Canadian Blood Services (CBS) is reviewing its lifetime ban on men who have sex with men and is considering moving toward a one-year deferral policy.
The notification follows a UK announcement, on Sept 8, about a similar policy change.
Currently, Canadian Blood Services and its Quebec counterpart, Héma-Québec, will not accept blood from any man who has had sex with another man, even once, since 1977. Under the proposed changes, men would be banned from donating blood only if they have had sex with another man any time in the previous 12 months.
The deferral would still keep out most gay men who are sexually active, even those in monogamous relationships or those who participate only in low-risk sexual activities, such as oral sex or anal sex with a condom.
Heterosexuals who have multiple partners and do not use condoms would not be similarly banned, despite their high-risk activity.
CBS says it can’t allow monogamous gay donors because donor clinics lack the time or resources to conduct individual risk assessments, so it needs its screening questionnaire to quickly categorize donors into high- or low-risk groups.
Dana Devine, vice-president of medical, scientific and research affairs at CBS, says that the policy represents an incremental approach to lifting the ban to one that screens for risky activity.
“The reason that we haven’t tried to refine to that level yet is we’re trying to change the deferral from an infinity-based deferral to a time-based one,” she says. “We’re trying to take this one step at a time.”
Even though every donated unit of blood is tested for HIV and other communicable diseases, a deferral period is necessary because HIV can exist in the blood for some time before it is detectable, Devine says. The UK chose a 12-month period to be safe.
“The full year is a margin of safety that’s been put into place in respect of the patients who receive the products,” Devine says.
The Canadian policy is still likely months away from being instituted, as CBS must finish its own set of risk assessments, have them approved by stakeholder organizations, and receive final approval from Health Canada.
Adrian Lomaga, who once filed a lawsuit against Héma-Québec alleging that its blood ban was discriminatory but withdrew it when CBS announced it would review its policy, says that a one-year deferral period is a fair compromise for now, as the research isn’t complete on the risk posed by sexually active gay men.
“At the moment there haven’t been any studies done to assess the risk posed by the long-term monogamous gay couple. What studies that are out there do suggest that there is a higher prevalence of sexually transmitted diseases in the gay community, and I’m not certain about what the studies say about the number of lifetime partners that a gay man has,” he says.
“At this time, given the scientific state of knowledge, a one-year deferral would be fair. My stance was that the blood banks were treating like risks unlike. It didn’t seem to be an equitable assessment of risk,” Lomaga says.
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