Both Canadian Blood Services (CBS) and the US Food And Drug Administration (FDA) are reexamining their policies banning blood donations from all men who have had sex with men (MSM) even once since 1977.
“As you can imagine on a complex issue like this there’s consultations — the whole epidemiology of the science, the ethical side, the societal issues,” says CBS media relations director Ron Vezina. “We’re hopeful that by the end of this calendar year we’ll be closer to a position.
“It’s not that we’re targetting one group,” Vezina says. “We’re targetting specific risk factors.”
CBS is a national, independent, not-for-profit, charitable organization whose sole mission is to manage the blood and blood products supply in all provinces and territories, except Quebec, which is governed by Hema-Quebec.
The MSM ban, which does not distinguish between safe or unsafe sex, has been in place in both Canada and the US since 1983, but is being reconsidered because of the improved screening techniques now available, namely nucleic acid amplification testing (NAT). NAT is a highly sensitive method used to detect different viruses from donations before they enter the blood supply. It can detect low levels of genetic material present after infection but before the body has begun producing antibodies in response.
CBS has been using NAT to screen for hepatitis C since 1999 and HIV since 2001. This technology can detect HIV in blood three to five days earlier than existing tests that have a window period of about 16 days. Other tests are still used as well because infected individuals may be NAT-negative if their viral load falls below detectable levels, and yet still test positive using other, more common, antibody tests.
The Canadian Hemophilia Society (CHS) supports the current donor restrictions, including the MSM ban. “We understand that people could perceive this as discriminatory… but it has to be justified in terms of protecting someone’s health,” says David Page, CHS director of programs and communications. “The question’s in the science: Can it be justified? And we think it can.”
Gilles Marchildon, executive director of Egale Canada, calls the CBS donor questionnaire discriminatory.
“The straight man who has had unsafe sex can give blood, but a gay man who has had safe sex cannot give blood simply because of his affiliation with a definable group. That doesn’t make sense,” says Marchildon.
“In Portugal the blood collection agency [has] gone ahead and lifted the ban because modern-day tests are precise enough to detect HIV and hepatitis in donated blood. It would seem now that science supports the lifting of the ban.”
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