHS and patients of much needed blood donations, regularly contributing to a shortfall in the blood supply.
The new policy stipulates that gay and bisexual men will be banned – not for life – but for 12 months from their last oral or anal sexual encounter with another man. Although the new policy is a big improvement on the existing lifetime exclusion, a 12-month ban is still excessive and unjustified. Most gay and bisexual men do not have HIV and will never have HIV. If they always have safe sex with a condom, have only one partner and test HIV negative, their blood is safe to donate. They can and should be allowed to help save lives by becoming donors. Sadly, the 12-month ban will apply even if the blood of gay and bisexual men is safe – even if they always use a condom and even if they test HIV-negative. Protecting the blood supply is the number one priority. Patients come first. But ensuring blood safety does not require such a lengthy time span during which all gay and bisexual men are barred from donating blood.
The blood service could have opted for a much shorter exclusion period. It should focus on excluding donors who have engaged in risky sexual behaviour, those who are HIV-positive and donors whose HIV status cannot be accurately determined because of the delay between the potential date of infection and the period when the HIV virus and HIV antibodies manifest and become detectable in an infected person's blood. Reducing the exclusion period for blood donations from gay and bisexual men should go hand-in-hand with a "safe blood" education campaign targeted at the gay community, to ensure no one donates blood if they are at risk of HIV and other blood-borne infections due to unsafe sexual behaviour. We also need a major drive to vaccinate gay and bisexual men against Hepatitis A and B, to prevent these infections getting into the blood supply.
In addition, the questionnaire that would-be blood donors have to answer should be made more detailed for men who've had sex with men, in order to more accurately identify the degree of risk, if any, that their blood may pose. A few additional questions would improve donor awareness of risk factors and more accurately exclude those whose blood may not be safe.
Overall, there is a strong case for only excluding men who have had risky sex without a condom. Regrettably, the blood service's new policy makes no distinction between sex with a condom and sex without one. Any oral or anal sex between men in the previous 12 months – even with protection – will be grounds for continuing to refuse a donor under the new rules. This is unjustified. If a condom is used correctly, it is very effective against the transmission and contraction of HIV. Men who use condoms every time without breakages – and who test HIV negative – should not be barred from donating blood.
With these provisos and safeguards, a shorter exclusion period would be reasonable and not endanger the blood supply. The blood donated would be safe. Patients needing transfusions would be the winners.
